AUTHOR=Gilio Luana , Galifi Giovanni , Centonze Diego , Stampanoni Bassi Mario 

TITLE=Case Report: Overlap Between Long COVID and Functional Neurological Disorders

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.811276

DOI=10.3389/fneur.2021.811276

ISSN=1664-2295

ABSTRACT=Long lasting symptoms have been reported in a considerable proportion of patients after severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection. This condition, defined as “post-acute Covid”, “long Covid”, or “long-haul Covid”, has also been described in non-hospitalized patients and in individuals asymptomatic during the acute infection. The diagnostic criteria for post Covid syndrome may overlap with the DSM-5 definition of functional neurological disorders (FNDs).
We report a 23-year-old man who developed, after asymptomatic Covid-19, a complex symptomatology characterized by fatigue, episodic shortness of breath, nocturnal tachycardia, and chest pain. He also complained of attention and memory difficulties, fluctuating limb dysesthesia and weakness of his left arm. After neurological examination, a diagnosis of FND was made. Notably, the patient was also evaluated at a post Covid center and received a diagnosis of long Covid-19 syndrome. After 4 months of psychoanalytic psychotherapy and targeted physical therapy in our center for FNDs, dysesthesia and motor symptoms had resolved, and the subjective cognitive complaints had improved significantly. However, the patient had not fully recovered as mild symptoms persisted limiting physical activities. 
Long-term post Covid symptoms and FNDs may share underlying biological mechanisms, such as stress and inflammation. Our case suggests that functional symptoms may coexist with long Covid symptoms and may improve with targeted interventions. In patients presenting with new fluctuating symptoms after SARS-CoV-2 infection, the diagnosis of FNDs should be considered, and positive clinical signs should be carefully investigated.