PDF(Pubmed)
Abstract：
A growing number of case reports and series have described a wide spectrum of neurological manifestations of COVID-19 disease including encephalopathy, cerebrovascular disease, and Guillain-Barre syndrome (GBS). However, peripheral neuropathy associated with COVID-19 disease has been uncommonly reported. Here, we describe a young patient with a COVID-19 infection who developed unilateral sciatic neuropathy during the course of treatment requiring prolonged physical medicine and rehabilitation stay. She was treated in the intensive care unit (ICU) for hypoxic respiratory failure for 22 days total, during which she was intubated, sedated, and paralyzed for 14 days. She received dexamethasone, convalescent plasma, and remdesivir for COVID-19; she also received ceftriaxone and azithromycin for possible superimposed bacterial pneumonia. The hypoxic respiratory failure was improved progressively, and she was extubated. On day 17 of ICU stay, she reported numbness and weakness in left leg and had 0/5 motor strength at the left ankle in all directions. She was able to move left hip and knee and had decreased sensation to light touch and pain from the level of the left knee to the toes. Imaging of the brain and spine showed no obvious findings that would explain the neurological symptoms. On electromyography (EMG), there was acute denervation in the left tibialis anterior muscle. She required prolonged physical medicine and rehabilitation care, greater than 60 days during which she had some improvement in sensation, but remained without ankle movement for two more months. This could be a rare manifestation of COVID-19-induced sciatic mono-neuropathy given her symptoms, EMG reports, clinical exam, and normal imaging studies.
摘要：
越来越多的病例报告和系列报道描述了COVID-19疾病的广泛神经系统表现，包括脑病，脑血管疾病，和格林-巴利综合征（GBS）。然而,与COVID-19疾病相关的周围神经病变的报道并不常见。这里,我们描述了一名患有COVID-19感染的年轻患者,他在治疗过程中出现了单侧坐骨神经病变,需要长期物理药物治疗和康复治疗.她在重症监护病房（ICU）接受了22天的低氧性呼吸衰竭治疗。在此期间她被插管，镇静剂,瘫痪了14天.她接受了地塞米松,恢复期血浆,和瑞德西韦治疗COVID-19；她还接受头孢曲松和阿奇霉素治疗可能的叠加细菌性肺炎。低氧性呼吸衰竭逐渐好转，她被拔管了.在ICU入住的第17天，她报告左腿麻木和无力，左脚踝在所有方向上都有0/5的运动强度。她能够移动左臀部和膝盖，并且从左膝盖到脚趾的轻度触摸和疼痛的感觉下降。大脑和脊柱的成像显示没有明显的发现可以解释神经系统症状。在肌电图（EMG）上，左胫骨前肌有急性神经支配。她需要长期的物理药物和康复护理，超过60天，她的感觉有所改善，但两个月没有脚踝运动。考虑到她的症状，这可能是COVID-19诱发的坐骨神经单神经病的罕见表现，EMG报告，临床检查,和正常的影像学研究。
