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Knowledge of neurological complications of COVID mounting: What you need to know

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Editor's note:  For more coverage of the 2022 AAP National Conference & Exhibition, visit

Keeping up with the latest developments on COVID-19 may seem like a herculean task for many pediatricians.

“It feels like what's true one week maybe has changed by the next week, and there's always new variants and always things that seem to be changing,” said Courtney J. Wusthoff, M.D., M.S., FAAP, associate professor of neurology and pediatrics at Stanford University in Palo Alto, Calif. “But we know a whole lot more now than we did two years ago.”

Among that new knowledge are neurological conditions and emergencies associated with COVID in children.

Dr. Wusthoff and Elizabeth R. MackDiaz, M.D., FAAP, plan to share the latest information during the session “Neurologic Complications of COVID Infection in Children” (S2217) from 9-10 a.m. PDT Saturday, Oct. 8 in rooms 256-258A of the convention center.

“I am really passionate about pediatricians just learning about acute neurologic emergencies in children in general because they serve as frontline providers for our patients and are the people that we rely on in the critical care setting to refer patients on to seek more advanced care in those neurologic emergencies,” said Dr. MackDiaz, assistant professor in the Department of Pediatrics, Division of Critical Care at Medical University of South Carolina and a member of the AAP Section on Critical Care.

Dr. MackDiaz will review the basic pathophysiology of COVID infection and how it is thought to affect the central nervous system. She also will help attendees recognize medical emergencies associated with COVID such as stroke, meningoencephalitis and seizures.

Dr. Wusthoff, a member of the AAP Section on Neurology, will review acute neurologic symptoms of COVID as well as chronic symptoms (i.e., long COVID). She also will talk about strategies to handle what she calls “COVID but not COVID.”

“There are some health problems for children and infants that have arisen out of the pandemic that aren't necessarily direct features of COVID infection but that are certainly consequences of the COVID pandemic,” she said.

An example is a functional neurological disorder referred to as “TikTok tics.”

“And it's not because COVID has infected children who have these motor disorders, but it seems to be related to the stress of the pandemic and to the way that COVID has changed the way that we're interacting with each other in our society,” Dr. Wusthoff said.

“Children can recover remarkably well when you take those conditions seriously and you intervene early,” she added.

Both Dr. Wusthoff and Dr. MackDiaz also want to offer reassurance that attendees know more than they might think and are making a difference.

“For me, it's just nice to be able to talk with the frontline providers and remind them that they're doing a great job taking care of kids and providing good anticipatory guidance to families,” Dr. MackDiaz said.

Added Dr. Wusthoff: “My take-home message is that pediatricians have a lot of the tools already and can find a lot of other great tools to help take care of kids, even as we continue to navigate uncertainty about exactly how COVID affects different systems and might affect kids long term.”

For more information on the National Conference, visit View the conference schedule at

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