Abnormal movements in hospitalized COVID-19 patients: A case series

Jeffrey R. Clark; Eric M. Liotta; Nicholas J. Reish; Nathan A. Shlobin; Steven C. Hoffman; Zachary S. Orban; Patrick H. Lim; Igor J. Koralnik; Ayush Batra

doi:10.1016/j.jns.2021.117377

Abnormal movements in hospitalized COVID-19 patients: A case series

Jeffrey R. Clark, Eric M. Liotta, Nicholas J. Reish, Nathan A. Shlobin, Steven C. Hoffman, Zachary S. Orban, Patrick H. Lim, Igor J. Koralnik, Ayush Batra^*

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Background: Abnormal movements in Covid-19 patients have been reported with varying degree of frequency, prompting neurologic consultation and additional diagnostic evaluation. We sought to evaluate the frequency and etiology of abnormal movements among hospitalized Covid-19 patients undergoing neurologic consultation. Methods: We retrospectively analyzed the first 50 consecutive patients with confirmed Covid-19 hospitalized at our tertiary medical care center who underwent acute inpatient neurology consultation from March 2020 through May 2020. Indication for neurologic consultation and diagnostic studies performed were identified by electronic medical record review. Results: Of the 50 initial consultation requests, 11 (22.0%) patients were evaluated for abnormal movements (nine male and two female). Myoclonus was diagnosed in 6/11 (54.5%) patients. Additionally, two patients were diagnosed with seizures (confirmed on EEG in one), while two additional patients were diagnosed with tremor (physiologic and probable functional). A single case of serotonin syndrome was also identified. Conclusion: Abnormal movements observed in hospitalized Covid-19 patients can have a wide range of etiologies and were a frequent initial indication for neurologic consultation. Myoclonus was the most frequent type of abnormal movement observed. Early clinical recognition and directed diagnostic work-up is essential for accurate diagnoses in these patients.

Original language	English (US)
Article number	117377
Journal	Journal of the Neurological Sciences
Volume	423
DOIs	https://doi.org/10.1016/j.jns.2021.117377
State	Published - Apr 15 2021

Funding

Study authors would like to thank funding sources that partially funded efforts for this study. Dr. Reish was funded in part by National Institutes of Health Grant U24NS107233. Dr. Liotta receives funding through National Institutes of Health Grant L30 NS098427.

Keywords

COVID-19
Movement disorder
Myoclonus
Seizure
Serotonin syndrome
Tremor

ASJC Scopus subject areas

Clinical Neurology
Neurology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jns.2021.117377

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title = "Abnormal movements in hospitalized COVID-19 patients: A case series",

abstract = "Background: Abnormal movements in Covid-19 patients have been reported with varying degree of frequency, prompting neurologic consultation and additional diagnostic evaluation. We sought to evaluate the frequency and etiology of abnormal movements among hospitalized Covid-19 patients undergoing neurologic consultation. Methods: We retrospectively analyzed the first 50 consecutive patients with confirmed Covid-19 hospitalized at our tertiary medical care center who underwent acute inpatient neurology consultation from March 2020 through May 2020. Indication for neurologic consultation and diagnostic studies performed were identified by electronic medical record review. Results: Of the 50 initial consultation requests, 11 (22.0%) patients were evaluated for abnormal movements (nine male and two female). Myoclonus was diagnosed in 6/11 (54.5%) patients. Additionally, two patients were diagnosed with seizures (confirmed on EEG in one), while two additional patients were diagnosed with tremor (physiologic and probable functional). A single case of serotonin syndrome was also identified. Conclusion: Abnormal movements observed in hospitalized Covid-19 patients can have a wide range of etiologies and were a frequent initial indication for neurologic consultation. Myoclonus was the most frequent type of abnormal movement observed. Early clinical recognition and directed diagnostic work-up is essential for accurate diagnoses in these patients.",

keywords = "COVID-19, Movement disorder, Myoclonus, Seizure, Serotonin syndrome, Tremor",

author = "Clark, {Jeffrey R.} and Liotta, {Eric M.} and Reish, {Nicholas J.} and Shlobin, {Nathan A.} and Hoffman, {Steven C.} and Orban, {Zachary S.} and Lim, {Patrick H.} and Koralnik, {Igor J.} and Ayush Batra",

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doi = "10.1016/j.jns.2021.117377",

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AU - Clark, Jeffrey R.

AU - Liotta, Eric M.

AU - Reish, Nicholas J.

AU - Shlobin, Nathan A.

AU - Hoffman, Steven C.

AU - Orban, Zachary S.

AU - Lim, Patrick H.

AU - Koralnik, Igor J.

AU - Batra, Ayush

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N2 - Background: Abnormal movements in Covid-19 patients have been reported with varying degree of frequency, prompting neurologic consultation and additional diagnostic evaluation. We sought to evaluate the frequency and etiology of abnormal movements among hospitalized Covid-19 patients undergoing neurologic consultation. Methods: We retrospectively analyzed the first 50 consecutive patients with confirmed Covid-19 hospitalized at our tertiary medical care center who underwent acute inpatient neurology consultation from March 2020 through May 2020. Indication for neurologic consultation and diagnostic studies performed were identified by electronic medical record review. Results: Of the 50 initial consultation requests, 11 (22.0%) patients were evaluated for abnormal movements (nine male and two female). Myoclonus was diagnosed in 6/11 (54.5%) patients. Additionally, two patients were diagnosed with seizures (confirmed on EEG in one), while two additional patients were diagnosed with tremor (physiologic and probable functional). A single case of serotonin syndrome was also identified. Conclusion: Abnormal movements observed in hospitalized Covid-19 patients can have a wide range of etiologies and were a frequent initial indication for neurologic consultation. Myoclonus was the most frequent type of abnormal movement observed. Early clinical recognition and directed diagnostic work-up is essential for accurate diagnoses in these patients.

AB - Background: Abnormal movements in Covid-19 patients have been reported with varying degree of frequency, prompting neurologic consultation and additional diagnostic evaluation. We sought to evaluate the frequency and etiology of abnormal movements among hospitalized Covid-19 patients undergoing neurologic consultation. Methods: We retrospectively analyzed the first 50 consecutive patients with confirmed Covid-19 hospitalized at our tertiary medical care center who underwent acute inpatient neurology consultation from March 2020 through May 2020. Indication for neurologic consultation and diagnostic studies performed were identified by electronic medical record review. Results: Of the 50 initial consultation requests, 11 (22.0%) patients were evaluated for abnormal movements (nine male and two female). Myoclonus was diagnosed in 6/11 (54.5%) patients. Additionally, two patients were diagnosed with seizures (confirmed on EEG in one), while two additional patients were diagnosed with tremor (physiologic and probable functional). A single case of serotonin syndrome was also identified. Conclusion: Abnormal movements observed in hospitalized Covid-19 patients can have a wide range of etiologies and were a frequent initial indication for neurologic consultation. Myoclonus was the most frequent type of abnormal movement observed. Early clinical recognition and directed diagnostic work-up is essential for accurate diagnoses in these patients.

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KW - Movement disorder

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KW - Seizure

KW - Serotonin syndrome

KW - Tremor

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Abnormal movements in hospitalized COVID-19 patients: A case series

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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