COVID-19-associated polyneuritis cranialis: Difference between revisions
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==Historical Perspective== | ==Historical Perspective== | ||
*In '''1937''' French physicians Guillain G. et al. first described a [[Infectious disease |postinfectious syndrome]] affecting the [[cranial nerves]], associated with albuminocytological dissociation. The syndrome did not involve the [[limbs]] unlike [[Guillain-Barré syndrome]] and was called 'polyneuritis cranialis'.<ref name="WakerleyYuki2015">{{cite journal|last1=Wakerley|first1=Benjamin R.|last2=Yuki|first2=Nobuhiro|title=Polyneuritis cranialis—subtype of Guillain–Barré syndrome?|journal=Nature Reviews Neurology|volume=11|issue=11|year=2015|pages=664–664|issn=1759-4758|doi=10.1038/nrneurol.2015.115}}</ref> | *In '''1937''' French physicians Guillain G. et al. first described a [[Infectious disease |postinfectious syndrome]] affecting the [[cranial nerves]], associated with albuminocytological dissociation. The syndrome did not involve the [[limbs]] unlike [[Guillain-Barré syndrome]] and was called 'polyneuritis cranialis'.<ref name="WakerleyYuki2015">{{cite journal|last1=Wakerley|first1=Benjamin R.|last2=Yuki|first2=Nobuhiro|title=Polyneuritis cranialis—subtype of Guillain–Barré syndrome?|journal=Nature Reviews Neurology|volume=11|issue=11|year=2015|pages=664–664|issn=1759-4758|doi=10.1038/nrneurol.2015.115}}</ref> | ||
*Polyneuritis cralialis associated with [[COVID-19]] was first reported in two [[patients]] by Consuelo Gutiérrez-Ortiz et al. from Madrid, Spain on April 17th, 2020. The team reported both [[Guillain-Barré syndrome classification | *Polyneuritis cralialis associated with [[COVID-19]] was first reported in two [[patients]] by Consuelo Gutiérrez-Ortiz et al. from Madrid, Spain on April 17th, 2020. The team reported both [[Guillain-Barré syndrome classification|Miller Fisher syndrome]] and polyneuritis cranialis in pattients with confirmed [[oropharyngeal]] [[RT PCR]] [[COVID-19]] test.<ref name="Gutiérrez-OrtizMéndez2020">{{cite journal|last1=Gutiérrez-Ortiz|first1=Consuelo|last2=Méndez|first2=Antonio|last3=Rodrigo-Rey|first3=Sara|last4=San Pedro-Murillo|first4=Eduardo|last5=Bermejo-Guerrero|first5=Laura|last6=Gordo-Mañas|first6=Ricardo|last7=de Aragón-Gómez|first7=Fernando|last8=Benito-León|first8=Julián|title=Miller Fisher Syndrome and polyneuritis cranialis in COVID-19|journal=Neurology|year=2020|pages=10.1212/WNL.0000000000009619|issn=0028-3878|doi=10.1212/WNL.0000000000009619}}</ref> | ||
==Classification== | ==Classification== | ||
There is no established system for the classification of polyneuritis cranialis but the disease itself is a [[Guillain-Barré syndrome]]-Miller Fisher syndrome interface | There is no established system for the classification of polyneuritis cranialis but the disease itself is a [[Guillain-Barré syndrome]]-[[Guillain-Barré syndrome classification|Miller Fisher syndrome]]interface.<ref name="WakerleyYuki2015">{{cite journal|last1=Wakerley|first1=Benjamin R.|last2=Yuki|first2=Nobuhiro|title=Polyneuritis cranialis—subtype of Guillain–Barré syndrome?|journal=Nature Reviews Neurology|volume=11|issue=11|year=2015|pages=664–664|issn=1759-4758|doi=10.1038/nrneurol.2015.115}}</ref> | ||
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===Laboratory Findings=== | ===Laboratory Findings=== | ||
*A positive [[oropharyngeal]] swab [[RT PCR]] [[COVID-19]] test. | *A positive qualitative real-time [[oropharyngeal]] swab [[RT PCR]] [[COVID-19]] test. | ||
*Albuminocytological dissociation | *Albuminocytological dissociation | ||
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OR | OR | ||
There are no MRI findings associated with [disease name]. However, | There are no MRI findings associated with [disease name]. However, an MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3]. | ||
===Other Imaging Findings=== | ===Other Imaging Findings=== | ||
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The optimal therapy for [malignancy name] depends on the stage at diagnosis. | The optimal therapy for [malignancy name] depends on the stage at diagnosis. | ||
OR | OR | ||
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OR | OR | ||
