scholarly journals Neurological manifestations of coronavirus infections: a systematic review

2020 ◽  
Author(s):  
Jesper Almqvist ◽  
Tobias Granberg ◽  
Antonios Tzortzakakis ◽  
Stefanos Klironomos ◽  
Evangelia Kollia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebrovascular Disorders ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Diagnostic Workup ◽  
Neurological Manifestations ◽  
Chronic Disability ◽  
Neuropsychiatric Complications ◽  
Immune Mediated ◽  
Depth Analysis

In order to optimize diagnostic workup of the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, we systematically reviewed neurological and neuroradiological manifestations of SARS-CoV-2 and all other known human coronavirus species (HCoV). Which lessons can we learn? We identified relevant publications (until July 26h 2020) using systematic searches in PubMed, Web of Science and Ovid EMBASE with predefined search strings. A total of 4571 unique publications were retrieved, out of which 378 publications were selected for in-depth analysis by two raters, including a total of 17549 (out of which were 14418 SARS-CoV-2) patients. Neurological complications and associated neuroradiological manifestations are prevalent for all HCoVs (HCoV-229E, HKU1, NL63, OC43, Middle East respiratory syndrome (MERS)-CoV, SARS-CoV-1 and SARS-CoV-2). Moreover, there are similarities in symptomatology across different HCoVs, particularly between SARS-CoV-1 and SARS-CoV-2. Common neurological manifestations include fatigue, headache and smell/taste disorders. Additionally, clinicians need to be attentive for at least five classes of neurological complications: (1) Cerebrovascular disorders including ischemic stroke and macro/micro-hemorrhages, (2) encephalopathies, (3) para-/postinfectious immune-mediated complications such as Guillain-Barre syndrome and acute disseminated encephalomyelitis, (4) (meningo-)encephalitis, potentially with concomitant seizures and (5) neuropsychiatric complications such as psychosis and mood disorders. Our systematic review highlights the need for vigilance regarding neurological complications in patients infected by SARS-CoV-2 and other HCoVs, especially since some complications may result in chronic disability. Neuroimaging protocols should be designed to specifically screen for these complications. Therefore, we propose practical imaging guidelines to facilitate the diagnostic workup and monitoring of patients infected with HCoVs.

scholarly journals Relevance of CSF, Serum and Neuroimaging Markers in CNS and PNS Manifestation in COVID-19: A Systematic Review of Case Report and Case Series

2021 ◽  
Vol 11 (10) ◽  
pp. 1354
Author(s):  
Sanjiti Podury ◽  
Samiksha Srivastava ◽  
Erum Khan ◽  
Mihir Kakara ◽  
Medha Tandon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Corpus Callosum ◽  
Neurological Complication ◽  
Case Series ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Manifestations ◽  
Comprehensive Review ◽  
Inflammatory Disorders

Background: The data on neurological manifestations in COVID-19 patients has been rapidly increasing throughout the pandemic. However, data on CNS and PNS inflammatory disorders in COVID-19 with respect to CSF, serum and neuroimaging markers is still lacking. Methods: We screened all articles resulting from a search of PubMed, Google Scholar and Scopus, using the keywords “SARS-CoV-2 and neurological complication”, “SARS-CoV-2 and CNS Complication” and “SARS-CoV-2 and PNS Complication” looking for transverse myelitis, vasculitis, acute disseminated encephalomyelitis, acute hemorrhagic necrotizing encephalitis (AHNE), cytotoxic lesion of the corpus callosum (CLOCC) and Guillain-Barré syndrome (GBS), published between 1 December 2019 to 15 July 2021. Results: Of the included 106 CNS manifestations in our study, CNS inflammatory disorders included transverse myelitis (17, 14.7%), AHNE (12, 10.4%), ADEM (11, 9.5%), CLOCC/MERS (10, 8.6%) and vasculitis (4, 3.4%). Others were nonspecific encephalopathy, encephalitis, seizures and stroke. Most patients were >50 years old (75, 70.8%) and male (64, 65.3%). Most (59, 63.4%) were severe cases of COVID-19 and 18 (18%) patients died. Of the included 94 PNS manifestations in our study, GBS (89, 92.7%) was the most common. Most of these patients were >50 years old (73, 77.7%) and male (59, 64.1%). Most (62, 67.4%) were non-severe cases of COVID-19, and ten patients died. Conclusion: Our comprehensive review of the clinical and paraclinical findings in CNS and PNS manifestations of COVID-19 provide insights on the pathophysiology of SARS-CoV-2 and its neurotropism. The higher frequency and severity of CNS manifestations should be noted by physicians for increased vigilance in particular COVID-19 cases.

