TABLE 1.
Neurological symptoms in COVID-19, Viral Encephalitis (Grouped/assorted by the neurological spectrum observed in COVID-19), showing their proximity in presentation.
| Neurological symptoms | Corresponding clinical Indications | ||
|---|---|---|---|
| COVID-19 | Viral encephalitis | Therapeutic effects of thiamine on WKS and other neurological conditions | |
| Altered mental status | |||
| (Mao et al., 2020; Wang et al., 2020) | Disorientation (Chaudhuri and Kennedy, 2002) | Mental Confusion (Reuler et al., 1985; Sechi and Serra, 2007), impaired Memory (Sechi and Serra, 2007) | Confusion: WKS classic triad |
| Epiphora, conjunctival congestion, or chemosis (swollen conjunctiva) (Wu et al., 2020); ophthalmoplegia(Lantos et al., 2020) (part of MFS) | Ocular Paralysis (Keane, 2007), internuclear Ophthalmoplegia (Hedges III, 1994; Keane, 2005; Sanjay et al., 2009) | Ophthalmoplegia (nystagmus) (Sechi and Serra, 2007) | Ocular: WKS classic triad |
| Ataxia (Yeh et al., 2004; Mao et al., 2020) (part of MFS): movement (Lantos et al., 2020), and unstable walking (Wang et al., 2020) | Ataxia (Brechtelsbauer et al., 1997; Chaudhuri and Kennedy, 2002) | Gait Ataxia (Sechi and Serra, 2007) | Ataxia: WKS classic triad |
| Fatigue (Wang et al., 2020), dizziness and languidness (Mao et al., 2020; Wang et al., 2020), malaise(Wang et al., 2020), headache (Mao et al., 2020; Wang et al., 2020) | Weakness and Somnolence (Brechtelsbauer et al., 1997), Nausea (Whitley and Gnann, 2002) | Lack of energy/Fatigue, drowsiness, fainting, Sluggishness (Sechi and Serra, 2007); Apathy (Sechi and Serra, 2007) | Generalized features |
| Cerebral hemorrhage (Wang et al., 2020), cerebral infarction (Wang et al., 2020) | Cerebral Hemorrhage (Kabakus et al., 2005), intracranial Pressure (Kumar et al., 2009) | Hemorrhages (Sechi and Serra, 2007) | Cerebrovascular |
| Epilepsy (Hao et al., 2020; Mao et al., 2020) | Epilepsy (Aguilar and Rasmussen, 1960; Misra et al., 2008) | Seizures (Alcohol Withdrawal) (Nguyen and Lam, 2020) | Pathophysiological |
| Encephalomyelitis: demyelinating (Steardo et al., 2020; Wang et al., 2020), disseminated (Reichard et al., 2020) | Encephalomyelitis (Whitley, 1990; Dale, 2003) | Demyelination (Rao and Topiwala, 2020) within periventricular structures | Pathomorphological |
| Hypogeusia (low ability to taste) | |||
| (Finsterer and Stollberger, 2020; Gautier and Ravussin, 2020; Lechien et al., 2020; Mao et al., 2020) | Hypogeusia (low ability to taste) (Henkin et al., 1975) | Efficacy not well-established | Sensory |
| Hyposmia (low ability to smell) (Bénézit et al., 2020; Finsterer and Stollberger, 2020; Lechien et al., 2020; Mao et al., 2020) | Hyposmia (low ability to smell) (Henkin et al., 1975) | Efficacy not well-established | Sensory |
| Nerve pain (Azhideh, 2020) (also in the head and face region (Mao et al., 2020)) | Neuralgia (Johnson et al., 2010; Tang et al., 2013) | Neuralgia (Rose and Jacobson, 1940; Eckert and Schejbal, 1992) | Neuralgia |
| Tachycardia (He et al., 2020; Kochi et al., 2020) | Tachycardia (Chua et al., 1999; Chaudhuri and Kennedy, 2002) | Racing of heart (faster heartbeat), low blood pressure (Sechi and Serra, 2007), Tachycardia (Sechi and Serra, 2007) | Cardiovascular |
| Muscle injury | |||
| (Cascella et al., 2020; Mao et al., 2020) | Dysarthria (Brechtelsbauer et al., 1997), nerve Impairment (Ripamonti et al., 2020) | Motor impairment (Pitel et al., 2011), motor cortex Excitability (Nardone et al., 2010) | Motor |
| Areflexia (part of MFS) (Lantos et al., 2020) | |||
Therapeutic effects of thiamine on the corresponding neurological symptoms of pro-inflammatory origin that are also observed in viral infection.
WKS: Wernicke Korsakoff Syndrome (Blass and Gibson, 1977); MFS: Miller Fisher Syndrome (Mori et al., 2001).