Neurology
. 2020 Jul 8;10.1212/WNL.0000000000010282.
doi: 10.1212/WNL.0000000000010282. Online ahead of print.
Acute Hypokinetic-Rigid Syndrome Following SARS-CoV-2 Infection
Antonio M?ndez-Guerrero 1 , Mar?a Isabel Laespada-Garc?a 1 , Adolfo G?mez-Grande 2 , Mariano Ruiz-Ortiz 1 , V?ctor Antonio Blanco-Palmero 1 , Francisco Javier Azcarate-Diaz 1 , Pablo R?bano-Su?rez 1 , Eva ?lvarez-Torres 3 , Carlos Pablo de Fuenmayor-Fern?ndez de la Hoz 1 , Diana Vega P?rez 2 , Raquel Rodr?guez-Montalb?n 3 , Alfredo P?rez-Rivilla 4 , Javier Sayas Catal?n 5 , Ana Ramos- Gonz?lez 6 , Jes?s Gonz?lez de la Aleja 1
Affiliations
- PMID: 32641525
- DOI: 10.1212/WNL.0000000000010282
Abstract
Objective: To report a case of a patient infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who acutely developed a hypokinetic-rigid syndrome.
Methods: Patient data were obtained from medical records from the "Hospital Universitario 12 de Octubre" in Madrid, Spain. [123I]-ioflupane dopamine transporter single-photon emission CT (DaT-SPECT) images were acquired 4 hours after a single dose of 185 MBq of 123I-FP-CIT. Quantitative analysis was performed using DaTQUANTTM software providing the specific binding ratio (SBR) and z-score values of the striatum.
Results: We report a previously healthy 58-year-old man who developed hyposmia, generalized myoclonus, fluctuating and transient changes in level of consciousness, opsoclonus and an asymmetric hypokinetic-rigid syndrome with ocular abnormalities after a severe SARS-CoV-2 infection. DaT-SPECT confirmed a bilateral decrease in presynaptic dopamine uptake asymmetrically involving both putamina. Significant improvement in the parkinsonian symptoms was observed without any specific treatment.
Conclusion: This case study provides clinical and functional neuroimaging evidence to support that SARS-CoV-2 can gain access to the central nervous system, affecting midbrain structures and leading to neurological signs and symptoms.