Objective: To study the frequency and characteristics of movement disorders in patients with COVID-19 at two tertiary-care hospitals in Western India.

Background: As of March 2021, a few dozen cases of movement disorders have been reported in patients with COVID-19 including myoclonus, tremor and parkinsonism, due to systemic complications, structural lesions or postinfection syndromes.

Method: –

Results: Approximately 7000 patients with COVID-19 were seen between March 2020 and February 2021 at 2 tertiary-care centers in Western India, of which 3 patients, mean age 48 years (range:18-95) were identified to have developed new-onset movement disorders. Patient 1: 95-year man with stable ischemic heart disease, 5 weeks after recovery from severe acute respiratory distress syndrome, bacterial sepsis and prolonged ventilator support developed critical illness neuropathy and multifocal segmental myoclonus, predominantly involving the shoulders and hands. He died 4 weeks later due to sepsis. Patient 2: 18-year girl, 10 days after recovery from mild COVID-19, developed fever and status epilepticus. Brain MRI showed acute disseminated encephalomyelitis and bilateral caudate nuclei and thalamic lesions. Ventilatory support was required for 5 days. Seizures were controlled with midazolam, fosphenytoin, phenobarbital and levetiracetam. On recovery, she had mild generalized chorea and was discharged on levetiracetam and lacosamide. Over the last 6 months, she has resumed college and has only subtle residual chorea. Patient 3: 48-year man with diabetes mellitus and on maintenance hemodialysis, 7 weeks after recovery from mild COVID-19, developed disabling acute generalized chorea-dystonia. Brain MRI was normal. Serum Purkinje cell cytoplasmic antibody type-1 was present. He died one week later due to sudden cardiorespiratory arrest. All 3 patients had varying severity of COVID-19 (severe in patient 1 and mild in other two) and delayed onset movement disorders (mean interval 5 weeks, range: 3-7). Patient 1 developed segmental myoclonus following radiculitis due to critical illness neuropathy, whereas in the other 2 patients possibly a postinfection neurological syndrome, led to the observed movement disorders.

Conclusion: Our reports reiterate that new-onset movement disorders are rare in patients with COVID-19. They may occur as a sequelae of neuronal injury due to systemic complications or postinfection syndromes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/new-onset-movement-disorders-in-patients-with-covid-19-from-two-centers-in-western-india/