COVID-19 as a rare cause of facial nerve neuritis in a pediatric patient

Zain, Sultan; Petropoulou, Kalliopi; Mirchia, Kanish; Hussien, Abdelmohsen Radwan; Mirchia, Kavya

doi:10.1016/j.radcr.2021.03.063

Cited by 14 publications

(21 citation statements)

References 15 publications

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“…MRI revealed ipsilateral atrophy and hyperintensity of the lateral rectus muscle 5 weeks after onset of diplopia, representing a likely correlate for denervation of the abducens nerve due to a direct or indirect virus-mediated insult. In contrast to our patient and other case reports about SARS-CoV-2 associated cranial nerve palsies (5,8,9), this patient's palsy did not improve over time.…”

Section: Discussioncontrasting

confidence: 99%

“…We present a 2year-old boy with unilateral abducens nerve palsy as a likely post-infectious complication of COVID-19. Hereby, we want to show that cranial nerve involvement may occur as post-infectious complication of pediatric SARS-CoV-2-infection in addition to the previously described context of acute SARS-CoV-2-infection and MIS-C (3,6,8,9,12). In addition, this case lays special emphasis on pediatric sixth cranial nerve palsy in the context of SARS-CoV-2, a topic only discussed in one publication so far (3).…”

Section: Introductionmentioning

confidence: 92%

“…Besides known involvement of the olfactory bulb, COVID-19 may also present with other cranial nerve dysfunctions including the optic, abducens, oculomotor and facial nerve as well as lower cranial nerves (5-7). There are only few reports of cranial nerve involvement for children (3,6,(8)(9)(10)(11). We present a 2year-old boy with unilateral abducens nerve palsy as a likely post-infectious complication of COVID-19.…”

Section: Introductionmentioning

confidence: 93%

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Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

et al. 2021

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Children have been described to show neurological symptoms in acute coronavirus disease 2019 (COVID-19) and multisystemic inflammatory syndrome in children (MIS-C). We present a 2-year-old boy's clinical course of unilateral acute sixth nerve palsy in the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Onset of the palsy in the otherwise healthy boy occurred seven days after symptoms attributed to acute infection had subsided respectively 3 weeks after onset of respiratory symptoms. SARS-CoV-2 specific IgG was detected in serum as well as in cerebrospinal fluid. The patient showed a prolonged but self-limiting course with a full recovery after three and a half months. This case illustrates in a detailed chronological sequence that sixth cranial nerve involvement may occur as post-infectious, self-limiting complication of pediatric SARS-CoV-2-infection thus expanding the neurological spectrum of symptoms for children with COVID-19. Clinicians should be aware of the possibility of post-infectious sixth nerve palsy related to SARS-CoV-2-infection particularly in view of recent respiratory tract infection or confirmed cases of SARS-CoV-2-infection amongst the patient's close contacts.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 93%

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Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

et al. 2021

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“…Although HIGM has four subtypes, he probably has X-linked CD40 ligand (CD40L) deficiency. Secondly, Bell’s palsy associated with SARS-CoV-2 in children have been reported by some other researchers after this report [2] , [3] . I disagree with the authors and think that Bell’s palsy is not a coincidental finding alongside the SARS-CoV-2 infection.…”

supporting

confidence: 56%

“…I disagree with the authors and think that Bell’s palsy is not a coincidental finding alongside the SARS-CoV-2 infection. Also, Bell’s palsy in children seems to happen with SARS-CoV-2 infection without having any immunodeficiency [2] , [3] .…”

mentioning

confidence: 99%

Bell’s palsy development during SARS-CoV-2 infection

Özdemir¹

2021

Brain and Development

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Facial palsy as a manifestation of COVID‐19: A systematic review of cases

Khurshid

Sohail

et al. 2022

Health Science Reports

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Background and Aims Facial palsy is a rare complication of the COVID‐19 infection. Herein, we conducted a systematic review of all published cases of facial palsy post‐COVID‐19 infection in an attempt to educate the general population and medical practitioners regarding the likely occurrence of facial palsy in COVID‐19 patients, its detection, effective treatment plan, and prognosis of the condition. Methods We searched PubMed, Google Scholar, and Directory of Open Access Journals (DOAJ) from December 1, 2019 to September 21, 2021. Results We included 49 studies bearing accounts of 75 cases who had facial palsy. The mean age of patients was 42.9 ± 19.59 years, with a male‐to‐female ratio of 8:7. The majority of the cases were reported from Brazil ( n = 14), USA ( n = 9), Turkey ( n = 9), and Spain ( n = 9). Noticeably, 30.14% of COVID‐19 patients were diagnosed with Guillain‐Barré syndrome. In total, 22.97% of patients complained of bilateral facial paralysis ( n = 17), whereas ipsilateral paralysis was observed in 77.03% ( n = 57). These were common complaints of Lagophthalmos, otalgia, facial drooping, dysarthria, and compromised forehead wrinkling. The treatment regimen mainly included the use of corticosteroids ( n = 51) (69.86%), antivirals ( n = 23) (31.51%), IVIG ( n = 18) (24.66%), antibiotics ( n = 13) (17.81%), antiretroviral ( n = 9) (12.33%), and antimalarial ( n = 8) (10.96%) medications. In all, 35.62% of patients ( n = 26) adhered to a combination of antiviral and corticosteroid‐based therapy. Positive treatment outcomes were observed in 83.58% ( n = 56) of cases. In contrast, 10 patients (14.93%) showed nonsignificant recovery, out of which 3 (4.48%) died from the disease. Conclusion The association of facial palsy with COVID‐19 is controversial and therefore requires further investigation and published work to confirm a causal relationship. However, physicians should not overlook the likelihood of facial palsy post‐COVID‐19 infection and treat it accordingly.

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COVID-19 as a rare cause of facial nerve neuritis in a pediatric patient

Cited by 14 publications

References 15 publications

Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

Bell’s palsy development during SARS-CoV-2 infection

Facial palsy as a manifestation of COVID‐19: A systematic review of cases

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