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This is a case report of a patient who developed a hypokinetic-rigid syndrome in the context of severe SARS-CoV-2 infection. After the respiratory infection, the patient had a brief period of transient recurrent impairment of consciousness and myoclonus, followed by symmetric hypokinetic-rigid syndrome with ocular abnormalities. DaT-SPECT images showed a bilateral decrease in presynaptic dopamine uptake asymmetrically that involved both putamina. The patient's parkinsonian symptoms improved without specific treatments.
This additional case builds the evidence for possible postinfectious parkinsonism related to SARS-CoV-2 infection.
– Codrin I. Lungu, MD
This abstract is available on the publisher's site.
To report a case of a patient infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who acutely developed a hypokinetic-rigid syndrome.
Patient data were obtained from medical records from the Hospital Universitario 12 de Octubre in Madrid, Spain. [123I]-ioflupane dopamine transporter (DaT) SPECT images were acquired 4 hours after a single dose of 185 MBq of 123I-FP-CIT. Quantitative analysis was performed with DaTQUANT software providing the specific binding ratio and z score values of the striatum.
We report a previously healthy 58-year-old man who developed hyposmia, generalized myoclonus, fluctuating and transient changes in level of consciousness, opsoclonus, and an asymmetric hypokinetic-rigid syndrome with ocular abnormalities after a severe SARS-CoV-2 infection. DaT-SPECT confirmed a bilateral decrease in presynaptic dopamine uptake asymmetrically involving both putamina. Significant improvement in the parkinsonian symptoms was observed without any specific treatment.
This case study provides clinical and functional neuroimaging evidence to support that SARS-CoV-2 can gain access to the CNS, affecting midbrain structures and leading to neurologic signs and symptoms.
Acute Hypokinetic-Rigid Syndrome Following SARS-Cov-2 Infection
Neurology 2020 Oct 13;95(15)e2109-e2118, A Méndez-Guerrero, MI Laespada-García, A Gómez-Grande, M Ruiz-Ortiz, VA Blanco-Palmero, FJ Azcarate-Diaz, P Rábano-Suárez, E Álvarez-Torres, CP de Fuenmayor-Fernández de la Hoz, D Vega Pérez, R Rodríguez-Montalbán, A Pérez-Rivilla, J Sayas Catalán, A Ramos-González, J González de la Aleja