Post-COVID-19 opsoclonus-myoclonus syndrome and encephalopathy associated with leucine-rich glioma-inactivated 1 (LGI-1) antibodies

Smyth, Duncan; Kyaw, Kaung Myat; Legister, Amy; MacFarlane, George; Sankar, Udayaraj Uma; Patel, Mehool; Clough, Chris; Kulendran, A; Mulroy, Eoin

doi:10.1016/j.jns.2021.119982

Cited by 12 publications

(12 citation statements)

References 14 publications

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“…These 61 articles comprised 47 on COVID-19-associated AIE, 1 case report on possible Bickerstaff encephalitis, 1 case series on both of the above subgroups, and 12 on vaccine-associated AIE. The articles included 52 case reports 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 and 9 case series. 5 6 67 68 69 70 71 72 73 Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Rare reports of antineuronal-antibody-associated AIE included two cases of CASPR2 30 71 and single reports of antimyelin, 69 LGI-1, 39 GFAP, 34 amphiphysin, 58 Yo, 69 and a novel antibody detected against mouse brain neuronal proteins 24 associated with AIE. All of the cases showed a temporal association with SARS-CoV-2 infection.…”

Section: Resultsmentioning

confidence: 99%

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AI-CoV Study: Autoimmune Encephalitis Associated With COVID-19 and Its Vaccines—A Systematic Review

et al. 2022

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Background and Purpose Autoimmune encephalitis (AIE) following coronavirus disease 2019 (COVID-19) is an underexplored condition. This study aims to systematically review the clinico-investigational and pathophysiologic aspects of COVID-19 and its vaccines in association with AIE, and identify the factors predicting neurological severity and outcomes. Methods Relevant data sources were searched using appropriate search terms on January 15, 2022. Studies meeting the criteria for AIE having a temporal association with COVID-19 or its vaccines were included. Results Out of 1,894 citations, we included 61 articles comprising 88 cases: 71 of COVID-19-associated AIE, 3 of possible Bickerstaff encephalitis, and 14 of vaccine-associated AIE.There were 23 definite and 48 possible seronegative AIE cases. Anti-NMDAR (N-methyl-D-aspartate receptor; n =12, 16.9%) was the most common definite AIE. Males were more commonly affected (sex ratio=1.63) in the AIE subgroup. The neurological symptoms included alteredmental state ( n =53, 74.6%), movement disorders ( n =28, 39.4%), seizures ( n =24, 33.8%), behavioural ( n =25, 35.2%), and speech disturbances ( n =17, 23.9%). The median latency to AIE diagnosis was 14 days (interquartile range=4–22 days). Female sex and ICU admission had higherrisks of sequelae, with odds ratio (OR) of 2.925 (95% confidence interval [CI]=1.005–8.516)and 3.515 (95% CI=1.160–10.650), respectively. Good immunotherapy response was seen in42/48 (87.5%) and 13/13 (100%) of COVID-19-associated and vaccine-associated AIE patients, respectively. Sequelae were reported in 22/60 (36.7%) COVID-19 associated and 10/13 (76.9%) vaccine-associated cases. Conclusions The study has revealed diagnostic, therapeutic, and pathophysiological aspects of AIE associated with COVID-19 and its vaccines, and its differences from postinfectious AIE. Systematic review registration PROSPERO registration number CRD42021299215

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

AI-CoV Study: Autoimmune Encephalitis Associated With COVID-19 and Its Vaccines—A Systematic Review

et al. 2022

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“…Two further cases were reported in association with ataxia and myoclonus and resolved after corticosteroids with or without IVIg [86–88], while another case presented with ataxia and confusion but no myoclonus, and unfortunately succumbed to his disease [89]. Multiple additional cases have since been reported [88,90 ▪ ,91–98]. Given the observed latencies and the known postinfectious causes of OMAS, it is likely that a postinfectious cerebellitis is responsible for the post-COVID entity as well.…”

Section: Coronavirus Disease 2019 Opsoclonus Syndromementioning

confidence: 97%

Efferent neuro-ophthalmic complications of coronavirus disease 2019

Dinkin

Sathi

2022

Current Opinion in Ophthalmology

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Purpose of reviewWe set out to describe efferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe syndromes affecting ocular motility and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, COVID-19 continues to pose an international threat that may rarely result in diplopia or nystagmus.Recent findingsEfferent complications include cranial nerve palsies leading to diplopia, either isolated or in association with Miller Fisher syndrome. Nystagmus has been observed in the setting of hemorrhagic acute necrotizing encephalopathy and brainstem infarcts, and opsoclonus syndrome has been described.SummaryObserved neuro-ophthalmic associations need to be confirmed through larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.

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“…Lumbar puncture was not performed in eight cases.SARS-CoV-2 RT-PCR in the CSF was negative in all tested cases. In three reports, autoantibodies were identified: against glial fibrillary acidic protein (GFAP) [16], leucine-rich glioma-inactivated 1 (LGI-1) [29], and glutamic acid decarboxylase (anti-GAD) [22]. Another study described a patient with post-COVID-19 ataxia-myoclonus syndrome in whom autoantibodies directed against Purkinje cells of the cerebellum, striatal and hippocampal neurons were identified by nerve tissue immunostaining with serum and CSF [13].…”

Section: Ataxia/myoclonus/opsoclonus Syndromementioning

confidence: 99%

Hyperkinetic movement disorders following SARS-CoV-2 infection and vaccination — an update

Przytuła¹,

Sławek

2023

Neurol Neurochir Pol.

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The aim of this review was to summarise current knowledge regarding hyperkinetic movement disorders related to SARS-CoV-2 infection and vaccination in terms of phenomenology, epidemiology, pathogenesis and treatment. After a thorough review of the PubMed and Google Scholar databases (2020-2022), we identified myoclonus and ataxia sometimes accompanied by opsoclonus (AMS) as the two most frequent COVID-19 sequelae, with chorea, tremor and dystonia being very rare. The pathogenesis seems to be variable, but in the majority of AMS cases it was autoimmunological, with good response and recovery after corticosteroids or intravenous immunoglobulins infusions. Vaccination may be complicated by hyperkinetic movement disorders (e.g. tremor, dystonia), but this is very rare. Patients with Deep Brain Simulation depletion should not be postponed due to lockdowns as this may result in fatal outcomes.

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Post-COVID-19 opsoclonus-myoclonus syndrome and encephalopathy associated with leucine-rich glioma-inactivated 1 (LGI-1) antibodies

Cited by 12 publications

References 14 publications

AI-CoV Study: Autoimmune Encephalitis Associated With COVID-19 and Its Vaccines—A Systematic Review

AI-CoV Study: Autoimmune Encephalitis Associated With COVID-19 and Its Vaccines—A Systematic Review

Efferent neuro-ophthalmic complications of coronavirus disease 2019

Hyperkinetic movement disorders following SARS-CoV-2 infection and vaccination — an update

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