The relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and neurodegenerative diseases is yet to be fully clarified. Rapid worsening and even new-onset cases of those disorders have been reported in association with coronavirus disease 2019 (COVID-19). We describe three cases of neurodegenerative diseases in patients with SARS-CoV-2: a case of Creutzfeldt–Jakob disease during the COVID-19 acute phase, to our knowledge, is the second one described in the literature; a rapidly progressive Alzheimer's Disease; and a patient with frontotemporal dementia, and a quick decline of both cognitive and behavioral domains. This report suggests an association between SARS-CoV-2 infection and a higher probability of developing or accelerating neurodegenerative chronic neurologic conditions. We reinforce the need for a close cognitive follow-up in the aftermath of Sars-Cov2 infection.
Figure. Neutral cervical spine MRI sagittal images (A and B). In A, a T1-weighted image shows C6-T1 cord atrophy (arrowheads) and in B a T2-weighted image demonstrates slight detachment of the posterior dura mater (arrow). Flexion cervical spine MRI sagittal images (C and D). In C, a T2-weighted image reveals forward displacement of the posterior wall of the dural sac with some impression over the cord (arrow). In D, a contrast-enhanced T1-weighted image shows engorgement of the posterior epidural venous plexus, with enhancement (arrow). An 18-year-old male presented with a two-year history of bilateral hand tremulousness. Neurological examination revealed weakness in both hands, but predominantly on the right. With arms outstretched, distal mini-polymyoclonus occurred 1 . The rest of the neurological examination was unremarkable. Motor and sensory nerve conduction studies were normal. Electromyography showed fibrillations and fasciculations at rest and signs of mild chronic reinnervation in C8-T1 muscles bilaterally. Spine MRI with dynamic flexion sequences 2 revealed cervical cord atrophy, forward shifting of the posterior wall of the cervical dural sac, and contrast-enhancement of an enlarged posterior epidural compartment (Figure). This constellation of features suggests Hirayama disease.
A 57-year-old woman with a history of multiple sclerosis presented with a 5-day history of progressive headache and confusion, followed by left hemiparesis. The patient had stopped her previous fingolimod usage during the last 8 weeks. Brain MRI and 18F-FDG PET showed a subcortical tumefactive lesion with an intense peripheric rim of hypermetabolism and central hypometabolism, with central hyperintensity, thin isointense rim, and peripheral finger-like “tentacles” of edema with an irregular and thick border enhancement on postcontrast T2-weighted MRI. Brain biopsy showed features suggestive of relapsing MS. The patient improved after methylprednisone and plasma exchange.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.