Coronavirus Disease 2019 (COVID-19) From the Point of View of Neurologists: Observation of Neurological Findings and Symptoms During the Combat Against a Pandemic.

Some respiratory viruses have long been known to cause neurological involvement. A novel coronavirus, leading to severe acute respiratory syndrome, also called coronavirus disease 19 (COVID-19), seems to be a new member of neuroinvasive viruses. While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) keeps on spreading around the world rapidly, reports about the neurological manifestations associated with SARS-CoV-2, increases day by day. It is reported that a variety of symptoms and syndromes such as headache, dizziness, confusion, ataxia, epilepsy, ischemic stroke, neuropathic pain and myopathy are common especially in more severe COVID-19 patients. It is also suggested that the development of neurological complications is strongly associated with a poor outcome. On the other hand, hyposmia can be the unique symptom in COVID-19 carriers and this can serve as a marker for identifying the otherwise asymptomatically infected patients. It is thought that SARS-CoV-2 may cause neurological symptoms through direct or indirect mechanisms. Nevertheless, neuroinvasion capability of SARS-CoV2 is confirmed by the presence of the virus, in the cerebrospinal fluid of a COVID-19 patient with encephalitis, and this is proven by gene sequencing. In conclusion, during the COVID-19 pandemic, it is crucial to be aware of the possible neurological complications of the disease. Therefore, in this review, we aimed to report neurological manifestations associated with SARS-CoV-2 and possible underlying pathophysiological mechanisms. Due to the high homology of SARS-CoV-2 with other human coronaviruses such as SARS-CoV or Middle East Respiratory Syndrome (MERS)-CoV, reviewing the neurological involvement also associated with these coronaviruses will provide an idea about the longterm complications of COVID-19

Why electrophysiological reassessment is needed? The experience of our laboratory - A cross-sectional study

Introduction: Requesting repetition of an electrodiagnostic examination (EDX) for follow-up and/or diagnostic verification is common in the daily practice of a reference center. Objective: This study aimed to evaluate demographical and electrophysiological characteristics of the patients who were referred to a reference electrophysiology laboratory for reassessment, to explore the underlying reasons, and motives for ordering a reassessment. Methods: Patients who had at least one EDX study within the last year in one of the two different time periods (winter and summer) were included in the study. Their demographical features, preliminary diagnosis, and electrophysiological findings were assessed and compared with their previous EDX interpretations. Results: Thirty-five (14 female, 21 male) patients (7,7%) out of 457 patients from the winter period (November 11, 2018-December 12, 2018) and 38 (20 female, 18 male) patients (7,8%) out of 487 patients from the summer period (July 01, 2019-August 08, 2019) were included in the study. Age, gender, preliminary diagnosis, and the number of previous electrophysiologic tests were statistically similar between the two groups. The most common reason for reassessment was to verify or to follow-up on a diagnosis of motor neuron disease or polyneuropathy. Compared to the summer group, the patients who had previous EDX in a different center were more common in the winter group, mean duration between EDX studies was also shorter. Conclusion: In this study, we have inspected the patients referred to our laboratory within two different time frames in a year for a repeat EDX study. It was observed that the number of patients who underwent a repeat EDX was relatively low, and there was no significant difference not only in the preliminary diagnosis but also in the electrophysiological findings