Skeletal Manifestations Research Articles

Marfan syndrome in a paediatric cohort: the importance of family history.

Abstract Marfan syndrome is a rare connective tissue disorder secondary to mutations in the FBN1 gene, characterised by skeletal, ocular, and cardiovascular manifestations. We present an extensive cohort of paediatric patients with Marfan syndrome highlighting the vital importance of promptly referring paediatric first-degree relatives of Marfan syndrome paediatric patients to a tertiary hospital as our results confirm that they are at higher risk of aortic dilatation.

Brown tumor of the rib associated with primary hyperparathyroidism misdiagnosed as metastatic deposit - A case report

Brown tumor is a rare skeletal manifestation where multiple giant cell rich bony lesions, arise as a direct result of either primary or secondary hyperparathyroidism. It is caused by excess osteoclastic activity and hemosiderin deposition because of uncontrolled parathormone secretion. Brown tumors usually involve mandible, maxilla, clavicle, ribs, and pelvic bones. Our case report describes the case of a 42-year-old lady who consulted our hospital for multiple bony lesions in ribs suspicious of metastasis and summarizes our experience in diagnosis of similar cases that we might come across in the future.

Distal Arthrogryposis with Impaired Proprioception and Touch: A Novel Variant in PIEZO2 Gene in Omani Patients and a Genotype-Phenotype Review from a Single-Center Experience.

Distal arthrogryposis with impaired proprioception and touch (DAIPT) is an autosomal recessive neurogenetic disorder caused by homozygous pathogenic variants in the PIEZO2 gene. Here we present four Omani families with multiple affected members with DAIPT. The genetic diagnosis was established by whole exome sequencing and we identified a previously unreported homozygous missense variant PIEZO2 : c.1591T > C, P.(Trp531Arg) in one family with two affected members. All patients showed clinical manifestation shortly after birth including transient respiratory insufficiency, significant hypotonia, and gross motor developmental delay with preserved cognitive function. The skeletal manifestation including arthrogryposis is more pronounced with age as we saw in our older patient. This case report will be of importance for physicians and genetic counsellors for faster diagnosis and for offering carrier testing for at-risk family members as part of the premarital testing program, which could help in reducing the burden of this disorder.

How does sickle cell disease affect the peri-operative outcome in patients undergoing total knee arthroplasty? A large-scale, National Inpatient Sample-based study.

In view of the vaso-occlusive pathophysiology affecting osseous micro-circulation, sickle cell disease (SCD) is well known to present with diverse skeletal and arthritic manifestations. With prolonged life-expectancy over the past decades, there has been a progressive increase in the proportion of SCD patients requiring joint reconstructions. Owing to the paucity of evidence in the literature, the post-operative complication rates and outcome in these patients following total knee arthroplasty (TKA) are still largely unknown. Based on the National Inpatient Sample (NIS) database (using ICD-10 CMP code), patients who underwent TKA between 2016 and 2019 were identified. The cohort were classified into two groups: A-those with SCD; and B-those without. The data on patients' demographics, co-morbidities, details regarding hospital stay including expenditure incurred, and complications were analyzed and compared. Overall, 558,361 patients underwent unilateral, primary TKA; among whom, 493 (0.1%) were known cases of SCD (group A). Group A included a significantly greater proportion of younger (60.14 ± 10.87 vs 66.72 ± 9.50years; p < 0.001), male (77.3 vs 61.5%; p < 0.001); and African-American (88.2 vs 8.3%B; p < 0.001) patients, in comparison with group B. Group A patients were also at a significantly higher risk for longer duration of peri-operative hospital stay (p < 0.001), greater health-care costs incurred (p < 0.001), and greater need for alternative step-down health-care facilities (p < 0.001) following discharge. Among the SCD patients, 24.7%, 20.9% and 24.9% developed acute chest syndrome, pain crisis and splenic sequestration crisis, respectively during the peri-operative period. Group A patients had a statistically greater incidence of acute renal failure (ARF; p = 0.014), need for blood transfusion (p < 0.001) and deep vein thrombosis (DVT; p = 0.03) during the early admission period. The presence of SCD substantially lengthens the duration of hospital stay and enhances health care-associated expenditure in patients undergoing TKA. SCD patients are at significantly higher risk for systemic complications including acute chest syndrome, pain crisis, splenic sequestration crisis, acute renal failure, higher need for blood transfusions and deep venous thrombosis during the initial peri-operative period following TKA.

