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. 2021 Sep;133(17-18):902-908.
doi: 10.1007/s00508-021-01890-3. Epub 2021 Jun 15.

COVID-19-associated myoclonus in a series of five critically ill patients

Alexander Grieb  1 , Tamara Seitz  2 , Reinhard Kitzberger  2 , Manfred Schmidbauer  3 , Wolfgang Hoepler  2 , Sebastian Baumgartner  2 , Marianna T Traugott  2 , Erich Pawelka  2 , Mario Karolyi  2 , Georg Strasser  4 , Karolina Knibbe  4 , Hermann Laferl  2 , Alexander Zoufaly  2 , Christoph Wenisch  2 , Stephanie Neuhold  2
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COVID-19-associated myoclonus in a series of five critically ill patients

Alexander Grieb et al. Wien Klin Wochenschr. 2021 Sep.

Abstract

Background: In addition to respiratory symptoms, many patients with coronavirus disease 2019 (COVID-19) present with neurological complications. Several case reports and small case series described myoclonus in five patients suffering from the disease. The purpose of this article is to report on five critically ill patients with COVID-19-associated myoclonus.

Material and methods: The clinical courses and test results of patients treated in the study center ICU and those of partner hospitals are described. Imaging, laboratory tests and electrophysiological test results are reviewed and discussed.

Results: In severe cases of COVID-19 myoclonus can manifest about 3 weeks after initial onset of symptoms. Sedation is sometimes effective for symptom control but impedes respiratory weaning. No viral particles or structural lesions explaining this phenomenon were found in this cohort.

Conclusion: Myoclonus in patients with severe COVID-19 may be due to an inflammatory process, hypoxia or GABAergic impairment. Most patients received treatment with antiepileptic or anti-inflammatory agents and improved clinically.

Keywords: Case series; Intensive care; Movement disorders; SARS-CoV‑2; Sedation.

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Conflict of interest statement

A. Grieb, T. Seitz, R. Kitzberger, M. Schmidbauer, W. Hoepler, S. Baumgartner, M.T. Traugott, E. Pawelka, M. Karolyi, G. Strasser, K. Knibbe, H. Laferl, A. Zoufaly, C. Wenisch and S. Neuhold declare that they have no competing interests. The authors declare that no funding was received for this publication. The authors further declare that they have no financial or personal relationships with other people or organizations that could have inappropriately influenced this study.

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