Vijiala Sergiu, Epiney Jean-Benoît, Jöhr Jane, Pincherle Alessandro, Meyer Marie M, Du Pasquier Renaud, Prior John O, Diserens Karin
Unit of Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Service of Neurology, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), University of Lausanne, Lausanne, Switzerland.
Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), University of Lausanne, Lausanne, Switzerland.
Front Neurol. 2021 Apr 30;12:644848. doi: 10.3389/fneur.2021.644848. eCollection 2021.
Along with the propagation of COVID-19, emerging evidence reveals significant neurological manifestations in severely infected COVID-19 patients. Among these patients admitted to the intensive care unit (ICU), behavioral unresponsiveness may occur frequently, yet, there are still only a few cases reported and with rare descriptions of their motor behavior after pathological awakening. Several hypotheses regarding central lesions in these patients are conceivable. Here, we describe two acute SARS-CoV-2- infected patients who developed neurological symptoms evoking the condition of clinical cognitive motor dissociation (CMD). This diagnosis could be confirmed first by clinical observation of a dissociation between preserved cognitive abilities and lack of initial motor interaction and second, by performing F- FDG PET imaging. Accurate diagnosis led to an appropriate neuro-rehabilitation regimen with long-term neuro-rehabilitation leading to an improved outcome for both patients.
随着新冠病毒病（COVID-19）的传播，新出现的证据显示，重症COVID-19感染患者存在明显的神经表现。在这些入住重症监护病房（ICU）的患者中，行为无反应可能经常出现，然而，目前报道的病例仍然很少，且对其病理唤醒后的运动行为描述也很罕见。关于这些患者中枢病变的几种假说都是可以想象的。在此，我们描述了两名急性感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者，他们出现了引发临床认知运动分离（CMD）状态的神经症状。这一诊断首先可通过对保留的认知能力与最初缺乏运动互动之间分离的临床观察得到证实，其次可通过进行氟代脱氧葡萄糖（F-FDG）正电子发射断层显像（PET）来证实。准确的诊断带来了适当的神经康复方案，长期的神经康复使两名患者都取得了更好的结果。
