scholarly journals Spectrum of Neurological Manifestations in COVID-19: A Review

2021 ◽  
Vol 32 (2) ◽  
pp. 120-137
Author(s):  
Firoz Ahmed Quraishi ◽  
Aminur Rahman ◽  
Furial Quraishi Twinkle
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Neuromuscular Junctions ◽  
Respiratory Illness ◽  
The Body ◽  
Neurological Symptoms ◽  
Neurological Manifestation ◽  
Neurological Manifestations ◽  
Long Term Effects ◽  
Wide Range

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) is causing a worldwide pandemic of COVID-19 within a short span of time. Although patients with COVID-19 primarily present with fever and respiratory illness; a wide range of symptoms involving different systems have been described. While the neurological sequelae of the virus remain poorly understood, there are a growing number of reports of neurological manifestation of COVID-19.The neurological manifestation including both central and peripheral nervous system are increasingly reported in a very subset of COVID-19 patients. The SARS-CoV-2 enters the body mainly via the ACE- 2 receptors within the respiratory system, which causes the body to initiate an immunologic response against potential damage to non-renewable cells. There’s increasing evidence of accumulating that COVID-19, particularly in severe cases, can have neurological consequences although respiratory symptoms nearly always develop before neurological ones. Patients with pre-existing neurological conditions could also be at elevated risk for COVID-19 associated neurological symptoms. The neurological presentations of COVID-19 patients maybe acute and post-acute state. The acute presentations are classified into specific (such as stroke, encephalitis, acute polyneuropathy, etc.) and nonspecific (such as delirium, headache, dizziness, etc.) symptoms with anatomical involvement of either central nervous system including brain or spinal cord, and/or peripheral nervous system, neuromuscular junctions or muscles. Several neurological symptoms have also been demonstrated in post-acute or long covid-19 syndrome. There is a possibility to overlook or misinterpretation of, neurological symptoms in some COVID-19 patients. In infants and young children, the foremost common CNS phenomena are febrile seizures; in adults, non-focal abnormalities will be either neurological or constitutional. To date, neurological manifestations of COVID-19 are described largely within the disease trajectory, and also the long-term effects of such manifestations still remain unexplored and unfolded. This article is intended to review the possible neuro-invasive routes of SARS-CoV-2 and its mechanisms which initiate the neurological damage with neurological presentations of COVID-19 patients. Bangladesh J Medicine July 2021; 32(2) : 120-137

Overview of COVID-19 and neurological complications

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nasrin Hosseini ◽  
Shabnam Nadjafi ◽  
Behnaz Ashtary
Keyword(s):  
Nervous System ◽  
Severe Acute Respiratory Syndrome ◽  
Cranial Nerve ◽  
Virus Disease ◽  
Neurological Complications ◽  
The Body ◽  
Neurological Manifestations ◽  
Wide Range ◽  
The World ◽  
Symptoms And Signs

Abstract The sudden and storming onset of coronavirus 2 infection (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) was associated by severe acute respiratory syndrome. Recently, corona virus disease 19 (COVID-19) has appeared as a pandemic throughout the world. The mutational nature of the virus, along with the different means of entering and spreading throughout the body has involved different organs. Thus, patients are faced with a wide range of symptoms and signs. Neurological symptoms, such as anosmia, agnosia, stroke, paralysis, cranial nerve deficits, encephalopathy, meningitis, delirium and seizures, are reported as common complications affecting the course of the disease and its treatment. In this review, special attention was paid to reports that addressed the acute or chronic neurological manifestations in COVID-19 patients who may present acute respiratory syndrome or not. Moreover, we discussed the central (CNS) and peripheral nervous system (PNS) complications in SARS-Cov2-infected patients, and also the pathophysiology of neurological abnormalities in COVID-19.

scholarly journals SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms

2020 ◽  
Vol 21 (15) ◽  
pp. 5475 ◽  
Author(s):  
Manuela Pennisi ◽  
Giuseppe Lanza ◽  
Luca Falzone ◽  
Francesco Fisicaro ◽  
Raffaele Ferri ◽  
...  
Keyword(s):  
Nervous System ◽  
Molecular Mechanisms ◽  
Neuronal Damage ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Wide Range ◽  
Inflammatory State ◽  
Acute Polyneuropathy ◽  
The Central Nervous System ◽  
The Impact

Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called “cytokine storm”), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.

scholarly journals Polyneuropathy following COVID-19 infection: the rehabilitation approach

2021 ◽  
Vol 14 (5) ◽  
pp. e242330
Author(s):  
Ahmad Saif ◽  
Anton Pick
Keyword(s):  
Nervous System ◽  
Critical Illness ◽  
Peripheral Nervous System ◽  
Upper Limb ◽  
Inflammatory Disease ◽  
Pathological Process ◽  
Neurological Manifestations ◽  
Sensorimotor Polyneuropathy ◽  
System Disease ◽  
Symmetrical Pattern

