Besides respiratory symptoms, coronavirus disease 2019 , like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection. Guillain barre syndrome (GBS) is a neurological disorder that usually follows a viral infection, it is possible that COVID-19 infection and GBS are closely related. In this case report, we try to elucidate the relation between SARS-CoV-2 and GBS.
The COVID-19 pandemic has had a great impact on chronic diseases, including epilepsy. The imbalance of antiepileptic drugs in case of intercurrent infection with COVID-19 leads to worsening seizures. A 71-year-old man, followed for post-traumatic epilepsy for 30 years, was stabilized with phenobarbital and topiramate. He presented generalized tonic-clonic epileptic seizures without meningitis. He improved well on midazolam combined with the usual treatment before the diagnosis and worsening of the covid-19. The severity of the lung damage led to hypoxia, recurrence of seizures, and poor prognosis. The association between covid-19 and epilepsy remains pejorative despite management. An epileptic seizure should always be considered as a possible manifestation of COVID-19. The article aimed to establish the relationship between covid-19 and the risk of worsening seizures and to demonstrate the severity of the association between covid-19 and epilepsy in elderly patients.
The COVID-19 pandemic and its impact on health systems had a significant effect on the management of inflammatory diseases in the long term and myopathies could be signs of COVID-19, making it difficult to diagnose the cause and effect relationship. An unvaccinated 62-year-old female patient followed for polymyositis was tested positive for COVID-19 on polymerase chain reaction (PCR) of nasopharyngeal swab revealed by dyspnea and rhinorrhea with fever and pulmonary involvement of 75%. She had an enlarged left ventricle with complete left branch block, inaugural diabetes mellitus with ketosis, kidney dysfunction, and inflammatory syndrome. Despite the early initiation of invasive ventilation in combination with the national protocol against covid-19, the patient died on day 4 of care. The best management should anticipate comorbidities and the evolutionary profile would guide the continuation of the treatment. Polymyositis like other rheumatic diseases was associated with a very high risk of developing a severe form of COVID-19. The combination of elder age and comorbidities led to a severe form of COVID-19 and therefore to a poor prognosis. The article aimed to show the severity of the association of covid-19 with polymyositis at the comorbid stage.
Introduction and importance: Myasthenia gravis is an autoimmune disease characterized by the destruction of postsynaptic acetylcholine receptors in skeletal striated muscles. It is most common in young women. Myasthenia can be diagnosed by the detection of anti-acetylcholine receptor antibodies. Treatment includes anticholinesterase drugs, thymectomy, and restricting drugs that may aggravate myasthenia. The authors report a rare case of accidental revelation of myasthenia gravis in an elderly woman during sedation for diagnostic gastrointestinal fibroscopy. Case presentation : A 85-years-old female patient scheduled for diagnostic gastrointestinal fibroscopy presented signs of myasthenic crisis during the perioperative with severe respiratory failure. The diagnosis of myasthenia was confirmed by bioassay and electromyogram (EMG). Her chest CT scan showed a thymoma. The evolution was favorable as a result of early and appropriate management. Conclusion: Myasthenia can occur in perioperative settings outside the usual circumstances. The prognosis depends on early and adapted management.
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