Non-metastatic neurological manifestations of malignancy

2018 ◽  
Author(s):  
Nerissa Jordan
Keyword(s):  
Nervous System ◽  
Side Effects ◽  
Antibody Formation ◽  
Neurological Complications ◽  
Cns Infection ◽  
Neurological Manifestations ◽  
Local Effects ◽  
Immune Mediated ◽  
Neuronal Proteins ◽  
Systemic Malignancy

Neurological complications of systemic malignancy are frequent. They may reflect direct local effects of the tumour; CNS infection; side effects of chemotherapy or radiotherapy; nutritional or metabolic derangements; or a paraneoplastic syndrome. The paraneoplastic neurological syndromes are a group of disorders associated with a malignancy outside the nervous system. The pathophysiology is immune-mediated, with the tumour’s expression of neuronal proteins invoking antibody formation, which in turn results in neurological symptoms. This chapter will mainly focus on these syndromes.

scholarly journals Dengue: a new challenge for neurology

2012 ◽  
Vol 4 (3) ◽  
pp. 15 ◽  
Author(s):  
Marzia Puccioni-Sohler ◽  
Marco Orsini ◽  
Cristiane N. Soares
Keyword(s):  
Dengue Infection ◽  
Hemorrhagic Fever ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Immunoglobulin M ◽  
Neurological Manifestations ◽  
Dengue Vaccine ◽  
Autoimmune Reaction ◽  
Viral Antigens ◽  
The World

Dengue infection is a leading cause of illness and death in tropical and subtropical regions of the world. Forty percent of the world’s population currently lives in these areas. The clinical picture resulting from dengue infection can range from relatively minor to catastrophic hemorrhagic fever. Recently, reports have increased of neurological manifestations. Neuropathogenesis seems to be related to direct nervous system viral invasion, autoimmune reaction, metabolic and hemorrhagic disturbance. Neurological manifestations include encephalitis, encephalopathy, meningitis, Guillain-Barré syndrome, myelitis, acute disseminated encephalomyelitis, polyneuropathy, mononeuropathy, and cerebromeningeal hemorrhage. The development of neurological symptoms in patients with positive Immunoglobulin M (IgM) dengue serology suggests a means of diagnosing the neurological complications associated with dengue. Viral antigens, specific IgM antibodies, and the intrathecal synthesis of dengue antibodies have been successfully detected in cerebrospinal fluid. However, despite diagnostic advancements, the treatment of neurological dengue is problematic. The launch of a dengue vaccine is expected to be beneficial.

scholarly journals A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19

2020 ◽  
Author(s):  
Medha Tandon ◽  
Tejas R Mehta ◽  
Maha Daimee ◽  
Viral Patel ◽  
Apoorv Prasad ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neurological Complications ◽  
Common Finding ◽  
Pathophysiological Mechanism ◽  
Neurological Manifestations ◽  
Protein Levels ◽  
Csf Analysis ◽  
Cell Counts ◽  
Neurological Illness ◽  
Elevated Protein