A range of neurological manifestations associated with COVID-19 have been reported in the literature, but the pathogenesis of these have yet to be fully explained. The majority of cases of peripheral nervous system disease published thus far have shown a symmetrical pattern. In contrast, we describe the case of a patient with asymmetrical predominantly upper-limb sensorimotor polyneuropathy following COVID-19 infection, likely due to a multifactorial pathological process involving critical illness neuropathy, mechanical injury and inflammatory disease. His presentation, management and recovery contribute to the understanding of this complex condition and informs rehabilitation approaches.

scholarly journals Nervous system injury in alcoholic disease

2019 ◽  
Vol 11 (2S) ◽  
pp. 83-88
Author(s):  
O. E. Zinovyeva ◽  
N. V. Vashchenko ◽  
O. E. Mozgovaya ◽  
T. A. Yanakaeva ◽  
A. Yu. Emelyanova
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Alcohol Intoxication ◽  
Clinical Manifestations ◽  
Symptomatic Treatment ◽  
Chronic Alcohol ◽  
Neurological Manifestations ◽  
Chronic Alcohol Intoxication ◽  
Alcoholic Disease

The paper considers various variants of nervous system injury in alcoholic disease. It discusses the epidemiology, pathogenesis, diagnosis, and clinical manifestations of central and peripheral nervous system lesions in the presence of acute and chronic alcohol intoxication. Attention is paid to the issues of etiotropic, pathogenetic, and symptomatic treatment for neurological manifestations of alcoholic disease and to the role of neurotropic B vitamins in the treatment of alcohol-induced deficiency and non-deficiency states.

scholarly journals Neurological manifestations associated with SARS-CoV-2 infection: a narrative review

2021 ◽  
Author(s):  
Poliana Rafaela dos Santos Araújo ◽  
Kauan Alves Sousa Madruga ◽  
Bruna Alves Rocha ◽  
Lucas Oliveira Braga
Keyword(s):  
Nervous System ◽  
Meta Analysis ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Narrative Review ◽  
Common Symptom ◽  
Neurological Manifestations ◽  
Cns Involvement ◽  
Pubmed Database ◽  
Critical Patients

Background: Coronavirus disease (COVID-19), once identified, soon spread globally, becoming a pandemic. Although patients present mainly with respiratory complaints, several neurological symptoms have been reported. Symptoms range from headache and nonspecific dizziness to seizures and cerebrovascular disease (CVD). It has also been shown that the severity of the infection is directly proportional to the development of neurological symptoms, especially CVD and changes in mental status. Objective: The present study aims to briefly review the neurological manifestations of COVID-19 and discuss the pathogenic mechanisms of Central Nervous System (CNS) involvement. Methods: This is an exploratory narrative review with a descriptive approach, consisting of an active search for scientific articles in the PubMed database. The descriptors “coronavirus infections”, “COVID-19” and “Nervous system” were used, with the Boolean operators “OR” and “AND”. Eighteen articles of systematic review and meta-analysis were included. Results: CNS manifestations included, among others: encephalitis, encephalopathy, consciousness decrease, headache, dizziness, acute myelitis, and stroke. As for the peripheral nervous system, skeletal muscle damage, chemosensory dysfunction, and Guillain-Barré syndrome were observed, with hyposmia being the most common symptom. CNS involvement may be related to a worse prognosis. Conclusion: The clinical involvement of the nervous system in COVID-19 is not uncommon, and can result in several neurological complications, especially in the most critical patients. The pathophysiological mechanisms of these events still need further investigation. In the meantime, physicians should value extra-respiratory symptoms ranging from hyposmia, to potentially fatal manifestations, such as stroke and encephalopathy.

Clinical and functional characteristics of disabled people due to diseases of the peripheral nervous system at working age

2021 ◽  
Vol 99 (2) ◽  
pp. 108-114
Author(s):  
A. V. Berg ◽  
G. O. Penina
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Functional State ◽  
The Body ◽  
Disabled People ◽  
Functional Characteristics ◽  
Persons With Disabilities ◽  
Constant Pain ◽  
Working Age ◽  
Persistent Disability

