RESUMEN
Opsoclonus-myoclonus-ataxia syndrome is a heterogeneous constellation of symptoms ranging from full combination of these three neurological findings to varying degrees of isolated individual sign. Since the emergence of coronavirus disease 2019 (COVID-19), neurological symptoms, syndromes, and complications associated with this multi-organ viral infection have been reported and the various aspects of neurological involvement are increasingly uncovered. As a neuro-inflammatory disorder, one would expect to observe opsoclonus-myoclonus syndrome after a prevalent viral infection in a pandemic scale, as it has been the case for many other neuro-inflammatory syndromes. We report seven cases of opsoclonus-myoclonus syndrome presumably parainfectious in nature and discuss their phenomenology, their possible pathophysiological relationship to COVID-19, and diagnostic and treatment strategy in each case. Finally, we review the relevant data in the literature regarding the opsoclonus-myoclonus syndrome and possible similar cases associated with COVID-19 and its diagnostic importance for clinicians in various fields of medicine encountering COVID-19 patients and its complications.
Asunto(s)
Ataxia/fisiopatología , COVID-19/fisiopatología , Tos/fisiopatología , Fiebre/fisiopatología , Mialgia/fisiopatología , Síndrome de Opsoclonía-Mioclonía/fisiopatología , SARS-CoV-2/patogenicidad , Adulto , Anticonvulsivantes/uso terapéutico , Ataxia/diagnóstico por imagen , Ataxia/tratamiento farmacológico , Ataxia/etiología , Azitromicina/uso terapéutico , COVID-19/complicaciones , COVID-19/diagnóstico por imagen , Clonazepam/uso terapéutico , Tos/diagnóstico por imagen , Tos/tratamiento farmacológico , Tos/etiología , Disnea/diagnóstico por imagen , Disnea/tratamiento farmacológico , Disnea/etiología , Disnea/fisiopatología , Femenino , Fiebre/diagnóstico por imagen , Fiebre/tratamiento farmacológico , Fiebre/etiología , Humanos , Hidroxicloroquina/uso terapéutico , Levetiracetam/uso terapéutico , Masculino , Persona de Mediana Edad , Mialgia/diagnóstico por imagen , Mialgia/tratamiento farmacológico , Mialgia/etiología , Síndrome de Opsoclonía-Mioclonía/diagnóstico por imagen , Síndrome de Opsoclonía-Mioclonía/tratamiento farmacológico , Síndrome de Opsoclonía-Mioclonía/etiología , Oseltamivir/uso terapéutico , SARS-CoV-2/efectos de los fármacos , Ácido Valproico/uso terapéutico , Tratamiento Farmacológico de COVID-19RESUMEN
Pantothenate Kinase-associated Neurodegeneration (PKAN) is an autosomal recessive disorder that is caused by variation in pantothenate kinase-2 gene (PANK2) gene on chromosome 20. The common presentation of this disease includes progressive dystonia, Parkinsonism, retinopathy, cognitive impairment, and spasticity. The typical magnetic resonance imaging finding is eye of the tiger sign in globus pallidus and not pathogenic and not found in all patients. In the present study, we describe two siblings who have a novel variation of the PANK2 gene. These patients with the same genotype, have different ages at the onset of disease and also the various severity of the disease. The description of these cases helps to understand this disease, its symptoms, pathogenesis, and its treatment.