Przytuła Filip, Sławek Jarosław
Neurology&Stroke Department, St. Adalbert Hospital, Gdansk, Poland.
Department of Neurological-Psychiatric Nursing, Medical University of Gdansk, Poland.
Neurol Neurochir Pol. 2023;57(1):63-76. doi: 10.5603/PJNNS.a2023.0012. Epub 2023 Feb 17.
The aim of this review was to summarise current knowledge regarding hyperkinetic movement disorders related to SARS-CoV-2 infection and vaccination in terms of phenomenology, epidemiology, pathogenesis and treatment. After a thorough review of the PubMed and Google Scholar databases (2020-2022), we identified myoclonus and ataxia sometimes accompanied by opsoclonus (AMS) as the two most frequent COVID-19 sequelae, with chorea, tremor and dystonia being very rare. The pathogenesis seems to be variable, but in the majority of AMS cases it was autoimmunological, with good response and recovery after corticosteroids or intravenous immunoglobulins infusions. Vaccination may be complicated by hyperkinetic movement disorders (e.g. tremor, dystonia), but this is very rare. Patients with Deep Brain Simulation depletion should not be postponed due to lockdowns as this may result in fatal outcomes.
本综述的目的是从现象学、流行病学、发病机制和治疗方面总结当前关于与SARS-CoV-2感染和疫苗接种相关的运动亢进性运动障碍的知识。在对PubMed和谷歌学术数据库(2020 - 2022年)进行全面检索后,我们确定肌阵挛和共济失调有时伴有眼阵挛(AMS)是两种最常见的新冠后遗症,舞蹈症、震颤和肌张力障碍则非常罕见。发病机制似乎多种多样,但在大多数AMS病例中是自身免疫性的,在使用皮质类固醇或静脉注射免疫球蛋白后反应良好且可恢复。疫苗接种可能并发运动亢进性运动障碍(如震颤、肌张力障碍),但这非常罕见。因封锁而不应推迟进行脑深部电刺激术的患者,因为这可能导致致命后果。