Central and peripheral nervous system involvement by COVID-19: a systematic review of the pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings.

BACKGROUND: SARS-CoV-2 can affect the human brain and other neurological structures. An increasing number of publications report neurological manifestations in patients with COVID-19. However, no studies have comprehensively reviewed the clinical and paraclinical characteristics of the central and peripheral nervous system's involvement in these patients. This study aimed to describe the features of the central and peripheral nervous system involvement by COVID-19 in terms of pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings. METHODS: We conducted a comprehensive systematic review of all the original studies reporting patients with neurological involvement by COVID-19, from December 2019 to June 2020, without language restriction. We excluded studies with animal subjects, studies not related to the nervous system, and opinion articles. Data analysis combined descriptive measures, frequency measures, central tendency measures, and dispersion measures for all studies reporting neurological conditions and abnormal ancillary tests in patients with confirmed COVID-19. RESULTS: A total of 143 observational and descriptive studies reported central and peripheral nervous system involvement by COVID-19 in 10,723 patients. Fifty-one studies described pathophysiologic mechanisms of neurological involvement by COVID-19, 119 focused on clinical manifestations, 4 described neuropathology findings, 62 described neuroimaging findings, 28 electrophysiology findings, and 60 studies reported cerebrospinal fluid results. The reviewed studies reflect a significant prevalence of the nervous system's involvement in patients with COVID-19, ranging from 22.5 to 36.4% among different studies, without mortality rates explicitly associated with neurological involvement by SARS-CoV-2. We thoroughly describe the clinical and paraclinical characteristics of neurological involvement in these patients. CONCLUSIONS: Our evidence synthesis led to a categorical analysis of the central and peripheral neurological involvement by COVID-19 and provided a comprehensive explanation of the reported pathophysiological mechanisms by which SARS-CoV-2 infection may cause neurological impairment. International collaborative efforts and exhaustive neurological registries will enhance the translational knowledge of COVID-19's central and peripheral neurological involvement and generate therapeutic decision-making strategies. REGISTRATION: This review was registered in PROSPERO 2020 CRD42020193140 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193140.

Cefalea Cluster like, glaucoma y síndrome de Charles Bonnet: Reporte de caso con consideraciones especiales / Cluster-like headache, glaucoma and Charles Bonnet Syndrome: Case study with special considerations

La cefalea tipo cluster (cefalea en racimos) hace parte de un grupo de cefaleas primarias definidas por la SociedadInternacional de Cefaleas como cefaleas trigémino autonómicas. Es una condición clínica infrecuente que puedeser confundida con otras cefaleas primarias como: hemicránea paroxística, SUNCT y neuralgia del trigémino.Existen muchas enfermedades y lesiones intracraneales que pueden simular una cefalea tipo cluster, dentro deestas causas sintomáticas, los desórdenes neurooftalmologicos deben ser parte del diagnóstico diferencial detodos los pacientes con cefalea tipo cluster like. Hacemos el reporte de un paciente con cefalea tipo cluster likey síndrome de Charles Bonnet asociado a glaucoma intermitente de ángulo cerrado...

Cluster headache is part of a group of primary headache disorders defined by the International HeadacheSociety as trigeminal autonomic headaches. It is a rare clinical condition that can be confused with other primaryheadaches such as paroxysmal hemicrania, SUNCT and trigeminal neuralgia. There are many diseasesand intracranial lesions that may mimic cluster headache, within these symptomatic causes, neuro-ophthalmicdisorders should be part of the differential diagnosis of all patients with cluster like headache. We report thecase of a patient with cluster like headache and Charles Bonnet syndrome associated with intermittent angleclosureglaucoma...