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and | Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and | ||
===Primary Prevention=== | ===Primary Prevention=== | ||
* The disease itself is associated with [[COVID-19]] infection as believed to be an immune response so prevention of the [[infection]] itself is the most promising primary prevention strategy at the moment. | |||
*There have been rigorous efforts in order to develop a [[vaccine]] for [[COVID-10|novel coronavirus]] and several vaccines are in the later phases of trials.<ref name="urlNIH clinical trial of investigational vaccine for COVID-19 begins | National Institutes of Health (NIH)">{{cite web |url=https://www.nih.gov/news-events/news-releases/nih-clinical-trial-investigational-vaccine-covid-19-begins |title=NIH clinical trial of investigational vaccine for COVID-19 begins | National Institutes of Health (NIH) |format= |work= |accessdate=}}</ref> | |||
*The only prevention for [[COVID-19]] associated abdominal pain is the prevention and early diagnosis of the [[coronavirus-19]] infection itself. According to the [[CDC]], the measures include:<ref name="urlHow to Protect Yourself & Others | CDC">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html |title=How to Protect Yourself & Others | CDC |format= |work= |accessdate=}}</ref> | |||
**Frequent handwashing with soap and water for at least 20 seconds or using a [[alcohol rub|alcohol based hand sanitizer]] with at least 60% alcohol. | |||
There | **Staying at least 6 feet (about 2 arms’ length) from other people who do not live with you. | ||
**Covering your mouth and nose with a cloth face cover when around others and covering sneezes and coughs. | |||
**Cleaning and [[disinfect]]ing. | |||
[ | |||
=== | |||
==References== | ==References== | ||
Revision as of 14:41, 9 July 2020
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COVID-19 Microchapters |
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Diagnosis |
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COVID-19-associated polyneuritis cranialis On the Web |
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American Roentgen Ray Society Images of COVID-19-associated polyneuritis cranialis |
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Risk calculators and risk factors for COVID-19-associated polyneuritis cranialis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Synonyms and keywords:
Overview
Historical Perspective
- In 1937 French physicians Guillain G. et al. first described a postinfectious syndrome affecting the cranial nerves, associated with albuminocytological dissociation. The syndrome did not involve the limbs unlike Guillain-Barré syndrome and was called 'polyneuritis cranialis'.[1]
- Polyneuritis cralialis associated with COVID-19 was first reported in two patients by Consuelo Gutiérrez-Ortiz et al. from Madrid, Spain on April 17th, 2020. The team reported both Miller Fisher syndrome and polyneuritis cranialis in pattients with confirmed oropharyngeal RT PCR COVID-19 test.[2]
Classification
There is no established system for the classification of polyneuritis cranialis but the disease itself is a Guillain-Barré syndrome-Miller Fisher syndromeinterface.[1]
Pathophysiology
The exact pathogenesis of [disease name] is not fully understood.
OR
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
OR
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
OR
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
OR
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
OR
The progression to [disease name] usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.
Causes
Disease name] may be caused by [cause1], [cause2], or [cause3].
OR
Common causes of [disease] include [cause1], [cause2], and [cause3].
OR
The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
OR
The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.
Differentiating COVID-19-associated polyneuritis cranialis from other Diseases
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
OR
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
Epidemiology and Demographics
The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
OR
In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
OR
In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.
Patients of all age groups may develop [disease name].
