Overlooked Neurological Features Present in Long COVID: Svetlana Blitshteyn, MD, FAAN

WATCH TIME: 3 minutes

"For many years, those of us who specialize in these disorders have seen patients with very similar features that the patients with Long COVID have. Many of them presented [these features] after some viral or bacterial infection."

Following the infection rise from the COVID-19 pandemic, neurologists have diverted attention into trying to understand how their patients can manage the long-term symptoms of this infectious disease. Those previously infected have increasingly reported experiencing symptoms of Long COVID, also known as post-acute COVID, which can last for weeks or more following mild illness. This emerging condition may be related to a virus- or immune-mediated disruption of the autonomic nervous system that can cause orthostatic intolerance syndromes.¹ As this issue continues to be a prevalent trend, it may be important for neurologists to able to recognize these cases among their patients in order to provide better support toward the management of their condition.

Dysautonomia, often identified by autonomic nervous system dysfunction, includes a variety of disorders with the most frequent reported cases being postural orthostatic tachycardia syndrome, neurocardiogenic syncope, and orthostatic hypotension.² In a recent literature review published in Current Neurology and Neuroscience Reports, studies showed a significant overlap and shared pathophysiology in migraine and dysautonomia disorders. Author Svetlana Blitshteyn, MD, FAAN, director and founder of Dysautonomia Clinic, noted in the review that diagnosis and treatment of these disorders among those with migraine is crucial for providing patient centered care, reducing symptom burden, and improving functional impairment.

In a recent conversation with NeurologyLive^®, Blitshteyn, who also serves as a clinical associate professor of neurology at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, discussed how the neurological symptoms associated with COVID-19 have shed light on previously neglected post-viral manifestations. She also talked about the initiatives neurologists can undertake to bridge the gap between established medical practices and evolving scientific understanding. In addition, Blitshteyn spoke about the implications of recognizing and addressing neurological manifestations of systemic diseases, such as migraine.

REFERENCE
1. Dani M, Dirksen A, Taraborrelli P, et al. Autonomic dysfunction in 'long COVID': rationale, physiology and management strategies. Clin Med (Lond). 2021;21(1):e63-e67. doi:10.7861/clinmed.2020-0896
2. Blitshteyn S. Dysautonomia, Hypermobility Spectrum Disorders and Mast Cell Activation Syndrome as Migraine Comorbidities. Curr Neurol Neurosci Rep. 2023;23(11):769-776. doi:10.1007/s11910-023-01307-w