Correlation between Skeletal Manifestations of Sickle Cell Disease (SCD) and Transcranial Doppler Imaging Velocities

Context: Sickle cell disease (SCD), a genetic disorder, is a debilitating illness. Among the different complications of SCD, cerebrovascular complication results in stroke in pediatric population. The cause of stroke in those patients is attributed to vasculopathy, stenosis, or vaso-occlusion of distal internal carotid arteries. Another body system that is commonly affected is the musculoskeletal system. Both skeletal manifestations and vasculopathy in Circle of Willis in SCD are known consequences of the same underlying pathology. Aim: This study was conducted to assess the correlation between osseous findings and vasculopathy of Circle of Willis. Settings and Design: It was a chart review study conducted during December 2021 to January 2022. Children suffering from SCD were the study population. Materials and Methods: The sampling was done by using convenience purposive sampling technique. The data were collected as observations using picture archiving and communication system and then entered Excel spreadsheet. Statistical Analysis Used: The data were analyzed using SPSS, Version 28. The descriptive statistics including frequencies and percentages for the skeletal manifestations and transcranial Doppler imaging (TCDI) readings were calculated. To assess the association between skeletal manifestations and TCDI, a Chi-square test of independence was performed. Results: The findings showed that abnormal TCDI readings exhibited higher frequency on abnormal skeletal manifestations as compared to normal TCDI readings. Conclusion: The study showed that an osseous manifestation of disease was associated with vasculopathy of Circle of Willis vasculature. Therefore, osseous manifestations of SCD can be associated with the chance of stroke among the children since it is associated with the vasculopathy of Circle of Willis.

Complete pachydermoperiostosis with diffuse keratoderma mimicking thyroid Acropachy: A case report and review of literature

Pachydermoperiostosis (PDP) is a rare genodermatosis with prominent cutaneous, soft tissue and skeletal manifestations. It can mimic secondary causes of hypertrophic osteoarthropathy such as thyroid acropachy. Cutaneous manifestations can be debilitating and constitute critical clues to formulating an accurate diagnosis. Palmoplantar keratoderma is a seldom reported manifestation of the disease hence, its significance as a phenotypic variant of pachydermoperiostosis is unknown. We describe a rare case of complete pachydermoperiostosis with diffuse palmoplantar keratoderma in a young African man presenting with hyperhidrosis, hyper-defecation and weight loss who had been previously misdiagnosed with thyroid acropachy. The aim is to provide a detailed clinical description of both common and unconventional features of this rare disease. Pachydermoperiostosis manifests with diverse genotypic and phenotypic characteristics that can mimic treatable, secondary causes of hypertrophic osteoarthropathy. Keratoderma and hyper-defecation are seldom reported manifestations that may represent unique variants of PDP. Awareness of characteristic dermatological manifestations of the disease can enhance early and accurate clinical diagnosis and prevent needless investigations.

Rare case alert: Ochronotic arthropathy and its skeletal manifestations in 2 Indian siblings

Rare case alert: Ochronotic arthropathy and its skeletal manifestations in 2 Indian siblings

Oral kavitede kitle ve eşlik eden insidental papiller tiroid karsinomu ile başvuran normokalsemik primer hiperparatiroidizm olgusu

Hyperparathyroidism (HPT) is an endocrine disorder characterized by high secretion of parathyroid hormone. Brown tumor is one of the skeletal manifestations of HPT. Its overall prevalence is low (about 0.1%). Involvement of facial bones is extremely rare. The mandible is involved in 4.5% of cases. Primary HPT (PHPT)with vitamin D deficiency worsens the clinical course. Parathyroid adenoma is detected in ectopic places with a rate of 8.5%. 0.2% is intrathyroidal, 2% is located in different neck regions, 4.1% is in the upper mediastinum, and 2.2% is in the lower mediastinum. The prevalence of papillary thyroid cancer (PTC) in PHPT patients has been reported to range from 2% to 15%. In the literature, incidentally detected papillary thyroid cancer in patients with hyperparathyroidism was detected in patients who underwent total thyroidectomy associated with intrathyroidal parathyroid adenoma.&#x0D; In this article, we present a case of incidental papillary thyroid carcinoma with ectopic parathyroid adenoma accompanied by severe vitamin D, and diagnosed during accompanying surgery following a brown tumor was considered after primary hyperparathyroidism was detected. However, the patient was admitted with a mass in the oral cavity, diagnosed before as a pyogenic granuloma with a delayed diagnosis without considering brown tumor because it was normocalcemic. It is the first case in the literature of papillary thyroid carcinoma detected incidentally with ectopic parathyroid adenoma in the thyrothymic region.

