Mononeuropathy Multiplex After Severe SARS-CoV-2 Infection: A Case Series and Literature Review.

Q3 Medicine

Journal of Clinical Neuromuscular Disease Pub Date : 2023-09-01 DOI:10.1097/CND.0000000000000450

Alicia E Dupre, Michaël C C Slama

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Abstract

Introduction: Peripheral nerve injuries are being increasingly recognized in patients recovering from severe SARS-CoV-2 infections. Axonal neuropathies can occur, leading to lasting and disabling deficits.

Case reports: We present the cases of 3 patients who developed weakness and sensory symptoms after severe SARS-CoV-2 pneumonia. The clinical deficits revealed various patterns of injury including a mononeuropathy multiplex (MNM) in the first patient, a brachial plexopathy with superimposed MNM in the second patient, and a mononeuropathy superimposed on a polyneuropathy in the third patient. Electrodiagnostic studies revealed axonopathies. The patients with MNM were left with severe disability. The third patient returned to his baseline level of functioning.

Conclusions: Severe SARS-CoV-2 infections can result in disabling axonopathies. Possible explanations include ischemic nerve damage from the profound inflammatory response and traumatic nerve injuries in the ICU setting. Preventing severe disease through vaccination and antivirals may therefore help reduce neurologic morbidity.

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严重SARS-CoV-2感染后多发性单神经病变:病例系列和文献综述

在严重SARS-CoV-2感染的康复患者中，周围神经损伤越来越被认识到。可发生轴突神经病变，导致持久和致残的缺陷。病例报告:我们报告了3例严重SARS-CoV-2肺炎后出现虚弱和感觉症状的患者。临床缺陷显示了多种损伤模式，包括第一位患者的多发性单神经病变(MNM)，第二位患者的臂丛病合并MNM，以及第三位患者的多发性单神经病变。电诊断显示轴突病。MNM患者留下了严重的残疾。第三个病人的功能恢复到基线水平。结论:严重的SARS-CoV-2感染可导致致残性轴突病。可能的解释包括深度炎症反应引起的缺血性神经损伤和ICU环境中的外伤性神经损伤。因此，通过疫苗接种和抗病毒药物预防严重疾病可能有助于减少神经系统发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuromuscular Disease Medicine-Medicine (all)

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Journal of Clinical Neuromuscular Disease provides original articles of interest to physicians who treat patients with neuromuscular diseases, including disorders of the motor neuron, peripheral nerves, neuromuscular junction, muscle, and autonomic nervous system. Each issue highlights the most advanced and successful approaches to diagnosis, functional assessment, surgical intervention, pharmacologic treatment, rehabilitation, and more.