key: cord-0893328-by4sncpw
authors: Finsterer, Josef
title: Intensification of an Essential Tremor by SARS-CoV-2
date: 2022-05-02
journal: Cerebellum
DOI: 10.1007/s12311-022-01409-0
sha: a67d695b8f676fb5c951944451c23caccab987b3
doc_id: 893328
cord_uid: by4sncpw

nan

pre-infectious intensity of the tremor was reached again at the last follow-up.

We should be told why the patient was not treated with steroids or immunoglobulins. Since an abnormal immunological reaction is the most likely cause of the worsening tremor, it would have been indicted to apply immune modulating treatment to assess if such a therapy was beneficial or not.

A shortcoming of the study is that the patient did not undergo investigations of the cerebrospinal fluid (CSF). CSF investigations are obligatory to exclude aseptic pleocytosis, immune encephalitis, or SARS-CoV-2-associated meningitis.

Since the patient experienced relief of the tremor under alcohol, we should be told whether he drank alcohol regularly and if there was hepatopathy or hepatic encephalopathy, which could explain the worsening of the tremor as well.

We do not agree with the statement that inflammatory findings more likely confine to the cerebellum or the brainstem [1] . Immune encephalitis following a SARS-CoV-2 infection can occur in all cerebral locations.

Overall, the interesting study has some limitations and inconsistencies that call the results and their interpretation into question. Clarifying these weaknesses would strengthen the conclusions and could enhance the study.

Worsening of essential tremor after SARS-CoV-2 infection

A case of encephalitis following COVID-19 vaccine

A neurologist's rhombencephalitis after comirnaty vaccination. A change of perspective

A case of limbic encephalitis associated with severely COVID-19 infection

Acute cerebellitis in MIS-C: a case report