Abstract Background: Here we performed a systematic review of literature of CSF findings associated with neurological complications in coronavirus disease-2019 (COVID-19) to establish a pattern and understand the significance of CSF analysis which can possibly be useful in deciding prognosis and exploring therapeutic options in the future. Methods: We screened all articles resulting from a search of PubMed, Google Scholar and Scopus, using the keywords “SARS-CoV-2 in cerebrospinal fluid”, “SARS-CoV-2 and CNS Complication”.Results: We performed CSF analysis results in total of 113 patients from 67 papers. There were 7 patients out of 113 patients (6.2 %) were fatal and 35 patients (31 %) were considered severe and rest non-severe. Elevated cell counts (>5 cells/µL) were found in 43% (3/7) of the fatal cases, 25.7% (9/35) of the severe cases and 29.4% (15/51) of non-severe cases. The average CSF protein of 110.0 mg/dl found in fatal, and in 85.4mg/dl in non-fatal cases. Whereas, average CSF protein levels were 78 mg/dl in severe and 103 mg/dl in non-severe cases. In addition, 76.5% (13/17) of the patients with CNS complications and 74.1% (40/54) of the patients with a PNS manifestation showed elevated protein levels.Conclusion: The most common finding of CSF analysis in the setting of neurological manifestations in Covid-19 is noted to be elevated CSF protein with occasionally elevated, predominantly lymphocytic cell count. Interestingly, CSF protein is noted to be majorly elevated in all spectrums of severity of neurological illness including CNS and PNS complications. This may be indicative of only one common pathophysiological mechanism of neurological illness. In future, A combination of SARS-CoV-2 CSF RT-PCR, CSF IgM testing, and CNS targeting antibodies should be further studied to understand pathophysiology of neurological complications in Covid-19.

scholarly journals Acute Disseminated Encephalomyelitis in COVID-19: presentation of two cases and review of the literature

2020 ◽  
Vol 78 (12) ◽  
pp. 805-810 ◽  
Author(s):  
Cesar Castello Branco Lopes ◽  
Sonia Maria Dozzi Brucki ◽  
Carlos Eduardo Borges Passos Neto ◽  
Luiza Alves Corazza ◽  
José Pedro Soares Baima ◽  
...  
Keyword(s):  
White Matter ◽  
Systemic Disease ◽  
White Matter Lesions ◽  
Acute Disseminated Encephalomyelitis ◽  
Endothelial Damage ◽  
Neurological Manifestations ◽  
Immune Mediated ◽  
Tertiary Hospitals ◽  
Delayed Recovery ◽  
Observational Report

ABSTRACT Background: Neurological manifestations of COVID-19 are still incompletely understood. Neurological manifestations may be due to direct viral effect on neurons and glial cells, to an immune-mediated response to the virus, or to a hypercoagulable state and associated endothelial damage, as well as to severe systemic disease with prolonged intensive care unit stay. Objective: To describe two patients with severe SARS-CoV-2 infection and delayed recovery of consciousness after sedation withdrawal, in whom MRI disclosed multifocal white matter brain lesions, compatible with the diagnosis of acute disseminated encephalomyelitis. Methods: Observational report of two cases of severe COVID-19 infection in patients from two tertiary hospitals in São Paulo, Brazil. Results: These patients underwent neurologic and systemic evaluation for delayed awakening after sedation withdrawal. MRI displayed multifocal centrum semiovale lesions, suggestive of demyelinating inflammation. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) for SARS-CoV-2 was negative in both cases. Conclusion: A recurrent pattern of multifocal white matter lesions can occur in COVID-19 patients, possibly associated with delayed awakening. Additional studies are necessary to elucidate the role of the viral infection and of inflammatory and immune-mediated associated changes in neurological manifestations of COVID-19.

scholarly journals Was it a case of acute disseminated encephalomyelitis? A rare association following dengue fever

2013 ◽  
Vol 04 (03) ◽  
pp. 318-321 ◽  
Author(s):  
Ritu Karoli ◽  
Zeba Siddiqi ◽  
Jalees Fatima ◽  
Sumit Maini
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Febrile Illness ◽  
Complete Recovery ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Methyl Prednisolone ◽  
Immune Mediated ◽  
Atypical Manifestations ◽  
Lag Period

