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Acute hypokinetic-rigid syndrome following SARS-CoV-2 infection

2020; Lippincott Williams & Wilkins; Volume: 95; Issue: 15 Linguagem: Inglês

10.1212/wnl.0000000000010282

1526-632X

Antonio Méndez-Guerrero, María Isabel Laespada-García, Adolfo Gómez‐Grande, M. Ruiz Ortiz, Víctor Antonio Blanco-Palmero, Francisco Javier Azcárate-Díaz, Pablo Rábano‐Suárez, Eva Torres, Carlos Pablo de Fuenmayor‐Fernández de la Hoz, Diana Vega Pérez, Raquel Rodríguez-Montalbán, Alfredo Pérez‐Rivilla, Javier Sayas Catalán, Ana Ramos‐González, Jesús González de la Aleja,

Diabetes and associated disorders

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.Patient data were obtained from medical records from the Hospital Universitario 12 de Octubre in Madrid, Spain. [123I]-ioflupane dopamine transporter (DaT) SPECT images were acquired 4 hours after a single dose of 185 MBq of 123I-FP-CIT. Quantitative analysis was performed with DaTQUANT software providing the specific binding ratio and z score values of the striatum.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.This case study provides clinical and functional neuroimaging evidence to support that SARS-CoV-2 can gain access to the CNS, affecting midbrain structures and leading to neurologic signs and symptoms.