Changes of the lower limb deformity in children with FGF23-related hypophosphatemic rickets treated with Burosumab: a single-center prospective study.

Fibroblast growth factor 23 (FGF23)-related hypophosphatemic rickets (HPR) are characterized by excess circulating FGF23 and low concentrations of serum phosphorus, leading to skeletal manifestations of rickets, including lower limb deformities in children. The objective of this study was to prospectively evaluate whether treatment with burosumab, a monoclonal antibody neutralizing FGF23, changes lower limb deformities in HPR. Patients who were 15 years of age or younger with a documented clinical diagnosis of HPR, receiving burosumab treatment, and had a minimum follow-up period of one year were included in the study. Various radiological parameters were measured from anteroposterior and lateral radiographs of the bilateral lower limbs taken before administration of burosumab and at 3, 6, 9, and 12 months after treatment for evaluation of lower limb alignment. Outcome was classified as 'improvement', 'no change', or 'deterioration' after 12 months treatment. Five patients (10 limbs), with a mean age of 7.2 years were included in this study. The outcome was 'improvement' in six limbs and 'no change' in four limbs. There were no limbs of 'deterioration'. The improvement in deformities after treatment was more significant in younger patients who originally showed severe lower limb deformities. Older patients with milder deformities, on the other hand, showed less improvement. Burosumab therapy favorably changed lower-limb malalignment in children with FGF23-related HPR.

Long-term effects of eliglustat on skeletal manifestations in clinical trials of patients with Gaucher disease type 1

PurposeMost patients with Gaucher disease have progressive and often disabling skeletal manifestations. We examined the long-term effect of eliglustat treatment on bone outcomes in clinical trials in adults with Gaucher disease type 1. MethodsData from 4 completed phase 2 and 3 trials were evaluated in treatment-naïve patients or patients switching to eliglustat from enzyme replacement therapy (ERT). ResultsOverall, 319 of 393 (81%) eliglustat-treated patients remained in their trials until completion or commercial eliglustat became available. Mean eliglustat treatment duration ranged from 3.3 to 6.5 years. In treatment-naïve patients and ERT-switch patients, frequency and severity of bone pain decreased during eliglustat treatment. Mean lumbar spine T-scores shifted from abnormal to normal in treatment-naïve patients and remained in the healthy reference range or improved modestly in ERT-switch patients. Mean total bone marrow burden score shifted from marked-to-severe to moderate in treatment-naïve patients and remained moderate in ERT-switch patients. MIP-1β (marker of active bone disease) was elevated at baseline and decreased to the healthy reference range in treatment-naïve patients and remained in the healthy reference range among ERT-switch patients. ConclusionThese findings confirm the long-term efficacy of eliglustat on skeletal complications of Gaucher disease in treatment-naïve and ERT-switch patients.

Lumbosacral tuberculosis, a rare manifestation of Pott's disease – How identified human skeletons from the pre-antibiotic era can be used as reference cases to establish a palaeopathological diagnosis of tuberculosis

The macromorphological examination of identified human osteological collections from the pre-antibiotic era (e.g., Terry Collection) can provide invaluable information about the skeletal manifestations of tuberculosis (TB) in individuals who did not receive pharmaceutical therapy. With analysis of such collections, new diagnostic criteria for TB can be recognised which can be used in palaeopathological interpretation. The aim of our paper is to provide a reference and aid for the identification of TB in past populations by demonstrating and discussing in detail the vertebral alterations indicative of one of its rare skeletal manifestations, lumbosacral TB. These changes were detected in two individuals from the Terry Collection (Terry No. 760 and Terry No. 1093). These two case studies furnish palaeopathologists with a stronger basis for diagnosing lumbosacral TB in skeletons which exhibit similar vertebral lesions from osteoarchaeological series. To illustrate this, an archaeological case from Hungary (KK146) is also presented, displaying vertebral alterations resembling that of the two cases from the Terry Collection. Through the demonstrated case studies, we can derive a better insight into the disease experience of people who lived in the past and suffered from TB.

