Patient 1
A 49-year-old male presented with a one month history of paresthesias and difficulty ambulating. On exam, he was found to have ataxia on finger to nose and heel to shin, absent reflexes, loss of proprioception and vibratory sense in his fingers and toes with strength intact. He was found to have positive SARS-COV2-IgG. He was never vaccinated and never diagnosed with COVID-19 infection. CSF studies were negative for albuminocytologic dissociation. He received a 5-day course of IVIG and one dose of Rituximab with improvement of sensory ataxia.
Patient 2
A 28-year-old female presented with a one-month history of paresthesias and subjective generalized weakness. On exam, she was found to have absent reflexes, loss of proprioception fingers and toes with intact strength. She was found to have positive SARS-COV2-IgM. CSF studies were negative for albuminocytologic dissociation . She received a 5-day course of IVIG with slight improvement of sensory ataxia.
Patient 3
A 45-year-old female presented with a several month history of progressive paresthesias, generalized weakness, and difficulty ambulating. On exam, she was found to have mild proximal muscle weakness, profound loss of proprioception and vibratory sense in the hands and feet, truncal ataxia and diffuse areflexia. She was found to be Sars-CoV-2-IgM and IgG positive. CSF study revealed cytoalbuminologic disassociation. She received a 5-day course of IVIG with little clinical improvement. Subsequent EMG/NCS was significant for demyelinating axonal polyneuropathy with axonal loss and autonomic instability.