DOCSLIB.ORG

Significance and Associated Factors of Long-Term Sequelae in Patients After Acute COVID-19 Infection in Korea

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Significance and Associated Factors of Long-Term Sequelae in Patients After Acute COVID-19 Infection in Korea Infect Chemother. 2021 Sep;53(3):463-476 https://doi.org/10.3947/ic.2021.0022 pISSN 2093-2340·eISSN 2092-6448 Original Article Significance and Associated Factors of Long-Term Sequelae in Patients after Acute COVID-19 Infection in Korea Yoonjung Kim , Shin-Woo Kim , Hyun-Ha Chang , Ki Tae Kwon , Sohyun Bae , and Soyoon Hwang Division of Infectious Disease, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea Received: Mar 2, 2021 Accepted: Jul 5, 2021 ABSTRACT Corresponding Author: Background: As the coronavirus disease 2019 (COVID-19) pandemic has progressed, there Shin-Woo Kim, MD, PhD has been a growing awareness of the long-term impacts of the COVID-19 infection. However, Department of Internal Medicine, Kyungpook until recently, there was no published study that investigated COVID-19-related sequelae and National University School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu 41944, Korea. related factors for greater than six months from the onset of COVID-19 symptoms or the time Tel: +82-53-200-6525 of COVID-19 diagnosis in Korea. Fax: +82-53-424-5542 Materials and Methods: Online survey and statistical analysis were conducted by Kyungpook E-mail: [email protected] National University Hospital on 5,252 patients diagnosed as COVID-19 between February 18, Copyright © 2021 by The Korean Society 2020 and March 14, 2020. Responders aged between 16 and 70 years were included. Long- of Infectious Diseases, Korean Society for term sequelae were defined as persistent symptoms or signs ≥ 6 months after acute COVID-19 Antimicrobial Therapy, and The Korean Society infection. The survey was conducted from September 8, 2020 to September 10, 2020. for AIDS Clinical characteristics and self-reported clinical sequelae of the responders were analyzed This is an Open Access article distributed to investigate the prevalence and factors associated with sequelae using descriptive and under the terms of the Creative Commons multivariate logistic regression analysis. Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0/) Results: The median period from the date of the first symptom onset or COVID-19 diagnosis to which permits unrestricted non-commercial the time of the survey was 195 (interquartile range [IQR] 191 - 200) days. The response rate was use, distribution, and reproduction in any 17.1% (900 out of 5,252). The median age was 31 (IQR 24.0 - 47.0) years old, and 627 responders medium, provided the original work is properly were female (69.7%). Regarding the disease severity, 29 (3.2%) were asymptomatic, 763 cited. (84.8%) mild, 86 (9.6%) moderate, 17 (1.9%) severe, and 5 (0.6%) critical. In total, 591 (65.7%) ORCID iDs responders suffered from COVID-19-related long-term sequelae and 78 (8.6%) responders were Yoonjung Kim receiving outpatient treatment for COVID-19-related long-term sequelae. The most common https://orcid.org/0000-0002-7454-4014 symptoms identified during the isolation period were anosmia and ageusia at 44.5% and Shin-Woo Kim 43.5%, respectively. Fatigue was the most common long-term sequelae, accounting for 253 https://orcid.org/0000-0002-3755-8249 (26.2%) responders, followed by concentration difficulty, amnesia, cognitive dysfunction, Hyun-Ha Chang https://orcid.org/0000-0002-9405-2121 anxiety, and depression, which accounted for over 20%. Female gender was identified as the Ki Tae Kwon factor associated with mental and psychological long-term sequelae (P <0.05). https://orcid.org/0000-0003-4666-0672 Conclusion: The results showed that the rate of COVID-19-related long-term sequelae Sohyun Bae was 65.7%. The most common long-term sequela was fatigue. The risk factor identified https://orcid.org/0000-0002-0206-7108 was female gender. It was found that the long-term sequelae had various manifestations, Soyoon Hwang https://orcid.org/0000-0003-3618-174X including mental and psychological aspects. To improve the care of COVID-19 recovered patients with COVID-19-related long-term sequelae, the participation of a comprehensive and an interdisciplinary group of researchers is required. Keywords: COVID-19; SARS-CoV-2; Sequelae; Long-term consequences; Clinical sequelae https://icjournal.org 463 Long-term sequelae in patients after