Effortful speech with distortion of prosody following SARS-CoV-2 infection
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Effortful speech with distortion of prosody following SARS-CoV-2 infection Maria Sofia Cotelli 1 & Maria Cotelli 2 & Filippo Manelli 3 & Graziella Bonetti 4 & Renata Rao 5 & Alessandro Padovani 5 & Barbara Borroni 5 Received: 21 June 2020 / Accepted: 14 July 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been reported in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a 48-year-old Caucasian woman with SARS-CoV-2 infection followed by the onset of word finding difficulties, effortful speech along with prosody distortion, in the context of spared semantic and syntactic abilities. The clinical picture, perceived as foreign accent syndrome (FAS), was not associated with structural and functional imaging changes or neurophysiological assessment abnormalities. We suggest that FAS, herein perceived as a regional accent syndrome, should be considered a possible additional neurological manifestation of SARS-CoV-2. Keywords COVID-19 . SARS-CoV-2 . foreign accent syndrome . language . Neurology
Introduction The World Health Organization has declared COVID-19 a public health emergency of international concern. Since February 20, 2020, Lombardy, Italy, has experienced a major outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), with more than 90,000 cases and 16,000 deaths in the region as of June 15, 2020. Clinical studies have initially showed that COVID-19 presents with fever and upper respiratory symptoms. However, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04603-2) contains supplementary material, which is available to authorized users. * Barbara Borroni [email protected] 1
Neurology Unit, ASST-Valcamonica, Esine, Brescia, Italy
2
Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
3
Emergency Department, ASST-Valcamonica, Esine, Brescia, Italy
4
Laboratory of Clinical Pathology, ASST-Valcamonica, Esine, Brescia, Italy
5
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Piazza Spedali Civili 1, 25125 Brescia, Italy
more recently, a wide spectrum of neurological manifestations has been associated with COVID-19, including encephalitis, cerebrovascular disorders, delirium, and autoimmune neurological disorders [1, 2]. Herein, we report a case characterized by unusual speech disturbances with the onset after COVID-19, perceived as foreign accent syndrome (FAS), thus extending the spectrum of neurological symptoms related to the disease.
Case report We describe a 48-year-old Caucasian woman with SARSCoV-2 infection followed by the onset of effortful speech along with prosody distortion. On January 2020, she presented to the emergency room in Piario, Bergamo, one of the epicenter of
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