Pachydermoperiostosis with Chronic Diarrhoea: A Case Report

Pachydermoperiostosis (PDP) is a rare autosomal disorder characterized by periostosis, clubbing, thickening of the skin (pachyderma) of the face and scalp, seborrhea and hyperhydrosis. It is the primary form of hypertrophic osteoarthropathy (HOA), the other name of which is Touraine- Solente-Golé syndrome. PDP has various organ involvements and there are some rare associations of PDP with other disorders. Here we describe a 16-year-old boy who presented with skin and skeletal manifestations typical of PDP who also had chronic diarrhea, abdominal pain and weight loss. After giving treatment with risedronate sodium and mesalazine he got significant improvement in his skeletal and abdominal complaints.&#x0D; Bangladesh Med J. 2021 Sept; 50(3): 52-55

Novel Gamma-Glutamyl Carboxylase Mutation Causing Hemorrhagic and Non-Hemorrhagic VKCFD1 Phenotypes

Background: Vitamin K clotting factor deficiency (VKCFD) types 1 and 2 are very rare autosomal recessive disorders associated with reduced clotting factors activities for all vitamin K dependent clotting factors. Less than 30 cases are reported with defects in GGCX (gamma-glutamyl carboxylase) leading to VKCFD Type 1 (VKCFD1) or VKORC1 (vitamin K epoxide reductase complex subunit 1) leading to VKCFD Type 2 (VKCFD2). In addition to clotting factor deficiency, GGCX mutations can be associated with skeletal abnormalities such as bone hypoplasia, conductive hearing loss, mental retardation, and skin hyperlaxity. Here, we report an Arabic family with VKCFD1 harboring an unreported, new pathogenic variant in the GGCX gene. The proband presented at 17 months of age with severe bruising following trauma and work up demonstrated deficiencies of all Vitamin K dependent (VKD) coagulation proteins. Another sibling born 8 years later was also diagnosed with the same condition with abnormal coagulation parameters at birth. Additionally, the non-hemorrhagic manifestations diagnosed in both siblings were mid-facial hypoplasia with flat nasal bridge, dental abnormalities, and shortened distal phalanges representing a keutel syndrome-like phenotype. Both patients are currently managed with oral vitamin K supplementation with resolution of bleeding symptoms. Here we present the in-vitro assessment of the mutations effects to vitamin K supplementation and potential clinical implications. Methods: The proband, affected brother and mother, all underwent genetic evaluation at the University Clinic Bonn in Germany. DNA was isolated from the patient's blood and Sanger Sequencing was performed for the genes VKORC1 and GGCX. The identified new pathogenic variant in GGCX was further characterized by the in-vitro assay published by Ghosh et al. in 2021. Results: The brothers were found to be homozygous for c.[416G>A];[416G>A] p.(Cys139Tyr), a genetic variant in exon 4 of the GGCX gene. Mutations in VKORC1 gene leading to reduced activity for the VKD clotting factors were excluded confirming the diagnosis of VKCFD Type 1 (VKCFD1). The mother was found to be heterozygous for the same GGCX variant. The affected siblings and the mother were further genotyped for the promoter single nucleotide polymorphism in VKORC1 gene NG_011564.1:g.3588G>A (VKORC1:c.-1639 G>A) since this might correlate with the severity of the phenotypes in patients with skeletal manifestations. The brothers and mother were found to harbor VKORC1:c.-1639 GA, which has been associated with a 33% reduced VKORC1 expression. Treatment with 5mg of vitamin K resulted in increased activities of the VKD clotting factors (Table 1). However, clotting factor activities did not normalized after vitamin K supplementation. The in vitro characterization of the new identified pathogenic variant GGCX:p.C139Y (Figure 1) showed reduced activities for all VKD clotting factors, which did not reach wild type levels despite increasing concentrations of vitamin K. The levels of Matrix Gla protein (MGP), Bone Gla protein (BGLAP), and Gla-rich protein (GRP) showed almost no response to increasing amount of vitamin K. Discussion: Here, we report a new pathogenic variant in exon 4 of GGCX c.[416G>A];[416G>A] p.(Cys139Tyr) leading to VKCFD1 with reduced clotting factor activities and non-hemorrhagic manifestations. The pre and post vitamin K supplementation factor levels in the patients correlate with the in-vitro data and demonstrate failure of the clotting factor levels to normalize despite vitamin K supplementation. The in vitro data for the non-hematological VKD proteins indicate that the patients might develop a pseudoxanthoma elasticum (PXE)-like phenotype resulting into hyperlaxity of skin due to the almost zero levels of carboxylated GRP. The skeletal/bone phenotypes can be explained by the almost zero values for carboxylated MGP and GRP. To assess this in-vivo, levels of human MGP and BGLAP are currently being analyzed in the patients and mothers blood samples. These patients highlight the nuances associated with the diagnosis and management of patients with VKCFD. The antenatal management and timing of Vitamin K supplementation to prevent intrauterine bleeding is also unknown, and there may be benefit to starting early to prevent the bone and skin manifestations. Further research is warranted in rare bleeding disorders such as VKCFD. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Skeletal and dental manifestations of Glucose-6-phosphate dehydrogenase deficiency, thalassemia, and sickle cell anemia patients in Saudi Arabia.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, Thalassemia (THL), and Sickle cell anemia (SCA) are the most common inherited hematologic diseases globally. It is important to understand the skeletal and dental manifestations in orthodontic treatment. This study aimed at assessing and comparing skeletal and dental manifestations of G6PD deficiency, THL, and SCA patients with healthy controls in Saudi Arabia. This is a retrospective study of G6PD deficient, THL, and SCA patients' cephalometric records in Saudi Arabia. This study included 136 subjects (G6PD=34, THL=34, SCA=34, and healthy control=34), aged between 18-32 years. 17 skeletal, dental, and soft tissue cephalometric measurements obtained from the G6PD, THL, and SCA were compared to control measurements using ANOVA and Tukey's HSD post-hoc test. Intra-class correlation ranged between (ICC: 0.971-0.996), indicating excellent reliability of measurements. A statistically significant difference in skeletal, dental, and soft tissue measurements between each condition and controls was observed, except for Wits, PP-MP, Y-axis, UI-SN, NLA, and LI-E line in SCA, FMA, ANS-Me, UI-SN, and LI-A Pog in G6PD and Wits, Y-axis, UI-SN, UI-NA, LI-MP, LI-Apog and UI-E line in THL group (p˃0.05). SCA and THL patients showed class II skeletal patterns, while class III skeletal relationship was evident in patients with G6PD deficiency.