COVID-19 Funding INTRODUCTION This work was supported by the Research Program funded by the Korea Centers for With the progression of the novel coronavirus disease 2019 (COVID-19) pandemic, there Disease Control and Prevention (fund code 2020-ER5334-00) has been a growing awareness about the long-term impacts of COVID-19 infection, including cardiac, neurological, metabolic, and respiratory long-term sequelae. The Conflicts of interest clinical characteristics, treatment, and prognosis of patients who recovered from COVID-19 No conflicts of interest. infection have been extensively studied [1-3]; however, to our knowledge, there are limited Author Contributions studies on the prevalence, nature, duration, and factors related to sequelae in convalescent Conceptualization: YJK, SWK. Data curation: COVID-19 patients. YJK, SWK. Investigation: YJK, SB, SH, KTK, HHC, SWK. Supervision: SWK. Writing - Increasing evidence suggests that COVID-19 patients can experience long-lasting symptoms original draft: YJK, SWK. Writing - review & [4, 5], irrespective of the severity of the initial infection. Hence, detailed studies on COVID-19 editing: SB, SH, KTK, HHC, SWK. disease severity are required to establish the optimal management of such individuals. We know from the previous studies that severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) from previous coronavirus epidemics were associated with a significant psychiatric burden in the acute and postillness stages. In SARS and MERS, after recovery from the infection, fatigue, sleep disorder, and impaired concentration and memory were reported in more than 15% of patients at a follow-up period ranging between 6 weeks and 39 months [6-8]. It is identified that individuals with COVID-19 experience psychiatric symptoms persisting months after the initial infection [9]. In particular, significant psychological symptoms, such as depression and anxiety, were reported in up to 40% of patients following COVID-19, similar to patients with previous coronavirus infections [10, 11]. However, few studies have investigated the psychological sequelae [12] and associated factors in recovered COVID-19 patients. Furthermore, because COVID-19 is a new disease, much about the clinical course, including the long-term sequelae, remains uncertain. Daegu is a city with a population of 2.4 million and is the first city in Korea to experience a severe COVID-19 outbreak that affected > 5,000 COVID-19 patients in early 2020. Hence, a large number of patients were cured and recovered from COVID-19 infection, and the follow- up duration for COVID-19 survivors from the Korea was longer than that of patients from other countries around the world. To our knowledge, no study has assessed the COVID-19-related sequelae in Korea. Therefore, we investigated the sequelae in Korean patients to determine whether multiple relevant symptoms subsided after recovering from the COVID-19 infection, and to identify the factors related to the occurrence and persistence of long-term symptoms. MATERIALS AND METHODS 1. Study design and population Google online survey with information of the researcher’s name and analyses were conducted by infectious disease physicians at the Kyungpook National University Hospital located in Daegu city. Among patients who were diagnosed with COVID-19 between February 18, 2020 and March 14, 2020, 5,252 recovered patients aged between 16 and 70 years were identified from the clinical data registry provided by the Daegu Center for Infectious Diseases Control and Prevention. The survey duration was 3 days and the survey period was from September 8, 2020 to September 10, 2020. https://icjournal.org https://doi.org/10.3947/ic.2021.0022 464 Long-term sequelae in patients after COVID-19 The questionnaire survey list included sex, birth year, birth date, residential address, COVID-19 diagnosis date, symptom onset date, health-care utilization during and after the infection, quarantine end date, oxygen treatment history, symptoms during the quarantine period with the option of an open text field to add other symptoms, symptoms that persisted beyond the quarantine period, newly diagnosed diseases after COVID-19, exacerbation of underlying diseases after COVID-19, undergoing outpatient treatment for COVID-19-related sequelae, and wanting to connect for medical treatment of sequelae. Symptoms during the isolation period from acute COVID-19 included fever (≥37.5°C), febrile sense, myalgia, arthralgia, chilly