Author response: Miller Fisher Syndrome and polyneuritis cranialis in COVID-19
JuliánBenito-León, Neurologist, University hospital "12 de Octubre"
AntonioMéndez-Guerrero, Neurologist, University hospital "12 de Octubre"
ConsueloGutiérrez-Ortiz, Neuro-ophtalmologist, University hospital "Príncipe de Asturtias"
Submitted May 22, 2020
We thank Drs. Ni and Xu for their letter on our study.1 We think that our two patients developed Miller Fisher syndrome and polyneuritis cranialis due to an aberrant immunologic response to COVID-19. As we previously commented in the article, oropharyngeal swab test for SARS-CoV-2 by qualitative real-time reverse-transcriptase–polymerase-chain-reaction (PCR) assay was positive in both patients and negative in the cerebrospinal fluid (CSF). We did not examine the presence of antibodies for SARS-CoV-2 in CSF because that technique had not been validated. In the patient who acutely presented with Miller Fisher syndrome, CSF PCR for enterovirus, herpes simplex virus type 1 and 2, and varicella zoster virus were negative as well as CSF-VDRL test. On the other hand, in the patient with polyneuritis cranialis, these tests could not performed because of the extreme circumstances of the University Hospital “Príncipe de Asturias”, Alcala de Henares, Madrid, at the peak of this pandemic. Notwithstanding, considering the temporal relationship, we feel that SARS-CoV-2 infection was responsible for the development of these two neurological pictures.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
Reference
Gutiérrez-Ortiz C, Méndez A, Rodrigo-Rey S, et al. Miller Fisher Syndrome and polyneuritis cranialis in COVID-19. Neurology 2020 Epub Apr 17.
We thank Drs. Ni and Xu for their letter on our study.1 We think that our two patients developed Miller Fisher syndrome and polyneuritis cranialis due to an aberrant immunologic response to COVID-19. As we previously commented in the article, oropharyngeal swab test for SARS-CoV-2 by qualitative real-time reverse-transcriptase–polymerase-chain-reaction (PCR) assay was positive in both patients and negative in the cerebrospinal fluid (CSF). We did not examine the presence of antibodies for SARS-CoV-2 in CSF because that technique had not been validated. In the patient who acutely presented with Miller Fisher syndrome, CSF PCR for enterovirus, herpes simplex virus type 1 and 2, and varicella zoster virus were negative as well as CSF-VDRL test. On the other hand, in the patient with polyneuritis cranialis, these tests could not performed because of the extreme circumstances of the University Hospital “Príncipe de Asturias”, Alcala de Henares, Madrid, at the peak of this pandemic. Notwithstanding, considering the temporal relationship, we feel that SARS-CoV-2 infection was responsible for the development of these two neurological pictures.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
Reference