최재필 (서울의료원) | 상위피인용논문 > 한빛사

상위피인용논문

조회704

서울의료원

J. Clin. Neurol., 2017 Jul;13(3):227-233 | https://doi.org/10.3988/jcn.2017.13.3.227 Neurological Complications during Treatment of Middle East Respiratory Syndrome

Jee-Eun Kim,^a Jae-Hyeok Heo,^a Hye-ok Kim,^b Sook-hee Song,^b Sang-Soon Park,^a Tai-Hwan Park,^a Jin-Young Ahn,^a Min-Ky Kim,^a and Jae-Phil Choi^c

^aDepartment of Neurology, Seoul Medical Center, Seoul, Korea.
^bDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.
^cDivision of Infectious Diseases, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.

Correspondence: Jee-Eun Kim, MD, PhD., Jae-Phil Choi, MD.

Abstract

Background and Purpose
Middle East respiratory syndrome (MERS) has a high mortality rate and pandemic potential. However, the neurological manifestations of MERS have rarely been reported since it first emerged in 2012.

Methods
We evaluated four patients with laboratory-confirmed MERS coronavirus (CoV) infections who showed neurological complications during MERS treatment. These 4 patients were from a cohort of 23 patients who were treated at a single designated hospital during the 2015 outbreak in the Republic of Korea. The clinical presentations, laboratory findings, and prognoses are described.

Results
Four of the 23 admitted MERS patients reported neurological symptoms during or after MERS-CoV treatment. The potential diagnoses in these four cases included Bickerstaff's encephalitis overlapping with Guillain-Barré syndrome, intensive-care-unit-acquired weakness, or other toxic or infectious neuropathies. Neurological complications did not appear concomitantly with respiratory symptoms, instead being delayed by 2–3 weeks.

Conclusions
Neuromuscular complications are not rare during MERS treatment, and they may have previously been underdiagnosed. Understanding the neurological manifestations is important in an infectious disease such as MERS, because these symptoms are rarely evaluated thoroughly during treatment, and they may interfere with the prognosis or require treatment modification.

논문정보