Skeletal Manifestations of Sickle Cell Disease, Role of Plain Radiograph in Predicting the Diagnosis and Management

Skeletal Manifestations of Sickle Cell Disease, Role of Plain Radiograph in Predicting the Diagnosis and Management

LBODP017 Unusual Presentation Of Brown Tumors In Tertiary Hyperparathyroidism: A Case-based Review

Abstract Brown tumor (BT) is a rare non-neoplastic skeletal manifestation of untreated tertiary hyperparathyroidism (THPT) that is associated with renal osteodystrophy in patients with End-Stage Renal Disease (ESRD). Nearly half of patients with ESRD have Osteitis Fibrosa Cystica (OFC) of varying severity, which is the most common form of renal osteodystrophy. BT represents the extreme form of OFC. As a result of frequent monitoring of bone profile and the expansion of pharmacological therapy, the disease is increasingly being diagnosed in its early stages; however, some are still seen at an advanced stage. Depending on the tumor size, the management will range from a conservative approach with supportive parathyroidectomy to a comprehensive surgical removal. Here, we report a rare case of an extensive BT of the pelvis in a patient with ESRD and THPT who was also found to have coincidental papillary thyroid cancer following total thyroidectomy and parathyroidectomy with a postoperative complication of hungry bone syndrome. She then underwent prophylactic intramedullary nail fixation for an impending fracture in the right femur. This case report highlights the importance of considering BT as a differential diagnosis of lytic bone lesions and that measuring serum calcium, phosphorus, and parathyroid hormone as part of the initial evaluation is essential to identify the correct diagnosis. Multidisciplinary team approach with frequent follow-up is crucial to allow early diagnosis and prevent unnecessary surgical interventions. Presentation: No date and time listed

Generation of a human TGFB3-hIPSC line, BBANTWi010-A, from a Loeys-Dietz syndrome type V patient

Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder presenting with a variety of cardiovascular, skeletal, craniofacial and cutaneous manifestations. Aortic rupture or dissection of a thoracic aortic aneurysm (TAA) is the most life-threatening complication. We generated a an iPSC line from peripheral mononuclear blood cells of a TAA-presenting Loeys-Dietz syndrome type V patient with a causal, heterozygous variant in the TGFB3 gene (MIM* 190230, NM_003239.4:c.787G > C, p.(Asp263His)). The iPSCs present with the typical iPSC morphology, express pluripotency markers, have a normal karyotype and possess tri-lineage differentiation capability.

