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Neurological Complications during Treatment of Middle East Respiratory Syndrome.
J Clin Neurol. 2017 Jul; 13(3):227-233.JC

Abstract

BACKGROUND AND PURPOSE

Middle East respiratory syndrome (MERS) has a high mortality rate and pandemic potential. However, the neurological manifestations of MERS have rarely been reported since it first emerged in 2012.

METHODS

We evaluated four patients with laboratory-confirmed MERS coronavirus (CoV) infections who showed neurological complications during MERS treatment. These 4 patients were from a cohort of 23 patients who were treated at a single designated hospital during the 2015 outbreak in the Republic of Korea. The clinical presentations, laboratory findings, and prognoses are described.

RESULTS

Four of the 23 admitted MERS patients reported neurological symptoms during or after MERS-CoV treatment. The potential diagnoses in these four cases included Bickerstaff's encephalitis overlapping with Guillain-Barré syndrome, intensive-care-unit-acquired weakness, or other toxic or infectious neuropathies. Neurological complications did not appear concomitantly with respiratory symptoms, instead being delayed by 2-3 weeks.

CONCLUSIONS

Neuromuscular complications are not rare during MERS treatment, and they may have previously been underdiagnosed. Understanding the neurological manifestations is important in an infectious disease such as MERS, because these symptoms are rarely evaluated thoroughly during treatment, and they may interfere with the prognosis or require treatment modification.

Authors+Show Affiliations

Department of Neurology, Seoul Medical Center, Seoul, Korea. junenr@gmail.com.Department of Neurology, Seoul Medical Center, Seoul, Korea.Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.Department of Neurology, Seoul Medical Center, Seoul, Korea.Department of Neurology, Seoul Medical Center, Seoul, Korea.Department of Neurology, Seoul Medical Center, Seoul, Korea.Department of Neurology, Seoul Medical Center, Seoul, Korea.Division of Infectious Diseases, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea. dasole@hanmail.net.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28748673

Citation

Kim, Jee Eun, et al. "Neurological Complications During Treatment of Middle East Respiratory Syndrome." Journal of Clinical Neurology (Seoul, Korea), vol. 13, no. 3, 2017, pp. 227-233.
Kim JE, Heo JH, Kim HO, et al. Neurological Complications during Treatment of Middle East Respiratory Syndrome. J Clin Neurol. 2017;13(3):227-233.
Kim, J. E., Heo, J. H., Kim, H. O., Song, S. H., Park, S. S., Park, T. H., Ahn, J. Y., Kim, M. K., & Choi, J. P. (2017). Neurological Complications during Treatment of Middle East Respiratory Syndrome. Journal of Clinical Neurology (Seoul, Korea), 13(3), 227-233. https://doi.org/10.3988/jcn.2017.13.3.227
Kim JE, et al. Neurological Complications During Treatment of Middle East Respiratory Syndrome. J Clin Neurol. 2017;13(3):227-233. PubMed PMID: 28748673.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurological Complications during Treatment of Middle East Respiratory Syndrome. AU - Kim,Jee Eun, AU - Heo,Jae Hyeok, AU - Kim,Hye Ok, AU - Song,Sook Hee, AU - Park,Sang Soon, AU - Park,Tai Hwan, AU - Ahn,Jin Young, AU - Kim,Min Ky, AU - Choi,Jae Phil, PY - 2017/02/15/received PY - 2017/05/16/revised PY - 2017/05/18/accepted PY - 2017/7/28/entrez PY - 2017/7/28/pubmed PY - 2017/7/28/medline KW - Guillain-Barré syndrome KW - Middle East respiratory syndrome KW - neurological complications KW - peripheral neuropathy SP - 227 EP - 233 JF - Journal of clinical neurology (Seoul, Korea) JO - J Clin Neurol VL - 13 IS - 3 N2 - BACKGROUND AND PURPOSE: Middle East respiratory syndrome (MERS) has a high mortality rate and pandemic potential. However, the neurological manifestations of MERS have rarely been reported since it first emerged in 2012. METHODS: We evaluated four patients with laboratory-confirmed MERS coronavirus (CoV) infections who showed neurological complications during MERS treatment. These 4 patients were from a cohort of 23 patients who were treated at a single designated hospital during the 2015 outbreak in the Republic of Korea. The clinical presentations, laboratory findings, and prognoses are described. RESULTS: Four of the 23 admitted MERS patients reported neurological symptoms during or after MERS-CoV treatment. The potential diagnoses in these four cases included Bickerstaff's encephalitis overlapping with Guillain-Barré syndrome, intensive-care-unit-acquired weakness, or other toxic or infectious neuropathies. Neurological complications did not appear concomitantly with respiratory symptoms, instead being delayed by 2-3 weeks. CONCLUSIONS: Neuromuscular complications are not rare during MERS treatment, and they may have previously been underdiagnosed. Understanding the neurological manifestations is important in an infectious disease such as MERS, because these symptoms are rarely evaluated thoroughly during treatment, and they may interfere with the prognosis or require treatment modification. SN - 1738-6586 UR - https://www.unboundmedicine.com/medline/citation/28748673/full_citation L2 - https://thejcn.com/DOIx.php?id=10.3988/jcn.2017.13.3.227 DB - PRIME DP - Unbound Medicine ER -
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