RESUMEN
We report the case of a 12-years-old patient who subacutely developed a positive and negative myoclonus of limbs and face, drowsiness and memory deficits after getting infected by SARS-CoV-2. On admission, nasopharyngeal swab for SARS-CoV-2, brain and spinal MRI with and without contrast, EEG, chest X-ray and abdominal ultrasound were negative. CSF physical-chemical examination, culture, PCR testing for SARS-CoV-2 and other pathogens, and oligoclonal IgG bands were negative as well. A full panel blood test, including clotting, autoimmunity and paraneoplastic blood studies, did not show any alteration. The neuropsychological examination showed an impairment in memory, visual-motor coordination, inductive reasoning skills, attention, and concentration. The patient was first treated with clonazepam and then with intravenous methylprednisolone for five days, with poor response. For this reason, he then received a cycle of IVIG, thus reaching a gradual and complete recovery. To date, this is the first case of a COVID-19 associated myoclonus affecting a paediatric patient.
Asunto(s)
COVID-19/complicaciones , COVID-19/psicología , Trastornos Mentales/virología , Mioclonía/virología , Atención , COVID-19/fisiopatología , Niño , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Factores Inmunológicos/uso terapéutico , Masculino , Trastornos Mentales/diagnóstico , Mioclonía/diagnóstico , Mioclonía/terapia , Pruebas Neuropsicológicas , Desempeño Psicomotor , SíndromeAsunto(s)
Compuestos de Bencidrilo/uso terapéutico , Esclerosis Múltiple/complicaciones , Enuresis Nocturna/tratamiento farmacológico , Enuresis Nocturna/etiología , Adulto , Sistema Nervioso Central/efectos de los fármacos , Sistema Nervioso Central/fisiopatología , Estimulantes del Sistema Nervioso Central/uso terapéutico , Fatiga/tratamiento farmacológico , Fatiga/etiología , Femenino , Humanos , Interferon beta-1b , Interferón beta/uso terapéutico , Masculino , Modafinilo , Esclerosis Múltiple/tratamiento farmacológico , Esclerosis Múltiple/fisiopatología , Enuresis Nocturna/fisiopatología , Sensibilidad y Especificidad , Sueño/efectos de los fármacos , Sueño/fisiología , Resultado del Tratamiento , Vigilia/efectos de los fármacos , Vigilia/fisiologíaRESUMEN
We evaluated the differences in grey matter concentration (GMC) by voxel-based morphometry (VBM) in patients with cryptogenic occipital epilepsies. VBM analysis was performed in 11 patients with cryptogenic occipital epilepsies compared to 11 healthy controls. VBM analysis in patients revealed focal areas of reduced GMC in the occipital cortex and, more interestingly, increased GMC in the midbrain tegmentum and basal ganglia (globus pallidus and thalamus). VBM may disclose slight structural abnormalities in the brain of cryptogenic epilepsy patients, not evident with standard MRI. To the best of our knowledge, this is the first literature report describing areas of altered GMC in patients with occipital epilepsy. We hypothesize that these findings might be related to epileptic discharges and/or their diffusion and suggest that midbrain, globus pallidus and thalamus may be part of a functional network originating from the occipital areas.