Abstract
Coronavirus disease 2019 (COVID-19) pandemic is caused by the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) and since the outbreak, many neurological features and syndromes are reported with this multi-organ viral infection. Lance-Adams syndrome (LAS) also referred to as chronic post hypoxic myoclonus is defined as action myoclonus which can occur as generalized, focal, or multifocal repeated myoclonic motor movements which involve the face, trunk, or extremities and it is one of the neurological complications that are related to COVID-19 infection. LAS is reported as a delayed complication of cardiac arrest, which causes cerebral hypoxia leading to myoclonus. We report a case of a 58-year-old male patient diagnosed as a case of LAS secondary to hypoxia occurring because of COVID-19 without cardiac arrest and to the best of our knowledge it is the second case reported with this similar mechanism. Moreover, we discuss the possible pathophysiological relationship between LAS and COVID-19 and various treatment strategies. Eventually, we review the related articles in the literature regarding the LAS and various types of myoclonus associated with COVID-19 infection.
Highlights
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered in Wuhan, China, in December 2019, and the global pandemic of Coronavirus disease 2019 (COVID-19) on May 1, 2021, has reached 153 million cases
The chronic type of Post-hypoxic myoclonus (PHM), which is known as Lance-Adams syndrome (LAS), begins within days to weeks after cardiopulmonary resuscitation (CPR) and persists in patients who have recovered consciousness after CPR [5,6]
The vitals were BP of 153/75 mm of Hg, heart rate of 104 beats/min, temperature of 98.6 °F, and respiratory rate of 40 breaths/min with oxygen saturation of 77% on room air which increased to 94% on 15L non-rebreather mask (NRBM)
Summary
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered in Wuhan, China, in December 2019, and the global pandemic of Coronavirus disease 2019 (COVID-19) on May 1, 2021, has reached 153 million cases. The chronic type of PHM, which is known as Lance-Adams syndrome (LAS), begins within days to weeks after cardiopulmonary resuscitation (CPR) and persists in patients who have recovered consciousness after CPR [5,6]. ECG at this time showed sinus tachycardia of 110 beats/minute He was diagnosed with a case of COVID-19 pneumonia and was started on the specific treatment of COVID 19. Following six weeks of diagnosis of COVID pneumonia, the patient developed progressive weakness in all four limbs. On examination consciousness was preserved with bilateral mild lower motor neuron facial weakness, generalized areflexia with a power of 3/5 in both proximal and distal muscles in all the limbs. Myoclonus has improved, and the patient is able to walk with support
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