Neurological complications during treatment of middle east respiratory syndrome

Jee Eun Kim, Jae Hyeok Heo, Hye Ok Kim, Sook Hee Song, Sang Soon Park, Tai Hwan Park, Jin Young Ahn, Min Ky Kim, Jae Phil Choi

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381 Scopus citations


Background and Purpose Middle East respiratory syndrome (MERS) has a high mortality rate and pandemic potential. However, the neurological manifestations of MERS have rarely been reported since it first emerged in 2012. Methods We evaluated four patients with laboratory-confirmed MERS coronavirus (CoV) infections who showed neurological complications during MERS treatment. These 4 patients were from a cohort of 23 patients who were treated at a single designated hospital during the 2015 outbreak in the Republic of Korea. The clinical presentations, laboratory findings, and prognoses are described. Results Four of the 23 admitted MERS patients reported neurological symptoms during or after MERS-CoV treatment. The potential diagnoses in these four cases included Bickerstaff’s encephalitis overlapping with Guillain-Barré syndrome, intensive-care-unit-acquired weakness, or other toxic or infectious neuropathies. Neurological complications did not appear concomi-tantly with respiratory symptoms, instead being delayed by 2–3 weeks. Conclusions Neuromuscular complications are not rare during MERS treatment, and they may have previously been underdiagnosed. Understanding the neurological manifestations is important in an infectious disease such as MERS, because these symptoms are rarely evaluated thoroughly during treatment, and they may interfere with the prognosis or require treatment modification.

Original languageEnglish
Pages (from-to)227-233
Number of pages7
JournalJournal of Clinical Neurology (Korea)
Issue number3
StatePublished - 2017

Bibliographical note

Publisher Copyright:
© 2017 Korean Neurological Association.


  • Guillain-Barré syndrome
  • Middle East respiratory syndrome
  • Neurological complications
  • Peripheral neuropathy


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