sense, fatigue, cough, sore throat, nasal congestion or rhinorrhea, sputum, dyspnea, chest discomfort, chest tightness, palpitation, arrhythmia, headache, depression, anxiety, nausea or vomiting, diarrhea, gastrointestinal discomfort, anosmia, ageusia (loss of taste), and hypoacusis. The sequelae were categorized into 45 symptoms and signs and included fever (≥37.5°C), febrile sense, myalgia, arthralgia, chilly sense, fatigue, cough, sore throat, nasal congestion or rhinorrhea, sputum, dyspnea, chest discomfort, chest tightness, palpitation, arrhythmia, headache, brain fog, cognitive dysfunction, concentration difficulty, amnesia, dizziness, abnormal directional sensibility, insomnia including poor sleep quality, hyperemia, hallucination, seizure, depression, anxiety, social phobia,
Load more

Recommended publications
  • Second Edition
    COVID-19 Evidence Update COVID-19 Update from SAHMRI, Health Translation SA and the Commission on Excellence and Innovation in Health Updated 4 May 2020 – 2nd Edition “What is the prevalence, positive predictive value, negative predictive value, sensitivity and specificity of anosmia in the diagnosis of COVID-19?” Executive Summary There is widespread reporting of a potential link between anosmia (loss of smell) and ageusia (loss of taste) and SARS-COV-2 infection, as an early sign and with sudden onset predominantly without nasal obstruction. There are calls for anosmia and ageusia to be recognised as symptoms for COVID-19. Since the 1st edition of this briefing (25 March 2020), there has been a significant expansion of literature on this topic, including 3 systematic reviews. Predictive value: The reported prevalence of anosmia/hyposmia and ageusia/hypogeusia in SARS-COV-2 positive patients are in the order of 36-68% and 33-71% respectively. There are reports of anosmia as the first symptom in some patients. Estimates from one study for hyposmia and hypogeusia: • Positive likelihood ratios: 4.5 and 5.8 • Sensitivity: 46% and 62% • Specificity: 90% and 89% The US Centres for Disease Control and Prevention (CDC) has added new loss or taste or smell to its list of recognised symptoms for SARS-COV-2 infection. To date, the World Health Organization has not. Conclusion: There is sufficient evidence to warrant adding loss of taste and smell to the list of symptoms for COVID-19 and promoting this information to the public. Context • Early detection of COVID-19 is key to the ongoing management of the pandemic.
    [Show full text]
  • Unifying the Motor & Non-Motor Features of Parkinson's Disease
    Unifying the Motor & Non-motor Features of Parkinson’s Disease Ali Shalash Professor of Neurology Chair of Ain Shams Movement Disorders Group Department of Neurology, Ain Shams Univeristy Cairo, Egypt AGENDA 1. Motor and non-motor Symptoms 2. Pathophysiology of Motor & NMS 3. Relation To Disease Course 4. NMS in motor subtypes 5. Motor & NMS fluctuation 6. Treatment of Motor & NMS: links Parkinson’s Disease • PD prevalence 1 % of populations older than 65 years (Abbas et al., 2018) • From 1990 to 2015, the number of with PD patients doubled to over 6 million, and double again to over 12 million by 2040 (Dorsey et al, 2018) • Aging populations, increasing longevity, decreasing smoking rates, and the by- products of industrialization MDS Clinical Diagnostic Criteria for PD Postuma et al 2015 MDS Clinical Diagnostic Criteria for PD Postuma et al 2015 Non-motor Symptoms of PD • Neuropsychiatric symptoms • Autonomic dysfunction • Depression up to 50-70 % • Drooling • Anxiety up to 60 % • Orthostatic hypotension 30–58% • Apathy 60 % • Urinary dysfunction • Psychosis up to 40% • Erectile dysfunction • Impulse control and related disorders • Gastrointestinal dysfunction 25–67% • Dementia, 24% to 40%. • Excessive sweating • Cognitive impairment 20-25% (other • Others than dementia mainly mild cognitive impairment) • Pain 30–85% • Fatigue 50% • Disorders of sleep and wakefulness • Olfactory dysfunction 90% • • Sleep fragmentation and insomnia Ophthalmologic dysfunction • Rapid eye movement sleep behavior disorder 65 % • Excessive daytime sleepiness Pathophysiology of Motor & NMS Neuropathology of PD: Motor Symptoms Two major pathologic processes: (a) premature selective loss of dopamine neurons: 30–70% cell loss ⇢ motor symptoms. (b) the accumulation of Lewy bodies, composed of α-synuclein Poewe, W.
    [Show full text]
  • COVID-19 Psychosis: a Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response?