Clinical Presentation and Characteristics of the Upper Extremity in Patients with Musculocontractural Ehlers-Danlos Syndrome.

Musculocontractural Ehlers-Danlos syndrome (mcEDS) is a subtype of EDS caused by defective dermatan sulfate biosynthesis, characterized by multiple malformations (craniofacial features, ocular and visceral malformations) and progressive cutaneous, skeletal, vascular, and visceral fragility-related manifestations. Repeated dislocations and deformities of the joints due to joint relaxation are observed, causing serious damage to the musculoskeletal system of the whole body; however, the motor function of the upper limbs and the morphology of the bone joints have not been systematically investigated. In this study, we present a detailed and comprehensive report on upper limb lesions of 13 patients with a mean age at the first visit of 21 years. Twelve patients (92.3%) had a history of dislocation. Eleven patients (84.6%) had shoulder dislocations, and two patients (15.4%) had elbow dislocations. Four patients (30.8%) had elbow osteoarthritis, and three patients (23.1%) had distal radioulnar joint (DRUJ) osteoarthritis. The phalanges and metacarpals are thin, and the ratio of medullary cavity of the metacarpal bone decreases with age. As bone and joint deformity progresses, patients with mcEDS should be recommended to receive regular follow-up, including radiology. The present findings suggest an important role for dermatan sulfate in the maintenance of the skeletal system.

ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ ТЯЖЕЛОЙ КИФОСКОЛИОТИЧЕСКОЙ ДЕФОРМАЦИИ ПОЗВОНОЧНИКА У ДВЕНАДЦАТИЛЕТНЕЙ ПАЦИЕНТКИ С БОЛЕЗНЬЮ ГОШЕ 3-го ТИПА: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ

Gaucher disease (GD) is an autosomal recessive genetic disease characterized by the accumulation of glucocerebroside in the lysosomes of macrophages of the reticuloendothelial system with the development of cytopenia, hepatosplenomegaly, bone lesions, and, in some cases, neurological disorders. Skeletal manifestations vary in severity and usually affect long bones with clinical presentation of bone pain, bone crises, avascular necrosis, decreased bone mineral density, and pathological fractures. Involvement of the spine and chest in the form of their deformities has an unclear mechanism of development and is mostly applied in neuronopathic forms of the disease, in particular, the type 3 GD. The authors represent a unique clinical case of successful treatment of severe kyphoscoliotic deformity in an adolescent with the type 3 GD. The routine monitoring of the spine in patients with chronic neuronopathic GD is necessary in order to perform the timely surgical intervention and to prevent the progression of the spinal deformity and neurological deficit.

COVID-19 AND ITS RELATION TO ANOSMIA, AGEUSIA AND OTHER NEUROLOGICAL MANIFESTATIONS

Background: Coronavirus disease (COVID-19) is an infectious disease and highly contagious caused by a newly discovered coronavirus (SARS-CoV-2),was firstly reported in Wuhan. SARS-CoV-2belongs to the family Coronaviridae, which belongs to the order Nidovirales. It has be report that bats are the primary natural reservoir that houses a number of CoVs. Risk Factors include: Age, Gender, Diabetes, Hypertension, Cardiovascular Diseases, Malignancy.&#x0D; The Aim: of this study to review the impact this virus has on the nervous system. And to explore the neurological manifestations experienced by coronavirus disease (COVID-19) patients.&#x0D; Methods: The study was a review article. Data was collected during the period from 1– 29 September, 2021. PubMed and EBSCO Information Services were chosen as the search databases for the publications used within the study. Topics concerning the updates in types, management, and outcomes the neurological manifestations of Covid-19 cases, published in English around the world. No software was utilized to analyze the data. The data was extracted based on our specific objectives.&#x0D; Results: Myalgia, headache, altered sensorium, hyposmia, and hypogeusia were the most commonly reported neurological signs of COVID-19. COVID-19 can also cause ischemic stroke, intracerebral hemorrhage, encephalomyelitis, and acute myelitis in the central nervous system, as well as peripheral nervous system manifestations like Guillain-Barré syndrome and Bell's palsy and skeletal muscle manifestations like rhabdomyolysis in the peripheral nervous system.&#x0D; Conclusion: We conclude that neurological manifestations includingischemic strokes, hypogeusia, hyposmia represents the most evident neurological manifestations in COVID-19 patients.