You may have already read my previous blog about possible skin involvement in COVID19 in my series of COVID19 multi-specialty educational blogs.
Today I am writing another guest blog with the help of my friend and a neurologist Dr. Jennifer Buczyner. In this blog, she discusses about possible neurological complications from COVID19 and what you need to know during this pandemic, if you or your family/friends have neurological disorders.
About Dr. Jennifer Buczyner:
Dr. Buczyner is a Board-certified adult neurologist practicing in Palm Beach Gardens, Florida. Her practice, Comprehensive Neurology of the Palm Beaches, focuses on all neurological disorders with special interest in migraine, stroke and neuromuscular conditions. She has served as a stroke director at Jupiter Medical Center since November of 2017.
She has been voted as a Top Doctor of Palm Beach 2018 and 2019 by Palm Beach illustrated. She was recently featured in Jupiter magazine as a Top Doctor 2020.
Dr. Buczyner's comments on COVID19 from neurology standpoint:
It is no surprise that there have been multiple reported neurologic complications of COVID. It also comes as no surprise that those who already have a neurologic diagnosis have experienced exacerbation or worsening of their condition during times of social distancing. In one study from Wuhan, 36.4% of confirmed patients had neurologic symptoms which included ischemic stroke, seizure, impaired consciousness, muscle complaints and peripheral nervous system complaints.
Most reported neurological manifestations of COVID include anosmia (loss of smell) and aguesia (loss of taste). This may occur days to weeks before any fever. Good news is that most patients report their sense of smell and taste return weeks later, though we all can agree there may be several smells one would not miss!
Peripheral nervous system complaints, such as an acute neuropathy called Guillian Barre Syndrome (GBS) have been reported in the literature. I have yet to see this in a COVID patient, but the history is one of an acute progressive weakness evolving over days associated with loss of reflexes and characteristic findings in the spinal fluid. We see this in many other infections including the flu and these patients require hospitalization and treatment for stabilization.
Stroke has been reported both ischemic (non- bleeding) and hemorrhagic (bleeding) in high risk population and even in our younger patients without risk factors due to clotting issues from the virus. Mount Sinai in New York recently reported 5 stroke cases in younger patients where the patient was not even aware of a positive COVID diagnosis but presented with stroke symptoms. Unfortunately, several of these patients delayed going to the hospital and were unable to receive potentially lifesaving treatment for stroke as these are time based. We say, ‘Time is Brain’ and even in these times, it is critical to seek immediate medical attention if you experience any acute neurologic complaints.
How is Dr. Buczyner managing her patients in current situation through virtual visits:
On my virtual visits (we agree these can be painful, but it’s all we’ve got right now), I am trying to counsel all of my patients with preexisting neurologic diagnoses of the potential for their neurologic diagnoses to worsen. My migraineurs have more headaches. My seizure patients more seizures. My stroke patients more frustrated with their lack of improvement and their rehab has halted. In my dementia patients, I am concerned about lack of appropriate hygiene and spreading. In other conditions such as ALS (Lou Gehrig’s disease) or MG (myasthenia gravis), I warn patients about potential worsening respiratory issues if exposed to the virus and ensure they are utilizing appropriate precautions.
She emphasizes on mental health and self care during this tough time:
At the end of our ‘virtual visit’, I do my best to ensure my patients are staying mentally healthy too. Mental health can be the gasoline for many chronic illnesses. These are trying times for everyone and it is important you find outlets to keep your spirits up. Find a new hobby, learn something new every day, call a friend you do not get to speak to often, spend quality family time together, find a pen pal, have a drink or dessert at night and don’t worry about the consequences. I have become Martha Stewart’s apprentice and have baked more cakes in recent weeks than in my lifetime. My kids now have new pen pals all over the country. I learned how to create an online lecture for my patients. I try to catch up with friends who uplift me several days a week.
It is vital that no one ignores their symptoms or fears going to a hospital if necessary. It is also reassuring that most of us will read this blog and never see or hear about anyone developing a neurologic complication from COVID.
Hang in there. The new normal is around the corner and all of us need to stay physically and mentally healthy to welcome it with open arms.