The clinical neurophysiology of COVID-19-direct infection, long-term sequelae and para-immunization responses: A literature review

• Published in: Clinical neurophysiology practice Vol. 8; pp. 3 - 11
• Main Authors: Haykal, M. Ayman, Menkes, Daniel L.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2023; International Federation of Clinical Neurophysiology. Published by Elsevier B.V; Elsevier
• Subjects: COVID-19; EEG; EMG; Evoked potentials; NCV; Neurophysiology; Review; COVID-19; NCV; Evoked potentials; EEG; EMG; Neurophysiology
• ISSN: 2467-981X; 2467-981X
• DOI: 10.1016/j.cnp.2022.09.005

•Several neurophysiological techniques are useful in evaluating neurological symptoms related to SARS-CoV-2 infection but cannot affirm a causative association.•There is no specific electrodiagnostic signature that is pathognomonic for SARS-CoV-2 infection, possible side effects of vaccination against SARS CoV-2 or “long COVID”.•However, clinical neurophysiology modalities have a role in the evaluation of “long COVID” as they may provide objective validation of the patient's reported symptoms. The COVID-19 pandemic resulting from the SARS-CoV-2 virus is in its third year. There is continuously evolving information regarding its pathophysiology and its effects on the nervous system. Clinical neurophysiology techniques are commonly employed to assess for neuroanatomical localization and/or defining the spectrum of neurological illness. There is an evolving body of literature delineating the effects of the SARS-CoV-2 virus on the nervous system as well as para-immunization responses to vaccination against this virus. This review focuses on the use of neurophysiological diagnostic modalities in the evaluation of potential acute and long-term neurological complications in patients that experience direct infection with SARS-CoV-2 and analyzes those reports of para-immunization responses to vaccination against the SARS-CoV-2 virus. The neurophysiological modalities to be discussed include electroencephalography (EEG), evoked potentials (EPs), nerve conduction studies and electromyography (EMG/NCV), autonomic function tests, transcranial magnetic stimulation (TMS) and Transcranial Doppler ultrasound (TCD).