ABSTRACTDengue infection, caused by a flavivirus is endemic in more than hundred countries, mostly in the developing world. Recent observations indicate that the clinical profile of dengue is changing, and that atypical manifestations are being reported more frequently. The exact incidence of various neurological complications is variable. Acute disseminated encephalomyelitis (ADEM) is a neurological manifestation rarely described in association with dengue. We present a patient, 32-year-old female who was diagnosed as a case of dengue fever initially after an acute febrile illness and two weeks later admitted in emergency with seizures and altered sensorium. Although MRI did not show typical lesions suggestive of ADEM, the lag period between initial dengue infection and neurological manifestations and complete recovery with methyl prednisolone point towards immune mediated demyelinating illness.

scholarly journals Neurological Complications of COVID-19: A Systematic Review of Literature

2020 ◽  
Author(s):  
Shitiz Sriwast ◽  
Samiksha Srivast ◽  
Saurabh Kataria ◽  
Violina Melnic ◽  
Amelia Adcock ◽  
...  
Keyword(s):  
Systematic Review ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Neurological Manifestation ◽  
Large Vessel ◽  
Inclusion Criteria ◽  
Vessel Occlusion ◽  
Conclusive Diagnosis ◽  
Conclusive Data

Abstract Background: To study the nature and frequency of occurrence of “significant” neurological complications in coronavirus disease-2019 (COVID-19) via a systematic review of the literature.Methods: We screened all articles resulting from a search of PubMed, Cochrane, Google Scholar and Scopus, using the keywords "COVID-19 and CNS", "SARS-CoV-2 and CNS”, “COVID-19 and neurological manifestation”, “SARS2 and neurological manifestation” and “COVID-19 and Brain” looking for reports of significant neurological manifestations that would potentially have an impact on the outcome.Results: Twenty-six articles met the inclusion criteria. The significant neurological diagnoses reported were stroke, Guillain Barre Syndrome (GBS) and its variants, encephalitis, seizures, acute hemorrhagic necrotizing encephalopathy, acute disseminated encephalomyelitis (ADEM) and transverse myelitis. Although stroke, predominantly ischemic, was observed in ~ 6% of COVID-19 patients from Wuhan, China, mortality in this cohort was 38%. Of the 24 pooled patients with reports of etiology, 17 had large vessel occlusions. GBS occurred in 5/1200 (0.4%) of the COVID-19 cohort from Italy. One of the six reported encephalitis cases, the ADEM case and the report of transverse myelitis do not have data for conclusive diagnosis.Conclusion: The most frequent significant neurological association with COVID-19 is stroke, predominantly ischemic. In a cohort from Wuhan, China, this was as frequent as ~ 6%, with a 38% mortality. Most common reported etiology is large vessel occlusion. Other reported significant neurological complications are GBS/variants, encephalitis, seizures and acute hemorrhagic necrotizing encephalopathy. The reports of ADEM and transverse myelitis lacked diagnostically conclusive data.

scholarly journals Neurological aspects of COVID-19

2021 ◽  
Vol 102 (6) ◽  
pp. 877-886
Author(s):  
M B Aliyeva ◽  
S S Saparbayev ◽  
D N Ayaganov ◽  
M S Kurmangazin ◽  
N M Tuychibaeva
Keyword(s):  
Neurological Disorders ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Hypoxemic Respiratory Failure ◽  
Systemic Complications ◽  
Central Nervous System Damage ◽  
Neuropsychiatric Complications ◽  
Taste Disorders ◽  
Hepatic Lesions ◽  
The City