    Journal Articles 2020 COVID-19 Psychosis: A Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response? S. J. Ferrando L. Klepacz Northwell Health, [email protected] S. Lynch M. Tavakkoli R. Dornbush See next page for additional authors Follow this and additional works at: https://academicworks.medicine.hofstra.edu/articles Part of the Psychiatry Commons Recommended Citation Ferrando SJ, Klepacz L, Lynch S, Tavakkoli M, Dornbush R, Baharani R, Smolin Y, Bartell A. COVID-19 Psychosis: A Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response?. 2020 Jan 01; 61(5):Article 6623 [ p.]. Available from: https://academicworks.medicine.hofstra.edu/articles/6623. Free full text article. This Article is brought to you for free and open access by Donald and Barbara Zucker School of Medicine Academic Works. It has been accepted for inclusion in Journal Articles by an authorized administrator of Donald and Barbara Zucker School of Medicine Academic Works. For more information, please contact [email protected]. Authors S. J. Ferrando, L. Klepacz, S. Lynch, M. Tavakkoli, R. Dornbush, R. Baharani, Y. Smolin, and A. Bartell This article is available at Donald and Barbara Zucker School of Medicine Academic Works: https://academicworks.medicine.hofstra.edu/articles/6623 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID- 19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source.
    [Show full text]
  • Abadie's Sign Abadie's Sign Is the Absence Or Diminution of Pain Sensation When Exerting Deep Pressure on the Achilles Tendo
    A.qxd 9/29/05 04:02 PM Page 1 A Abadie’s Sign Abadie’s sign is the absence or diminution of pain sensation when exerting deep pressure on the Achilles tendon by squeezing. This is a frequent finding in the tabes dorsalis variant of neurosyphilis (i.e., with dorsal column disease). Cross References Argyll Robertson pupil Abdominal Paradox - see PARADOXICAL BREATHING Abdominal Reflexes Both superficial and deep abdominal reflexes are described, of which the superficial (cutaneous) reflexes are the more commonly tested in clinical practice. A wooden stick or pin is used to scratch the abdomi- nal wall, from the flank to the midline, parallel to the line of the der- matomal strips, in upper (supraumbilical), middle (umbilical), and lower (infraumbilical) areas. The maneuver is best performed at the end of expiration when the abdominal muscles are relaxed, since the reflexes may be lost with muscle tensing; to avoid this, patients should lie supine with their arms by their sides. Superficial abdominal reflexes are lost in a number of circum- stances: normal old age obesity after abdominal surgery after multiple pregnancies in acute abdominal disorders (Rosenbach’s sign). However, absence of all superficial abdominal reflexes may be of localizing value for corticospinal pathway damage (upper motor neu- rone lesions) above T6. Lesions at or below T10 lead to selective loss of the lower reflexes with the upper and middle reflexes intact, in which case Beevor’s sign may also be present. All abdominal reflexes are preserved with lesions below T12. Abdominal reflexes are said to be lost early in multiple sclerosis, but late in motor neurone disease, an observation of possible clinical use, particularly when differentiating the primary lateral sclerosis vari- ant of motor neurone disease from multiple sclerosis.
    [Show full text]
  • Timeline and Outcome of Anosmia and Ageusia Associated with Covid-19 Infection: a Case Report
    Crimson Publishers Case Report Wings to the Research Timeline and Outcome of Anosmia and Ageusia Associated with Covid-19 Infection: A Case Report Viviane Flumignan Z1*, Cristina Scavasine V1, Ghizoni Teive HA1, Branco Germiniani FM1, Azevedo VF2, Paulo Roberto Z3 and Camargo Rogenski CAM4 1Neurology division, Brazil ISSN: 2639-0531 2Rheumatology division, Brazil 3Occupational medicine division, Brazil 4Othorrinolaringology division, Brazil Abstract Background: Viral respiratory diseases can present with ageusia (hypogeusia) and anosmia (hyposmia) due to viral neurotropism, usually manifest together with other symptoms in the acute phase neurologicand have in manifestations most instances do both not aprovide good and information short recovery. about Duringneither the the epidemic timeline, periodnor the of outcome COVID-19, of thesedoctors symptoms should consider in this scenario. SARS-CoV-2 infection as a differential diagnosis. Recent series reporting these Patient’s concerns: *Corresponding author: onset of fever, followed by A dry54-year-old cough on female the second physician day, andwith on well-controlled the 4th day the diabetes, patient hypertensionnoticed a sudden and gnan Z, Department of vascular neurolo arrhythmia who presented with an acute respiratory syndrome with influenza symptoms, with sudden gy, Brazil Viviane Flumi- - and total loss of smell and taste sensations. After 20 days, she noticed a mild return of flavor perception, Submission: mainly for spicy foods, but still complained of hyposmia and dysgeusia until the end of this report (30 Diagnoses: Published: days after the onset of neuropathic symptoms). April 28, 2020 COVID 19 associated with anosmia and ageusia induced by viral respiratory disease May 12, 2020 inflammation.Intervention: Outcomes: HowVolume to 2 - Issuecite 4this article: cyanocobalamin supplementation to 9,000 micrograms per day.
