Introduction
The novel Coronavirus Disease 2019 (COVID-19) is an infection caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which has been spreading rapidly amongst humans and causing a global pandemic. The notorious infection has shown to cause a wide spectrum of neurological syndrome, including autoimmune encephalitis.
Objective
Here, we systematically review the literature on autoimmune encephalitis that developed in the background of SARS-CoV-2 infections and also the possible pathophysiological mechanisms of auto-immune mediated damage to the nervous system.
Methodology
An exhaustive search was made in Medline/PubMed, Embase, Scopus and other medical databases, and 28 relevant published articles were selected according to the strict inclusion criteria.
Results
Autoimmune encephalitis can occur via three possible proposed pathophysiological mechanism and can manifest during or after the acute infection period. It is more common in adult but can also occur in the paediatric patients. There were various spectra of autoantibody panels reported including antineuronal antibody, anti-gangliosides antibody and onconeural antibody. Majority of the patients responded well to the immunomodulating therapy and achieved good recovery.
Conclusion
In conclusion, SARSCoV-2 infection can induce various spectrum of autoimmune encephalitis. It is a major concern since there is very limited long-term study on the topic. Hence, this review aims to elucidate on the potential long-term complication of SARS-CoV-2 infection and hopefully to improve the management and prognosis of COVID-19.
As the world embarks on mass vaccination against SARS-CoV2 to alleviate the spread of this highly contagious novel coronavirus, there are growing anecdotal reports on immune-related neurological complications following immunisation. Similarly, we encountered 2 cases of central nervous system demyelination at our centre with Comirnaty (BNT162b2), a mRNA-based COVID-19 vaccine. Our first patient had typical clinical-radiological manifestations of acute disseminated encephalomyelitis (ADEM) after his COVID-19 vaccination. This was the sixth reported case to date. Our second patient presented with an unusual complaint of trigeminal neuralgia, with an identifiable demyelinating lesion observed in the pons on neuroimaging. Both cases responded well to immunotherapy. However, larger prospective controlled studies and formal registries are much needed to ascertain a possible relationship between COVID-19 vaccines and acute central nervous system demyelination.
This study investigated the effects of comprehensive core body resistance exercise on lower extremity motor function in stroke survivors. This resistance exercise was developed to aid stroke patients with various severity to perform this exercise, aimed to improve their core strength, stability, and control. Thirty-four stroke patients aged 47.7±13.16 years old were selected from the Rehabilitation Department, Queen Elizabeth I Hospital in Sabah, Malaysia. All patients underwent supervised training either assistive, active or active resistance exercise, biweekly for 12 weeks. Motor function was evaluated using Fugl-Meyer Assessment Lower Extremity (FMA-LE). The data were collected at baseline and at four weeks training interval. Repeated measures ANOVA and paired t test were employed to analyse the effects of the resistance exercise on lower extremity motor function. The twelve-week resistance exercise showed statistically significant effects on lower extremity motor function, lower extremity, coordination/speed, passive joint motion, and joint pain. However, sensation was found insignificant. Paired t test showed statistically significant improvement in lower extremity motor function, lower extremity, coordination/speed, passive joint motion, joint pain, and sensation. This study suggested that the obtained results indicate that the core body resistance exercise was applicable without any induced negative effect such as spasticity or joint pain.
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