Relationship between COVID-19 and movement disorders: A narrative review

Abstract

Background and purpose: The scientific literature on COVID-19 is increasingly growing.

Methods: In this paper, we review the literature on movement disorders in the context of the COVID-19 pandemic.

Results: First, there are a variety of transient movement disorders that may manifest in the acute phase of COVID-19, most often myoclonus, with more than 50 patients described in the literature. New onset parkinsonism, chorea, and tic-like behaviours have also been reported. Movement disorders as a side effect after COVID-19 vaccination are rare, occurring with a frequency of 0.00002-0.0002 depending on the product used, mostly manifesting with tremor. Current evidence for potential long-term manifestations, for example, long COVID parkinsonism, is separately discussed. Second, the pandemic has also had an impact on patients with pre-existing movement disorder syndromes, with negative effects on clinical status and overall well-being, and reduced access to medication and health care. In many parts, the pandemic has led to reorganization of the medical system, including the development of new digital solutions. The movement disorder-related evidence for this is reviewed and discussed.

Conclusions: The pandemic and the associated preventive measures have had a negative impact on the clinical status, access to health care, and overall well-being of patients with pre-existing movement disorders.

Keywords: COVID-19; Sars-CoV-2; Spanish flu; chorea; dystonia; long COVID; myoclonus ataxia; parkinsonism; postencephalitic parkinsonism; tic-like behaviour; tics; vaccine.