The dominant position among the reasons of working-age population’s health deterioration belongs to diseases of the peripheral nervous system (PNS), the peak prevalence of which occurs at the age of 35–40. PNS diseases are diagnosed in about 76.0% of industrial workers, and account for more than half of all occupational diseases. They are the main cause of incapacitation and long-term disability. Publications on disability due to PNS diseases are isolated.The aim of the work. Clinical and functional characteristics of PNS disorders that cause disability in the working-age population.Material and methods. Among 91 496 first recognized as disabled in the Republic of Bashkortostan in 2014–2018, all disabled people of working age were selected due to PNS diseases, in which the main independent diagnosis was radiculopathy, polyneuropathy, neuropathy and vibratory disease with indication to lumbar-sacral radiculopathy with polyneuropathy of the upper extremities. 107 people were identified to constitute a closed cohort for a comprehensive study of the clinical-functional state and patterns of disability formation in them. The clinical-functional characteristic is given on the basis of the results of studies set forth in the directional medical documents and the assessment by an expert neurologist of the Main Bureau of Medical and Social Expertise. Statistical analysis was performed in Microsoft Excel.Results. The prevalence of PNS diseases has been found to be increasing. Three of the newly diagnosed neurological patients have been the carriers of PNS disease. PNS diseases are formed and reach peak in working age. Characterized by a chronic, progressive course, they often cause temporary and persistent disability. On average, there are 0.1 ± 0.028 persons with disabilities per 10 thousand of the able-bodied population due to PNS diseases, the level of which in dynamics for 2014–2018 increased by 1.7 times. Persons with disabilities (69.0%) are mainly represented by men, every second (50.6%) is over 50 years old, with an average age of 48.7 ± 5.7 years. The clinical-functional state is characterized by constant pain, numbness, seizures, restriction of movements in the limbs, sensory disorders, vegetative-vascular disorders.Conclusion. The quantitative evaluation of the main types of the body functions and main categories of vital activity persistent disorders made it possible to detect that 69.3 ± 4.4% persons with disabilities have persistent moderate abnormalities of functions in the range 40–60% (II degree), another 24.4 ± 3.8 — persistent pronounced abnormalities in the range 70–80% (III degree) and 6.3 ± 6.0% — persistent significant abnormalities in the range 90–100% (IV degree). The severity of impaired functioning of the body is the basis for the level of persistent disability determination.

Clinical neurological manifestations in patients suffering from peptic ulcer disease in the acute phase and in remission

2021 ◽  
Author(s):  
O. V. Demydas
Keyword(s):  
Duodenal Ulcer ◽  
Nervous System ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Peripheral Nervous System ◽  
Acute Phase ◽  
Neurological Examination ◽  
Acute Stage ◽  
Neurological Manifestations ◽  
Ulcer Disease

Objective — to analyze clinical neurological manifestations in patients suffering from peptic ulcer disease in the acute phase and in remission, based on the findings of a comprehensive clinical neurological, neuropsychological and paraclinical study. Methods and subjects.  84 patients suffering from PUD were comprehensively examined while in the acute phase of the disease and then all 84 were reexamined while in remission. The age range of the patients was from 25 to 60 years. The average age of the patient was 39.90 ± 1.29 years. The examined individuals were destributed into two groups based on whether they presented symptoms of an acute phase or remission of the peptic ulcer disease. The comprehensive examination included: interview and complaint analysis, neurological examination focused on the state of the autonomic nervous system, study of the neuropsychological differences (the trait and state anxiety levels monitoring based on the Spielberg‑Khanin scale, depressive state evaluation using Beck Depression Inventory, self‑perceived health assessment, mood and activity monitoring using the SAN questionnaire, cognitive impairment evaluation using the MMSE scale, assessment of the refocusing speeds and performance distribution using Schulte tables), as well as lab tests and procedures. Results. Most often, subjects complained of headache (74 (88.0 %) in the acute stage and 37 (44.0 %) in remission). The second most common was a complaint of pain in the thoracic spine (69 (82.1 %) and 35 (41.6 %), respectively). Complaints of dizziness, pain in the heart, palpitations, «interruptions» in the heart, paresthesia were often recorded. In 11 (12.4 %) patients with duodenal ulcer in the acute stage experienced episodes of syncopal state, while in the remission stage they were absent. Complaints that indicated the presence of psychoemotional disorders were anxiety, decreased memory and attention, and sleep disturbances. In patients with duodenal ulcer disease we revealed lesions of the central and peripheral nervous system. Central nervous system disorders were manifested in the form of vestibulo‑cerebellar syndrome (in 30 (35.7 %) patients in the acute stage and in 14 (16.6 %) in the remission stage), extrapyramidal disorders (respectively in 10 (11.9 %) and 4 (4.76 %)) and signs of pyramidal dysfunction (37 (44.0 %) and 15 (17.8 %)). Clinical and neurological examination of the peripheral nervous system in 68 (80.9 %) patients with peptic ulcer in the acute stage and in 31 (36.9 %) in the remission stage revealed polyneuropathy syndrome of varying degrees. Signs of polyneuropathy were accompanied by complaints of disorders of the peripheral nervous system (45 (53.5 %) and 15 (17.8 %) cases, respectively). In 27.4 % of patients with peptic ulcer disease in the acute stage of the complaint were absent at all, and only a thorough neurological examination revealed signs of polyneuropathy. In 56 (66.6 %) patients with peptic ulcer disease in the acute stage and 28 (33.3 %) in the remission stage, the morbidity of paravertebral points in the lower thoracic spine was revealed. Conclusions. Having analyzed the data obtained through the interviews, as well as the neurological characteristics of patients with peptic ulcer disease of the duodenum in the acute phase and in remission it was concluded that most of the somatic complaints and neurological manifestations were common in both the acute phase and the remission of the disease. However, all of the identified neurological differences were significantly more common in the acute phase of the disease.  