    [Show full text]
  • Ageusia and Anosmia, a Common Sign of COVID-19? a Case Series from Four Countries
    Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 20 May 2020 doi:10.20944/preprints202005.0327.v1 Peer-reviewed version available at J. Neurovirol. 2020; doi:10.1007/s13365-020-00875-8 1 Ageusia and anosmia, a common sign of COVID-19? A case series from four countries Jair Vargas-Gandica,1,2 Daniel Winter,1 Rainer Schnippe,1 Andrea G. Rodriguez- Morales,2,3 Johana Mondragon,2 Juan Pablo Escalera-Antezana,2,4,5 María del Pilar Trelles-Thorne,6 D. Katterine Bonilla-Aldana,2,7,8 Alfonso J. Rodriguez-Morales,2,5,8,9,10,* Alberto Paniz-Mondolfi.2,6,10,11,12,13 1Klinik für Allgemeine Innere Medizin, Sankt Vinzenz Hospital, Rheda-Wiedenbrück, Germany. 2Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19), Pereira, Risaralda, Colombia. 3Unidad Procedimientos, Policlínico Neurología, Centro de Referencia de Salud Dr. Salvador Allende Gossens, Santiago de Chile, Chile. 4National Telehealth Program, Ministry of Health, La Paz, Bolivia. 5Universidad Privada Franz Tamayo/UNIFRANZ, Cochabamba, Bolivia. 6Icahn School of Medicine at Mount Sinai, New York, USA. 7Semillero de Zoonosis, Grupo de Investigación BIOECOS, Fundación Universitaria Autónoma de las Américas, Sede Pereira, Pereira, Risaralda, Colombia. 8Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Risaralda, Colombia. 9Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia. 10Committee on Travel Medicine, Pan-American Infectious Diseases Association, Asuncion, Paraguay. 11Laboratorio de Señalización Celular y Bioquímica de Parásitos, Instituto de Estudios Avanzados (IDEA), Caracas, Caracas, Venezuela. 12Academia Nacional de Medicina, Caracas, Venezuela. 13Instituto de Investigaciones Biomedicas IDB / Incubadora Venezolana de la Ciencia, Cabudare, Edo.
    [Show full text]
  • Alteration, Reduction and Taste Loss: Main Causes and Potential Implications on Dietary Habits
    nutrients Review Alteration, Reduction and Taste Loss: Main Causes and Potential Implications on Dietary Habits Davide Risso 1,* , Dennis Drayna 2 and Gabriella Morini 3 1 Ferrero Group, Soremartec Italia Srl, 12051 Alba, CN, Italy 2 National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, MD 20892, USA; [email protected] 3 University of Gastronomic Sciences, Piazza Vittorio Emanuele 9, Bra, 12042 Pollenzo, CN, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-0173-313214 Received: 3 September 2020; Accepted: 23 October 2020; Published: 27 October 2020 Abstract: Our sense of taste arises from the sensory information generated after compounds in the oral cavity and oropharynx activate taste receptor cells situated on taste buds. This produces the perception of sweet, bitter, salty, sour, or umami stimuli, depending on the chemical nature of the tastant. Taste impairments (dysgeusia) are alterations of this normal gustatory functioning that may result in complete taste losses (ageusia), partial reductions (hypogeusia), or over-acuteness of the sense of taste (hypergeusia). Taste impairments are not life-threatening conditions, but they can cause sufficient discomfort and lead to appetite loss and changes in eating habits, with possible effects on health. Determinants of such alterations are multiple and consist of both genetic and environmental factors, including aging, exposure to chemicals, drugs, trauma, high alcohol consumption, cigarette smoking, poor oral health, malnutrition, and viral upper respiratory infections including influenza. Disturbances or loss of smell, taste, and chemesthesis have also emerged as predominant neurological symptoms of infection by the recent Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus strain 2 (SARS-CoV-2), as well as by previous both endemic and pandemic coronaviruses such as Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and SARS-CoV.
