Abstract Details

Title New-onset movement disorders after COVID-19

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 279

Objective To analyse the latency of movement disorders appearance after COVID-19 hypothesizing possible mechanisms underneath.

Background Many mechanisms were proposed about the link between COVID-19 and movement disorders, such as retrograde expansion or hematogenous dissemination, nevertheless, neuronal involvement could occur anytime through direct viral insult, cytokine release, hypoxia, immune-mediated neuroinflammation, coagulopathy and endothelial dysfunction syndrome, either alone or combined.

Design/Methods Data was collected on the medical records of patients that developed any type of movement disorder after COVID-19 infection. MRI was performed to all of them, and lumbar puncture in those who developed acute myoclonus and opsoclonus/myoclonus. A PET-scan was performed in one patient developing a parkinsonian syndrome after mild infection.

Results From all patients, 7 were males and 2 females (X=61.2 years). The most frequent comorbidities were diabetes and hypertension. The most frequent movement disorder was myoclonus (N=3; 33.3%), followed by tremor (N=2; 22.2%) and opsoclonus/myoclonus (N=2; 22.2%), the remaining patients had functional characteristics,(tremor and a parkinsonian syndrome) discarded by a brain PET-scan (N=2; 22.2%). The latency between COVID-19 and the onset of movement disorder was variable; being less in the appearance of myoclonus (X=10 days); medium in terms of tremor (X=25 days) and later with respect to opsoclonus/myoclonus, around 35 days, probably related to the underlying pathophysiological process, in which late appearance suggests a potential parainfectious or immune-mediated mechanism.

Conclusions Myoclonus was the most common one, followed by tremor, opsoclonus and functional movement disorders. All patients were treated according to the type and time of symptoms onset.
Despite the small sample, is useful to demonstrate a possible correlation between neurological symptoms onset with the underlying COVID-19 mechanism. Regarding myoclonus and tremor, hypoxic or vascular cause were proposed; although there is a hypothetical mechanism involving antigenic cross-reactivity. About the relationship to opsoclonus/myoclonus, (X=30 days latency), a post or para infectious immune-mediated cause is suspected.

Authors/Disclosures
Emilia M. Gatto, MD, FAAN (INEBA) PRESENTER	Dr. Gatto has received personal compensation in the range of $0-$499 for serving as a Consultant for UCB. Dr. Gatto has received personal compensation in the range of $0-$499 for serving as a Consultant for Bago Argentina. Dr. Gatto has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bago. Dr. Gatto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Dr. Gatto has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Janssen. Dr. Gatto has received research support from Roche. The institution of Dr. Gatto has received research support from CHDI.
	No disclosure on file
Martin Cesarini, MD (BIOGEN ARGENTINA)	No disclosure on file
	No disclosure on file
Jose Etcheverry	Jose Etcheverry has nothing to disclose.
Gustavo Da Prat de Magahlaes	Gustavo Da Prat de Magahlaes has nothing to disclose.

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