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Journal of Neurology
Published in: Journal of Neurology 10/2021

01-10-2021 | Magnetic Resonance Imaging | Review

Myoclonus and cerebellar ataxia associated with COVID-19: a case report and systematic review

Authors: Jason L. Chan, Keely A. Murphy, Justyna R. Sarna

Published in: Journal of Neurology | Issue 10/2021

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Abstract

Background

Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic in December 2019, neurological manifestations have been recognized as potential complications. Relatively rare movement disorders associated with COVID-19 are increasingly reported in case reports or case series. Here, we present a case and systematic review of myoclonus and cerebellar ataxia associated with COVID-19.

Methods

A systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline using the PubMed and Ovid MEDLINE databases, from November 1, 2019 to December 6, 2020.

Results

51 cases of myoclonus or ataxia associated with COVID-19, including our case, were identified from 32 publications. The mean age was 59.6 years, ranging from 26 to 88 years, and 21.6% were female. Myoclonus was multifocal or generalized and had an acute onset, usually within 1 month of COVID-19 symptoms. Myoclonus occurred in isolation (46.7%), or with ataxia (40.0%) or cognitive changes (30.0%). Most cases improved within 2 months, and treatment included anti-epileptic medications or immunotherapy. Ataxia had an acute onset, usually within 1 month of COVID-19 symptoms, but could be an initial symptom. Concurrent neurological symptoms included cognitive changes (45.5%), myoclonus (36.4%), or a Miller Fisher syndrome variant (21.2%). Most cases improved within 2 months, either spontaneously or with immunotherapy.

Conclusions

This systematic review highlights myoclonus and ataxia as rare and treatable post-infectious or para-infectious, immune-mediated phenomena associated with COVID-19. The natural history is unknown and future investigation is needed to further characterize these movement disorders and COVID-19.
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Metadata
Title
Myoclonus and cerebellar ataxia associated with COVID-19: a case report and systematic review
Authors
Jason L. Chan
Keely A. Murphy
Justyna R. Sarna
Publication date
01-10-2021
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 10/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-021-10458-0

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