GENERALIZED MYOCLONUS IN COVID-19


COVID-19 presents with various neurological manifestations in about 37% of patients. A recent report from Spain described generalised myoclonus in 3 patients with COVID-19. Patients were in older age group and had usual symptoms of COVID-19 such as fever, cough, breathing difficulty and anosmia at admission. Myoclonus developed in the second week of illness, characterised by jerky movements involving face, neck and upper limbs. Anti-epileptic drugs such as valproate, levetiracetam and clonazepam were of no use in controlling these myoclonic jerks. Myoclonus responded to immunotherapy with methylprednisolone in 2 patients, and one patient required plasmapheresis. MRI brain and EEG were normal.

Conclusions

1. Myoclonus can occur in patients with COVID-19.

2. Underlying mechanism could be immune-mediated or direct virus spread, affecting brainstem and hypothalamus.

3. Anti-epileptic drugs do not work. Immunotherapy is useful.

(Source: Neurology, May 21, 2020)

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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