Majority of COVID-19 associated psychiatric cases described include depression and anxiety in an outpatient, and agitation and confusion in the ICU setting. There are no reports of constellation of symptoms consistent with partial Klüver-Bucy syndrome, which often has infectious etiology. We report a case of 46 y/o Male with past medical history Cerebral Palsy with baseline left-sided hemiparesis, mild dysarthria, two concussions, cervical dystonia, bipolar disorder who developed intermittent episodes of speaking foreign language (Spanish), desire to consume previously rejected foods, staring spells, hypersexuality, change in his regular hobbies:artistic tendencies instead of previously preferred mathematical problem solving after having a prolonged COVID-19 infection with neuropathic pain in the feet and visual field defects on initial presentation. The patient was successfully treated with Carbamazepine.
Patient was monitored and treated in our neurology clinic, after a discharge from the hospital for his new onset acute neuropsychiatric symptoms.
Diagnostic workup included EEG/Video EEG/Brain MRI with and without contrast/Serum and CSF analysis, and has shown nonspecific white matter lesions on T2/FLAIR sequences of the brain MRI, paucicellularity on CSF flow cytometry with essentially absent B-lineage cells, increase in CD4/CD8 ratio, and decreased CD3%, CD8% and CD8 on a serum lymphocytic panel. SARS-COV-2 PCR remained positive for almost two months
COVID-19 has been associated with various short and long-term sequelae. Psychiatric complications are not infrequent, but are underreported. In our patient's case, he presented with symptoms of hypersexuality, dietary change, change in hobbies, vision disturbances, staring spells and episodes of clapping and speaking foreign language.We suggest, that this is the first case of a partial Klüver-Bucy syndrome after COVID-19 with the resolution of symptoms on carbamazepine.