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Among those who are affected by severe neurological manifestations, some may have acute cerebrovascular complications (5%), impaired consciousness (15%) or exhibit skeletal muscle hypokinesis (20%). The cause of the severe cognitive impairment and hypokinesis is unknown at this time. Potential causes include COVID-19 viral encephalopathy, toxic metabolic encephalopathy, post-intensive care unit syndrome and cerebrovascular pathology. We present a case of a 60 year old patient who sustained a prolonged hospitalization with COVID-19, had a cerebrovascular event and developed a persistent unexplained encephalopathy along with a hypokinetic state. He was treated successfully with modafinil and carbidopa\/levodopa showing clinical improvement within 3\u20137 days and ultimately was able to successfully discharge home.<\/jats:p>","DOI":"10.1136\/bcr-2020-239781","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T10:58:08Z","timestamp":1614682688000},"page":"e239781","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3263-2083","authenticated-orcid":false,"given":"Devjit","family":"Roy","sequence":"first","affiliation":[{"name":"Department of Medicine, Montefiore Nyack Hospital, Nyack, NY, USA"},{"name":"Department of Medicine, Albert Einstein - College of Medicine, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Medicine, Albert Einstein - College of Medicine, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirvana","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Montefiore Nyack Hospital, Nyack, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Zamudio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Montefiore Nyack Hospital, Nyack, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"2025082701264789000_14.3.e239781.1","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1097\/ALN.0000000000003296","article-title":"Intubation and ventilation amid the COVID-19 outbreak: Wuhan's experience","volume":"132","author":"Meng","year":"2020","journal-title":"Anesthesiology"},{"key":"2025082701264789000_14.3.e239781.2","unstructured":"Johns Hopkins coronavirus resource center. 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