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Neurology . Acute Hypokinetic-Rigid Syndrome Following SARS-CoV-2 Infection

tetano

Editor, Senior Moderator
Neurology


. 2020 Jul 8;10.1212/WNL.0000000000010282.
doi: 10.1212/WNL.0000000000010282. Online ahead of print.
Acute Hypokinetic-Rigid Syndrome Following SARS-CoV-2 Infection


Antonio M?ndez-Guerrero[SUP] 1 [/SUP], Mar?a Isabel Laespada-Garc?a[SUP] 1 [/SUP], Adolfo G?mez-Grande[SUP] 2 [/SUP], Mariano Ruiz-Ortiz[SUP] 1 [/SUP], V?ctor Antonio Blanco-Palmero[SUP] 1 [/SUP], Francisco Javier Azcarate-Diaz[SUP] 1 [/SUP], Pablo R?bano-Su?rez[SUP] 1 [/SUP], Eva ?lvarez-Torres[SUP] 3 [/SUP], Carlos Pablo de Fuenmayor-Fern?ndez de la Hoz[SUP] 1 [/SUP], Diana Vega P?rez[SUP] 2 [/SUP], Raquel Rodr?guez-Montalb?n[SUP] 3 [/SUP], Alfredo P?rez-Rivilla[SUP] 4 [/SUP], Javier Sayas Catal?n[SUP] 5 [/SUP], Ana Ramos- Gonz?lez[SUP] 6 [/SUP], Jes?s Gonz?lez de la Aleja[SUP] 1 [/SUP]



Affiliations

Abstract

Objective: 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.
Methods: Patient data were obtained from medical records from the "Hospital Universitario 12 de Octubre" in Madrid, Spain. [[SUP]123[/SUP]I]-ioflupane dopamine transporter single-photon emission CT (DaT-SPECT) images were acquired 4 hours after a single dose of 185 MBq of [SUP]123[/SUP]I-FP-CIT. Quantitative analysis was performed using DaTQUANT[SUP]TM[/SUP] software providing the specific binding ratio (SBR) and z-score values of the striatum.
Results: 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.
Conclusion: This case study provides clinical and functional neuroimaging evidence to support that SARS-CoV-2 can gain access to the central nervous system, affecting midbrain structures and leading to neurological signs and symptoms.
 
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