Case Report: Behavioral Unresponsiveness in Acute COVID-19 Patients: The Utility of the Motor Behavior Tool-Revised and 18F-FDG PET/CT

Sergiu Vijiala; Jean-Benoît Epiney; Jane Jöhr; Alessandro Pincherle; Marie M Meyer; Renaud Du Pasquier; John O Prior; Karin Diserens

doi:10.3389/fneur.2021.644848

Case Report: Behavioral Unresponsiveness in Acute COVID-19 Patients: The Utility of the Motor Behavior Tool-Revised and ¹⁸F-FDG PET/CT

Front Neurol. 2021 Apr 30:12:644848. doi: 10.3389/fneur.2021.644848. eCollection 2021.

Authors

Sergiu Vijiala¹, Jean-Benoît Epiney¹, Jane Jöhr¹, Alessandro Pincherle¹, Marie M Meyer², Renaud Du Pasquier³, John O Prior², Karin Diserens¹

Affiliations

¹ Unit of Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Service of Neurology, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), University of Lausanne, Lausanne, Switzerland.
² Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), University of Lausanne, Lausanne, Switzerland.
³ Department of Clinical Neurosciences, Service of Neurology, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), University of Lausanne, Lausanne, Switzerland.

Abstract

Along with the propagation of COVID-19, emerging evidence reveals significant neurological manifestations in severely infected COVID-19 patients. Among these patients admitted to the intensive care unit (ICU), behavioral unresponsiveness may occur frequently, yet, there are still only a few cases reported and with rare descriptions of their motor behavior after pathological awakening. Several hypotheses regarding central lesions in these patients are conceivable. Here, we describe two acute SARS-CoV-2- infected patients who developed neurological symptoms evoking the condition of clinical cognitive motor dissociation (CMD). This diagnosis could be confirmed first by clinical observation of a dissociation between preserved cognitive abilities and lack of initial motor interaction and second, by performing ¹⁸F- FDG PET imaging. Accurate diagnosis led to an appropriate neuro-rehabilitation regimen with long-term neuro-rehabilitation leading to an improved outcome for both patients.

Keywords: 18F-FDG; COVID-19; PET; SARS-CoV-2; neurological complications; unresponsiveness.

Publication types

Case Reports