Skin and Bones—and Muscle Too

Bioprinting ◽  
2021 ◽  
pp. 98-118
Author(s):  
Kenneth Douglas
Keyword(s):  
Skeletal Muscle ◽  
Central Nervous System ◽  
Nervous System ◽  
Cell Membrane ◽  
Motor Neuron ◽  
Neuromuscular Junctions ◽  
Skeletal Muscle Cell ◽  
The Body ◽  
The Central Nervous System ◽  
Judicious Choice

Abstract: This chapter recounts bioprinting studies of skin, bone, skeletal muscle, and neuromuscular junctions. The chapter begins with a study of bioprinted skin designed to enable the creation of skin with a uniform pigmentation. The chapter relates two very different approaches to bioprinted bone: a synthetic bone called hyperelastic bone and a strategy that prints cartilage precursors to bone and then induces the conversion of the cartilage to bone by judicious choice of bioinks. Muscles move bone, and the chapter discusses an investigation of bioprinted skeletal muscle. Finally, the chapter considers an attempt to bioprint a neuromuscular junction, a synapse—a minute gap—of about 20 billionths of a meter between a motor neuron and the cell membrane of a skeletal muscle cell. A motor neuron is a nerve in the central nervous system that sends signals to the muscles of the body.

scholarly journals Propylthiouracil and peripheral neuropathy

1992 ◽  
Vol 50 (2) ◽  
pp. 239-240
Author(s):  
Valentina Van Boekel ◽  
José Maurício Godoy ◽  
Luiz A. Lamy ◽  
Samira Assuf ◽  
João G. Corrêa Meyer Neto ◽  
...  
Keyword(s):  
Nervous System ◽  
Peripheral Neuropathy ◽  
Toxic Effect ◽  
Peripheral Nervous System ◽  
Graves Disease ◽  
Neurological Manifestations ◽  
Neurological Signs ◽  
Rare Manifestation

Peripheral neuropathy is a rare manifestation in hyperthyroidism. We describe the neurological manifestations of a 38 year old female with Graves' disease who developed peripheral neuropathy in the course of her treatment with propylthiouracil. After the drug was tapered off, the neurological signs disappeared. Therefore, we call attention for a possible toxic effect on peripheral nervous system caused by this drug.

Central nervous system pathologies and anaesthesia

2017 ◽  
Author(s):  
Steven J. Gill ◽  
Michael H. Nathanson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Preoperative Assessment ◽  
Careful Consideration ◽  
The Body ◽  
Levels Of Care ◽  
High Dependency ◽  
Organ Systems ◽  
Wide Range ◽  
Neurological Conditions

Anaesthesia induces changes in many organ systems within the body, though clearly none more so than the central nervous system. The physiology of the normal central nervous system is complex and the addition of chronic pathology and polypharmacy creates a significant challenge for the anaesthetist. This chapter demonstrates a common approach for the anaesthetist and specific considerations for a wide range of neurological conditions. Detailed preoperative assessment is essential to gain understanding of the current symptomatology and neurological deficit, including at times restrictions on movement and position. Some conditions may pose challenges relating to communication, capacity, and consent. As part of the consent process, patients may worry that an anaesthetic may aggravate or worsen their neurological disease. There is little evidence to support this understandable concern; however, the risks and benefits must be considered on an individual patient basis. The conduct of anaesthesia may involve a preference for general or regional anaesthesia and requires careful consideration of the pharmacological and physiological impact on the patient and their disease. Interactions between regular medications and anaesthetic drugs are common. Chronically denervated muscle may induce hyperkalaemia after administration of succinylcholine. Other patients may have an altered response to non-depolarizing agents, such as those suffering from myasthenia gravis. The most common neurological condition encountered is epilepsy. This requires consideration of the patient’s antiepileptic drugs, often relating to hepatic enzyme induction or less commonly inhibition and competition for protein binding, and the effect of the anaesthetic technique and drugs on the patient’s seizure risk. Postoperative care may need to take place in a high dependency unit, especially in those with limited preoperative reserve or markers of frailty, and where the gastrointestinal tract has been compromised, alternative routes of drug delivery need to be considered. Overall, patients with chronic neurological conditions require careful assessment and preparation, a considered technique with attention to detail, and often higher levels of care during their immediate postoperative period.

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