There has been a rise in people reporting post-COVID-19 brain disorders. City-based neurologists said they are noticing a spike in complications like Guillain-Barre syndrome, Bell’s palsy, insomnia apart from behavioural and cognitive issues.
Every year, July 22 is observed as World Brain Day and the theme this year is “brain health for all”.
Doctors said neurological complications affecting the brain are the second most common effect following COVID-19 infection, because the SARS-CoV-2 virus has the predilection to affect the lungs and the brain due to the presence of Ace2 receptors in both these areas. As a result the virus can affect the brain and the nervous tissues and cause a variety of complications.
N.K. Venkataramana, Founder-Chairman and Director of Neurosciences at Brains Super Speciality Hospital in Bengaluru, said inflammation in the brain during COVID-19 can persist for a variable amount of time, ranging from a few weeks to months leading to a variety of post-COVID-19 complications. These include severe headaches, epilepsy or arterial strokes due to altered clotting mechanisms and cerebral venous strokes due to altered immune mechanisms.
“We are also seeing patients with peripheral neuropathy, Bell’s palsy, and Guillain-Barre syndrome (GBS). In addition, pre-existing neurological conditions such as migraines, epilepsy, multiple sclerosis, and other autoimmune diseases can be aggravated,” he said.
Brain fog
The doctor said nearly 30% of recovered patients develop vague symptoms like heaviness of head, inability to concentrate, lack of focus, disturbed sleep, and a lack of drive, all put together in a syndrome called brain fog.
“These patients require proper evaluation and symptomatic treatment, lifestyle modification which includes healthy diet, adequate sleep, moderate exercise, and avoidance of alcohol and smoking and titration of pre-existing medications,” he explained.
Suvarna Alladi, Professor and Head of the Department of Neurology at NIMHANS, said some recovered patients are turning up with symptoms of anxiety, depression and memory loss.
“This is apart from major issues such as stroke, epilepsy and encephalopathy after an acute COVID-19 infection subsides. Sometimes they can have giddiness, weakness, fatigue, and delirium,” she said.
Behavioural, cognitive issues
Raghunandan Nadig, Professor of Neurology at St John’s Medical College Hospital, said he has been seeing many patients with behavioural and mood disorders apart from cognitive issues.
“Nearly 25% of recovered patients are coming to us with insomnia, anxiety and memory loss issues. Having been used to staying at home all through the two years of pandemic, some are developing adjustment issues. Most recover with proper counselling/ reassurance and do not require any medications,” he said.
Guruprasad Hosurkar, consultant neurologist at Manipal Hospital (Yeshwanthpur), said elderly patients with chronic degenerative neurological conditions, such as Parkinson’s disease, Alzheimer’s, and dementia, admitted with COVID-19 took a long time to recover. In some patients, these conditions worsened post-COVID-19, he said.
“Because of the lockdown, there was change in habits, decreased social interaction, poor physical activity, reduced access to existing medications, fear of illness, loss of near and dear ones. As a result, even now we see patients with tension-type headaches, insomnia, anxiety neurosis and depression, apart from neuropathy and stroke,” he added.
Brain health clinic
As part of Karnataka Brain Health Initiative(Ka-Bhi), the Health Department, in association with NIMHANS, will launch a brain health clinic at Jayanagar General Hospital in the city on Friday.
Ka-Bhi, designed to develop a model for prevention and management of neurological diseases and promote brain health from grassroots level of primary care to tertiary care, is being initiated on a pilot basis in Bengaluru South, Chickballapur, and Kolar districts. The government has appointed cricketer Robin Uthappa as he brand ambassador for this project.
