Objectives
Since the beginning of the COVID-19 pandemic, the Spanish Society of Neurology has run a registry of patients with neurological involvement for the purpose of informing clinical neurologists. Encephalopathy and encephalitis were among the most frequently reported complications. In this study, we analyse the characteristics of these complications.
Patients and methods
We conducted a retrospective, descriptive, observational, multicentre study of patients with symptoms compatible with encephalitis or encephalopathy, entered in the Spanish Society of Neurology's COVID-19 Registry from 17 March to 6 June 2020.
Results
A total of 232 patients with neurological symptoms were registered, including 51 cases of encephalopathy or encephalitis (21.9%). None of these patients were healthcare professionals. The most frequent syndromes were mild or moderate confusion (33%) and severe encephalopathy or coma (9.8%). The mean time between onset of infection and onset of neurological symptoms was 8.02 days. Lumbar puncture was performed in 60.8% of patients, with positive PCR results for SARS-CoV-2 in only one case. Brain MRI studies were performed in 47% of patients, with alterations detected in 7.8% of these. EEG studies were performed in 41.3% of cases, detecting alterations in 61.9%.
Conclusions
Encephalopathy and encephalitis are among the complications most frequently reported in the registry. More than one-third of patients presented mild or moderate confusional syndrome. The mean time from onset of infection to onset of neurological symptoms was 8 days (up to 24 hours earlier in women than in men). EEG was the most sensitive test in these patients, with very few cases presenting alterations in neuroimaging studies. All patients treated with boluses of corticosteroids or immunoglobulins progressed favourably.
A contagem oral como pré-requisito para aquisição do conceito de número foi ensinada através do procedimento de escolha de acordo com o modelo com crianças pré-escolares. Aos dois grupos foram ensinadas as relações de equivalência entre número e quantidade, porém a contagem oral foi ensinada apenas para o Grupo Experimental. No treino foram utilizados estímulos impressos (números, palavras e figuras) e auditivos (ditado). Ambos os grupos foram, então, submetidos a diferentes condições de teste para verificar o efeito da contagem oral. Na generalização foi utilizado um jogo de dominó. O desempenho dos sujeitos que foram submetidos ao ensino da contagem oral foi superior ao dos sujeitos que não passaram por esse procedimento. É discutida a importância da contagem oral na aquisição do conceito de número, sendo apontada como facilitadora no estabelecimento de relações de equivalência de estímulos não diretamente ensinadas (generalização).
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