    [Show full text]
  • 01/02/2018 Simvastatin and Taste Disorders Introduction
    Simvastatin and taste disorders Introduction Simvastatin (Zocor®) is a HMG-CoA reductase inhibitor. HMG-CoA-reductase inhibitors (statins) are competitive inhibitors of 3-hydroxy-3methylglutargyl coenzyme-A reductase, which play a role in the synthesis of cholesterol. Statins are widely used in primary and secondary prevention of cardiovascular diseases because of their effects on both the total cholesterol level and the LDL cholesterol level [1]. Simvastatin is indicated for hypercholesterolaemia and for prevention of cardiovascular mortality and morbidity [2]. Taste and smell are critical components of a person's overall sense of well-being and quality of life. [3]. Various drugs have been reported to alter the ability to taste and smell. Drug-induced taste disorders are classified into several subtypes. Taste disorders can be described as ageusia (complete loss of taste), hypogeusia (diminished sense of taste) or hypergeusia (enhanced gustatory sensitivity). Dysgeusia is a qualitative gustatory disturbance relating to a distorted taste perception or to a persistent taste sensation in the absence of stimulation. Frequently, gustatory stimuli are reported to be different from what they used to be; they are perceived as bitter, sour, or metallic [4]. Neurological Review ]. From the smell disorders anosmia describes the lack of ability to smell, hyposmia refers to a reduced ability to smell and hyperosmia to an enhanced ability to smell [3]. Dysosmia and parosmia are synonyms for distortion or perversion in the perception of an odorant; an unpleasant perception may occur when a normally pleasant odor is present, or the perception may occur when no odorant is present (olfactory hallucination) [5]. In July 2004, the Netherlands Pharmacovigilance Centre Lareb previously described a signal of dysgeusia associated with HMG-CoA-reductase inhibitors [6].
    [Show full text]
  • A Dictionary of Neurological Signs.Pdf
    A DICTIONARY OF NEUROLOGICAL SIGNS THIRD EDITION A DICTIONARY OF NEUROLOGICAL SIGNS THIRD EDITION A.J. LARNER MA, MD, MRCP (UK), DHMSA Consultant Neurologist Walton Centre for Neurology and Neurosurgery, Liverpool Honorary Lecturer in Neuroscience, University of Liverpool Society of Apothecaries’ Honorary Lecturer in the History of Medicine, University of Liverpool Liverpool, U.K. 123 Andrew J. Larner MA MD MRCP (UK) DHMSA Walton Centre for Neurology & Neurosurgery Lower Lane L9 7LJ Liverpool, UK ISBN 978-1-4419-7094-7 e-ISBN 978-1-4419-7095-4 DOI 10.1007/978-1-4419-7095-4 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2010937226 © Springer Science+Business Media, LLC 2001, 2006, 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made.
    [Show full text]
  • Neurology of Nutritional Deficiencies
    Current Neurology and Neuroscience Reports (2019) 19:101 https://doi.org/10.1007/s11910-019-1011-2 NEUROLOGY OF SYSTEMIC DISEASES (J BILLER, SECTION EDITOR) Neurology of Nutritional Deficiencies Kristin L. Miller1 & Gabriela Trifan1 & Fernando D. Testai1 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Purpose of Review The goal of this chapter is to educate clinicians on the neurologic manifestations of certain nutritional deficiencies in order to promptly identify and appropriately treat these patients. Recent Findings Many vitamin and nutritional deficiencies have been described dating back to the early days of neurology and medicine. Some are very rare and thus, there are no randomized controlled studies to assess supplementation or dosage; however, there are reviews of case reports that can assist clinicians in choosing treatments. Summary While endemic vitamin and nutritional deficiencies may be rarely encountered in many countries, vulnerable popu- lations continue to be at risk for developing neurologic complications. These populations include those with diseases causing malabsorption, the elderly, chronic alcohol users, as well as pregnant mothers with hyperemesis gravidarum to name a few. It is important to recognize syndromes associated with these nutritional deficiencies, as prompt identification and treatment may prevent permanent neurologic damage. Keywords Vitamin deficiency . B vitamin deficiency . Neurologic symptoms of vitamin deficiencies . Malabsorption vitamin deficiency . Nutritional deficiency Introduction Vitamin B1 (Thiamine) Deficiency A functional nervous system requires an adequate and consis- Background tent supply of appropriate nutrients. Worldwide, up to 820 million people are undernourished per the 2019 report by the Thiamine, also known as vitamin B1 or aneurin, is an essential Food and Agriculture Organization of the United Nations [1•].
