Two COVID-19-related video-accompanied cases of severe ataxia-myoclonus syndrome

Abstract

Aim of the study: The pandemic state of COVID-19 has resulted in new neurological post-infection syndromes. Recently, several papers have reported ataxia-myoclonus syndrome following SARS-CoV-2 infection. The aim of this study was to present our two cases and compare them to previously reported cases.

Materials and methods: We present two video-accompanied new cases with ataxia-myoclonus syndrome following SARS-CoV-2 infection and discuss the studies published so far.

Results: Ataxia-myoclonus syndrome, isolated myoclonus, opsoclonus-myoclonus syndrome as post-COVID-19 syndrome following infection have been described in 16 patients (including our two cases). Patients have been treated with intravenous immunoglobulins and/or steroids except for 4 patients, which resulted in a significant improvement within 1-8 weeks.

Conclusions and clinical implications: The increasing number of patients with a similar symptomatology shows a significant relationship between COVID-19 infection and ataxia-myoclonus syndrome. The subacute onset of neurological symptoms after a resolved COVID-19 infection and prominent response to immunotherapy may suggest that the neurological manifestations are immune-mediated. Although recovery is highly possible, it may take several weeks/months, and clinicians should be aware of this diagnosis and the beneficial effects of immunological treatment administered as soon as possible.

Keywords: COVID-19; SARS-CoV-2; ataxia; myoclonus; voice tremor.