Neurologische ziektebeelden als complicatie van COVID-19:

• COVID-19-encefalopathie. Er lopen studies naar vormen van encefalopathie die direct te linken zijn aan het doormaken van COVID-19. Wij zullen info op deze site plaatsen zodra er meer kennis over is. Voorlopige info:
  https://www.frontiersin.org/articles/10.3389/fnins.2022.855868/full
• Herseninfarct: Bloedpropjes die in de longen of hersenen terecht kunnen komen. In de hersenen veroorzaken zij een herseninfarct. In de longen veroorzaken zij een longembolie. Het is een belangrijk gevolg van COVID-19 dat veel mensen  bloedpropjes krijgen.
• Hersenbloeding: Om de bloedpropjes tegen te gaan die door COVID-19 veroorzaakt worden, wordt de patiënt met antistollingsmiddel behandeld, maar dit kan in enkele gevallen een hersenbloeding veroorzaken.
• Virale encefalitis: een hersenontsteking veroorzaakt door een virus.
  https://www.nationalgeographic.co.uk/science-and-technology/2021/08/how-does-covid-19-affect-the-brain-a-troubling-picture-emerges
• Virale encefalopathie: een zeldzame complicatie van griep (influenza) en andere virale infecties (zoals het coronavirus) is een acute necrotiserende encefalopathie. Necrotiserend betekent dat hersencellen afsterven. Encefalopathie is een verminderd functioneren van de hersenen.
• Wittestofafwijkingen in subcorticale frontale (voorhoofdskwab) en pariëtale kwabben (wandbeenkwabben). Zie onderzoek link
• Post anoxische encefalopathie (hypoxic-ischemic brain injury): Door zuurstoftekort werken hersenen verminderd goed.
• Mogelijk (dat verband wordt vermoed en onderzocht) de ziekte van Alzheimer en Parkinson, wat bleek na besmetting met het SARS virus in 2003. Het MERS virus ( MERS-CoV) veroorzaakte hersenontstekingen, en auto-immuunziektes. COVID-19 geeft een sterke reactie van het afweersysteem. Daardoor gaat het lichaam cytokines produceren (cytokinestorm), wat voor een ontsteking zorgt.

Neurologische en neuropsychologische gevolgen genoemd na een coronabesmetting / COVID-19:

• Neurofatigue, de beruchte hersenmoeheid
• Cognitieve klachten, brain-fog (hersenmist) moeite met denken, moeite met onthouden ( vergeetachtigheid), moeite met multitasking etc.
• Zintuiglijke overprikkeling
• Spraakproblemen, afasie, woordvindingsproblemen
• Verminderde reuk en smaak  / reuk- en smaakverlies (anosmie)
• Hoofdpijn
• Alle andere zichtbare en onzichtbare gevolgen van hersenletsel
• Guillain-Barré klachten (Het Guillain-Barré-syndroom is een neurologische aandoening waarbij het immuunsysteem op een infectie reageert en per ongeluk zenuwcellen aanvalt, wat resulteert in spierzwakte en uiteindelijk verlamming)
• Post Intensive Care symptomen na opname op IC. (PICS; zie alinea verderop)
• Delier
• Een onderzoek uit voorjaar 2023, toonde een opvallende hypoperfusie (niet goede doorbloeding) in een wijdverbreid cerebraal (grote hersenen) netwerk in de groep mensen met post-COVID-19, voornamelijk in de frontale cortex (frontale hersenschors), evenals de pariëtale (wandbeenkwab-schors) en temporale cortex (slaapkwab schors). De hypoperfusiegebieden geïdentificeerd in de regio's van de RECHTERHERSENHELFT waren uitgebreider. Deze bevindingen ondersteunen de hypothese van een grote netwerkdisfunctie bij post-COVID-patiënten met cognitieve klachten.

Neurologische klachten bij opname (NIET- typische COVID-19 klachten)

Er zijn wereldwijd mensen opgenomen in ziekenhuizen zonder specifieke COVID-19 klachten met griepsymptomen als hoesten of koorts, maar ze hadden wel typische neurologische klachten.

1. (hoofdpijn, duizeligheid, verminderd bewustzijn, ataxie, acute  beroerte/ CVA en epilepsie)
2. verminderd vermogen om dingen te proeven (hypogeusie), verminderd vermogen om te ruiken en om geuren te detecteren (hyposmie) en zenuwpijn/ neuropathische pijn (neuralgie)
3. skeletspiersymptomen.

Toen deze patiënten getest werden, bleken ze wel Covid-19 te hebben. In zeldzame gevallen lijkt het er op dat het cornavirus rechtstreeks de hersenen binnen kan dringen, zegt dr. Elissa Fory, een neuroloog bij Henry Ford Health System.

Genoemde klachten (niet bij allen dezelfde klachten):

• Bewustzijnsstoornissen / bewustzijnsveranderingen variërend van slaperigheid tot coma
• Verwarring
• Delier
• Hallucinaties (zie ook delier)
• Hoofdpijn
• Moeite met praten
• Duizeligheid
• Ataxie (verstoring van de coördinatie van bewegingen)
• Encefalopathie symptomen
• Encefalitis (hersenontsteking) symptomen
• Epileptische activiteit variërend van lichte afwezigheid, het maken van herhalende niet-doelbewuste bewegingen of een mentale statusverandering, waarbij mensen gewoon niet zichzelf zijn, tot zwaardere aanvallen.

SARS-CoV-2, het coronavirus dat COVID-19 veroorzaakt, kan neurologische aandoeningen veroorzaken door directe infectie van de hersenen of als gevolg van de sterke activering van het immuunsysteem. Het virus kan de bloed-hersenbarrière doorbreken.

PICS
Naast de cognitieve klachten door hersenschade, kunnen klachten ook ontstaan zijn door het Post intensive care syndroom (PICS). Nieuwe of verergerde klachten die ontstaan ten gevolge van een kritieke ziekte en de intensive care behandeling.

• Lichamelijke klachten (moeheid, verworven spierzwakte, slikstoornis, conditieverlies, kortademigheid)
• Cognitieve klachten als verminderde aandacht en concentratie
• Psychische problemen (angst, PTSS, depressie)
• Prikkelgevoeligheid

Partners, familieleden en andere naasten kunnen ook PICS ontwikkelen, dat wordt het Post Intensive Care Syndroom Familie genoemd, of PICS-F.
Lees meer.

Check

Als je twijfelt of jij hersenletsel of cognitieve klachten overgehouden hebt aan de coronabesmetting, dan kan je een checklist NAH invullen. NAH staat voor Niet-Aangeboren Hersenletsel, dus later in het leven opgelopen hersenschade.

Lees onze specifieke pagina over het Post-COVID syndroom / Long COVID Long staat voor langdurige klachten. Via deze link.

Lotgenotencontact

De Nederlandse facebookgroep ‘Corona patiënten met langdurige klachten’ heeft bijna 18 duizend leden.

Onderzoeken over langdurige (neurologische of hersenletsel) klachten nadat iemand Covid-19 heeft doorgemaakt

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• Langdurige klachten na ongecompliceerde Covid-19, Nederlands Tijdschrift voor Geneeskunde.

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  Avindra Nath MD Published in Neurology

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