    [Show full text]
  • 124 Epochs of Anosmia and Ageusia in Multiple Sclerosis
    78 ABSTRACTS 2 Director, Head of Corporate Medical Affairs, H. 29.0 for patients with anxious distress in the adjunctive Lundbeck A/S, Valby, Denmark brexpiprazole (n = 462) group and 29.1 in the placebo 3 Director, Global Medical Affairs, Otsuka (n = 327) group; while those with anxious depression Pharmaceutical Development & Commercialization, were 28.9 (brexpiprazole; n = 384) and 28.6 (placebo; Inc., Princeton, NJ, USA n = 282). Compared to those receiving placebo, patients 4 Senior Director, Biostatistics, Otsuka Pharmaceutical with both anxious distress and anxious depression who Development & Commercialization, Inc., Princeton, received adjunctive brexpiprazole showed a greater NJ, USA 5 Senior Director, Global Medical Affairs, Otsuka improvement in MADRS total score (LS mean difference = = Pharmaceutical Development & Commercialization, -2.38, p 0.0001 and -1.68, p 0.012, respectively). Inc., Princeton, NJ, USA These improvements, compared to placebo, were similar to those in patients who had not met the criteria for ABSTRACT: Study objectives: Symptoms of anxiety are anxious distress (-1.40, p = 0.023) or anxious depression prevalent in Major Depressive Disorder (MDD) and are (-2.17, p < 0.001). associated with greater illness severity, suicidality, impaired functioning and poor response to antidepres- CONCLUSION: Adjunctive brexpiprazole may be effica- sant treatment (ADT). In MDD, anxiety symptoms can be cious in reducing depressive symptoms both in patients assessed as ‘anxious distress’ (new DSM-5 specifier) or with or without symptoms of anxiety. ‘anxious depression’ (score ≥7 on the HAM-D anxiety/ FUNDING ACKNOWLEDGEMENTS: The studies were funded somatization factor). Brexpiprazole is a serotonin– by H. Lundbeck A/S and Otsuka Pharmaceutical Devel- dopamine activity modulator that is a partial agonist at opment & Commercialization, Inc.
    [Show full text]
  • Glossary of Terms for Acquire Brain Injury (ABI)
    Health Alerts: Measles (3) Home > Acquired Brain Injury Outreach Service (ABIOS) > Glossary of Terms for Acquire Brain Injury (ABI) | A1 | B2 | C3 | D4 | E5 | F6 | G7 | H8 | I J9 | K L M10 | N O11 | P Q12 | R13 | S14 | T15 | U V W16 | Absence seizure Short period of unconsciousness, characterised by cessation of voluntary motor activity, and amnesia of the event. See epilepsy and petit mal. Abstract reasoningProcess of reaching conclusions associations or generalisations rather than concrete, factual information. Abstract thinkingConcepts that are not concrete or are difficult to understand. Being able to apply abstract concepts to new situations and surroundings. The person living with an ABI may be unable to perform abstract thinking. AbuliaAbsence or inability to exercise will power or to make decisions. Also, slow reaction, lack of spontaneity, and brief spoken responses. Usually associated with damage to a cerebellar vessel. See also cerebellum. Acalculia Inability to perform even very simple mathematical calculations. Acute Care The phase of managing health problems which is conducted in a hospital on patients needing medical attention. Adaptive/Assistive Equipment A special device which assists in the performance of self-care, work or play/leisure activities or physical exercise. See also adaptive equipment catalogue. Adjusted Emotional adjustment. Having achieved a state where one is relatively stable and emotional responses are within a typical range. AdvocacyFull, active and open support for, and representation of an individual, group, cause or idea. Adynamia Difficulty initiating activities, gives the appearance of lethargy. AffectThe observable emotional condition (feeling, emotion, mood and temperament) of an individual at any given time.
    [Show full text]