COVID-19 相关肌阵挛：5 例危重症患者系列病例
COVID-19-associated myoclonus in a series of five critically ill patients.
机构信息
4th Medical Division for Infectious Disease Medicine and Tropical Medicine, Klinik Favoriten, Pav. C, Kundtratstr. 3, 1100, Vienna, Austria.
Head-Nerve Center, Medical Faculty, Sigmund Freud University, Freudplatz 2, 1020, Vienna, Austria.
出版信息
Wien Klin Wochenschr. 2021 Sep;133(17-18):902-908. doi: 10.1007/s00508-021-01890-3. Epub 2021 Jun 15.
BACKGROUND
In addition to respiratory symptoms, many patients with coronavirus disease 2019 (COVID-19) present with neurological complications. Several case reports and small case series described myoclonus in five patients suffering from the disease. The purpose of this article is to report on five critically ill patients with COVID-19-associated myoclonus.
MATERIAL AND METHODS
The clinical courses and test results of patients treated in the study center ICU and those of partner hospitals are described. Imaging, laboratory tests and electrophysiological test results are reviewed and discussed.
RESULTS
In severe cases of COVID-19 myoclonus can manifest about 3 weeks after initial onset of symptoms. Sedation is sometimes effective for symptom control but impedes respiratory weaning. No viral particles or structural lesions explaining this phenomenon were found in this cohort.
CONCLUSION
Myoclonus in patients with severe COVID-19 may be due to an inflammatory process, hypoxia or GABAergic impairment. Most patients received treatment with antiepileptic or anti-inflammatory agents and improved clinically.
背景
除了呼吸系统症状外，许多 COVID-19 患者还会出现神经系统并发症。一些病例报告和小病例系列描述了五名患有该疾病的患者出现肌阵挛。本文的目的是报告五例 COVID-19 相关肌阵挛的危重症患者。
材料和方法
描述了在研究中心 ICU 治疗的患者和合作医院患者的临床过程和检查结果。回顾并讨论了影像学、实验室检查和电生理检查结果。
结果
在 COVID-19 严重病例中，肌阵挛可在最初症状出现后约 3 周出现。镇静有时可有效控制症状，但会妨碍呼吸脱机。在本队列中未发现解释这种现象的病毒颗粒或结构病变。
结论
重症 COVID-19 患者的肌阵挛可能是由于炎症过程、缺氧或 GABA 能损害所致。大多数患者接受了抗癫痫或抗炎药物治疗，临床症状有所改善。
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