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
OBJECTIVE: Our aim was to look for a probable relationship between cerebral vasomotor reactivity (VMR) and orthostatic hypotension (OH) in Parkinson's disease (PD). MATERIALS AND METHODS: This study was conducted on 44 patients with PD. Assessment of cerebral VMR was performed by means of transcranial Doppler (TCD) of middle cerebral artery (MCA) before and after a vasodilatory stimulus, carbon dioxide test. Moreover, orthostatic hypotension was evaluated. RESULTS: OH was presented in 12 (27.3%) Parkinson's patients. The average resting blood flow velocity (BFV) in the MCA was 30.20 (SD=9.58)cms(-1) which significantly increased to 46.25 (SD=16.23)cms(-1) after carbon dioxide test (P<0.001). Impaired VMR was observed in 15 (34.1%) of the subjects, while it was not associated with the presence of OH (P=0.770). CONCLUSION: Evaluation of VMR in patients affected by PD, could assist in early diagnosis of cerebral autonomic dysfunction and prevent its serious consequences prior and more valid to OH.