OR
The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
OR
[Disease name] commonly affects individuals younger than/older than [number of years] years of age.
OR
[Chronic disease name] is usually first diagnosed among [age group].
OR
[Acute disease name] commonly affects [age group].
There is no racial predilection to [disease name].
OR
[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
[Disease name] affects men and women equally.
OR
[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
The majority of [disease name] cases are reported in [geographical region].
OR
[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
Risk Factors
There are no established risk factors for [disease name].
OR
The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
Screening
There is insufficient evidence to recommend routine screening for [disease/malignancy].
OR
According to the [guideline name], screening for [disease name] is not recommended.
OR
According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
Natural History, Complications, and Prognosis
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Diagnosis
Diagnostic Study of Choice
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
There are no established criteria for the diagnosis of [disease name].
History and Symptoms
The hallmark of polyneuritis cralialis is bulbar weakness with ophthalmoparesis. There is no ataxia or Hypersomnolence as seen in MFS.
Physical Examination
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Laboratory Findings
- A positive qualitative real-time oropharyngeal swab RT PCR COVID-19 test.
- Albuminocytological dissociation
Electrocardiogram
There are no ECG findings associated with [disease name].
X-ray
There are no x-ray findings associated with [disease name].
OR
An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
Echocardiography or Ultrasound
There are no echocardiography/ultrasound findings associated with [disease name].
OR
Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
CT scan
There are no CT scan findings associated with [disease name].
OR
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
MRI
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no MRI findings associated with [disease name]. However, an MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
Other Imaging Findings
There are no other imaging findings associated with [disease name].
OR
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
There are no other diagnostic studies associated with [disease name].
OR
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
There is no treatment for [disease name]; the mainstay of therapy is supportive care.
OR
Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
OR
The majority of cases of [disease name] are self-limited and require only supportive care.
OR
[Disease name] is a medical emergency and requires prompt treatment.
OR
The mainstay of treatment for [disease name] is [therapy].
OR
The optimal therapy for [malignancy name] depends on the stage at diagnosis.
OR
Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
OR
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
OR
Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
OR
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
Surgery
Surgical intervention is not recommended for the management of [disease name].
OR
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and
Primary Prevention
- The disease itself is associated with COVID-19 infection as believed to be an immune response so prevention of the infection itself is the most promising primary prevention strategy at the moment.
- There have been rigorous efforts in order to develop a vaccine for novel coronavirus and several vaccines are in the later phases of trials.[3]
- The only prevention for COVID-19 associated abdominal pain is the prevention and early diagnosis of the coronavirus-19 infection itself. According to the CDC, the measures include:[4]
- Frequent handwashing with soap and water for at least 20 seconds or using a alcohol based hand sanitizer with at least 60% alcohol.
- Staying at least 6 feet (about 2 arms’ length) from other people who do not live with you.
- Covering your mouth and nose with a cloth face cover when around others and covering sneezes and coughs.
- Cleaning and disinfecting.
References
- ↑ 1.0 1.1 Wakerley, Benjamin R.; Yuki, Nobuhiro (2015). "Polyneuritis cranialis—subtype of Guillain–Barré syndrome?". Nature Reviews Neurology. 11 (11): 664–664. doi:10.1038/nrneurol.2015.115. ISSN 1759-4758.
- ↑ Gutiérrez-Ortiz, Consuelo; Méndez, Antonio; Rodrigo-Rey, Sara; San Pedro-Murillo, Eduardo; Bermejo-Guerrero, Laura; Gordo-Mañas, Ricardo; de Aragón-Gómez, Fernando; Benito-León, Julián (2020). "Miller Fisher Syndrome and polyneuritis cranialis in COVID-19". Neurology: 10.1212/WNL.0000000000009619. doi:10.1212/WNL.0000000000009619. ISSN 0028-3878.
- ↑ "NIH clinical trial of investigational vaccine for COVID-19 begins | National Institutes of Health (NIH)".
- ↑ "How to Protect Yourself & Others | CDC".