Kimura Mizuki, Hashiguchi Shunta, Tanaka Kenichi, Hagiwara Manato, Takahashi Keita, Miyaji Yosuke, Joki Hideto, Doi Hiroshi, Koga Michiaki, Takeuchi Hideyuki, Tanaka Fumiaki
Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Front Neurol. 2021 Dec 24;12:822247. doi: 10.3389/fneur.2021.822247. eCollection 2021.
Takotsubo cardiomyopathy (TCM) is a stress-induced cardiomyopathy triggered by critical illness including severe neurological disorders. However, an association between TCM and Bickerstaff brainstem encephalitis (BBE) has rarely been described. During the current coronavirus disease 2019 (COVID-19) pandemic, growing evidence indicates that COVID-19 often leads to various neurological disorders, but there are few reports of an association between COVID-19 and BBE. Here we report a case of TCM associated with BBE triggered by COVID-19, which subsided with immunotherapy for BBE. Both transthoracic echocardiography and electrocardiography led to early and accurate diagnosis of TCM. Sustained hemodynamic instability due to TCM was immediately lessened with immunotherapy whereas additional plasmapheresis and immunotherapy were required to treat BBE. This case indicates that BBE might follow COVID-19 and TCM should be considered when hemodynamic status remains unstable in a patient with BBE.
应激性心肌病（TCM）是一种由包括严重神经系统疾病在内的危重病引发的应激性心肌病。然而，很少有文献描述TCM与比克斯特费尔德脑干脑炎（BBE）之间的关联。在当前的2019冠状病毒病（COVID-19）大流行期间，越来越多的证据表明，COVID-19常导致各种神经系统疾病，但关于COVID-19与BBE之间关联的报道很少。在此，我们报告一例由COVID-19引发的与BBE相关的TCM病例，该病例通过针对BBE的免疫治疗而缓解。经胸超声心动图和心电图均有助于早期准确诊断TCM。免疫治疗立即减轻了由TCM导致的持续血流动力学不稳定，而治疗BBE则需要额外的血浆置换和免疫治疗。该病例表明，BBE可能继发于COVID-19，对于患有BBE且血流动力学状态持续不稳定的患者，应考虑存在TCM的可能性。