The coronavirus disease COVID-19 began to spread worldwide in December 2019 from the city of Wuhan (China). COVID-19 is often accompanied by fever, hypoxemic respiratory failure and systemic complications (for example, gastrointestinal, renal, cardiac, neurological, and hepatic lesions), thrombotic phenomena. Central nervous system damage is caused by the primary effect on it, direct neuroinvasion of the virus, and more often by secondary effect due to systemic hyperinflammation. Neurological manifestations include fatigue, headache, insomnia, and olfactory/taste disorders. Neurological manifestations and complications of COVID-19 are diverse: (1) cerebral circulatory disorders, including ischemic stroke and macro/microhemorrhages; (2) encephalopathy; (3) para/postinfectious autoimmune complications, such as GuillainBarre syndrome; (4) meningoencephalitis; (5) neuropsychiatric complications (psychosis and mood disorders). In terms of pathogenesis, neurological disorders in COVID-19 can be caused by neurotropicity and neurovirulence of SARS-CoV-2, cytokine storm, hypoxemia, homeostasis disorders, as well as their combined effects. COVID-19 adversely affects the course and prognosis of chronic neurological disorders in comorbid patients. The review highlights the need for vigilance to early neurological complications in patients infected with SARS-CoV-2 and other coronaviruses, especially since some neurological complications may precede respiratory manifestations.

scholarly journals Neurological Complications of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Prateek Kumar Panda ◽  
Indar Kumar Sharawat ◽  
Pragnya Panda ◽  
Vivekanand Natarajan ◽  
Rahul Bhakat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Meta Analysis ◽  
Random Effect ◽  
Case Series ◽  
Neurological Complications ◽  
Severe Illness ◽  
Neurological Manifestations ◽  
Eligibility Criteria ◽  
Symptomatic Seizures

Abstract Background Knowledge about neurological complications of COVID-19 in children is limited due to the paucity of data in the existing literature. Some systematic reviews are available describing overall clinical features of COVID-19 in children and neurological complications of COVID-19 in adults. But to the best of our knowledge, no systematic review has been performed to determine neurological manifestations of COVID-19. Methods Six different electronic databases (MEDLINE, EMBASE, Web of Science, CENTRAL, medRxiv and bioRxiv) were searched for articles related to COVID-19 and neurological complications in children. Studies/case series reporting neurological manifestations of COVID-19 in patients aged ≤18 years, as well as case reports, as neurological complications appear to be rare. The pooled estimate of various non-specific and specific neurological manifestations was performed using a random effect meta-analysis. Results Twenty-one studies/case series and five case reports (3707 patients) fulfilled the eligibility criteria and were included in this systematic review, from a total of 460 records. Headache, myalgia and fatigue were predominant non-specific neurological manifestations, presenting altogether in 16.7% cases. Total of 42 children (1%) were found to have been reported with definite neurological complications, more in those suffering from a severe illness (encephalopathy—25, seizure—12, meningeal signs—17). Rare neurological complications were intracranial hemorrhage, cranial nerve palsy, Guillain–Barré syndrome and vision problems. All children with acute symptomatic seizures survived suggesting a favorable short-term prognosis. Conclusion Neurological complications are rare in children suffering from COVID-19. Still, these children are at risk of developing seizures and encephalopathy, more in those suffering from severe illness.

scholarly journals Dengue Fever and Neurology: Well Beyond Hemorrhage and Strokes

2020 ◽  
Author(s):  
Marco Antônio Machado Schlindwein ◽  
Isabelle Pastor Bandeira ◽  
Letícia Caroline Breis ◽  
Júlia Machado Rickli ◽  
Caio César Demore ◽  
...  
Keyword(s):  
Nervous System ◽  
Dengue Virus ◽  
Dengue Fever ◽  
Neurological Complications ◽  
The Body ◽  
Common Disease ◽  
Neurological Manifestations ◽  
Immune Mediated

Dengue virus an arbovirus is endemic in an area that comprise almost half of the world's population, contrary to past beliefs that dengue virus differentiate from other neuroinvasive arbovirus due to its lack of neurological invasion and disease related neurological complications excluding hemorrhagic and thromboembolic , the body of evidence have grown to demonstrate a series of neurological manifestations linked to dengue virus with possible mechanisms involving direct virus invasion of the nervous system or immune mediated complications. In this review we provide a wide approach to this neglect but not so rare manifestations of a very common disease.

Sign in / Sign up

Export Citation Format

Share Document