Facial Diplegia as a Rare Late Neurologic Manifestation of SARS-CoV-2 Infection

Judge, Casey; Moheb, Negar; Apolo, Ramiro Castro; Dupont, Joy L; Gessner, Michelle L; Yacoub, Hussam A.

doi:10.14740/jnr606

Cited by 9 publications

(13 citation statements)

References 6 publications

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“…In total, our search strategy revealed 215 articles (Figure 1, Table 2). After excluding duplicates and those not meeting inclusion criteria, a total of 32 papers were included in the current review with 46 patients, with an equal number ( n = 23) of males and females [11–42]. The maximum number of cases were from Brazil ( n = 9) and Turkey ( n = 9), followed by the United States ( n = 8), Iran ( n = 4), and Spain ( n = 3).…”

Section: Resultsmentioning

confidence: 99%

Surge of Bell's Palsy in the era of COVID‐19: Systematic review

Gupta

Jawanda²

2022

Euro J of Neurology

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Background and purpose With the progression of coronavirus infectious disease 2019 (COVID‐19), various neurological manifestations have been noticed in infected patients, and Bell's Palsy (BP) is one of the peripheral neuropathies among those. BP has been associated with various other viral agents. Its evidence in patients with COVID‐19 signifies the possibility of association between BP and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). This research was undertaken to evaluate the number of published cases of BP as the only major neurological manifestation in patients with COVID‐19 from March 2020 to December 2021 and to investigate the association of SARS‐CoV‐2 and BP. Methods A systematic review of the published English literature was performed using an electronic search in the PubMed/Medline, Scopus, Research Gate, Research Square, and Google Scholar databases, using keywords such as "COVID‐19" OR/AND "SARS‐CoV‐2" OR/AND "Bell's palsy" OR/AND "facial nerve palsy" OR/AND "neurological" OR/AND "manifestation". Results The search strategy revealed 32 relevant publications with a total of 46 patients. BP was the initial manifestation in 37% of cases, and in 63% of cases it developed after COVID‐19 symptoms; 71.7% of cases showed complete recovery, and 21.7% showed only partial relief from BP. Conclusions Although the number of documented cases in this research is low, evidence of BP as the only major neurological manifestation in patients with COVID‐19 signifies an important clinical finding and the possibility of another viral etiology of BP. More evidence is needed to establish the exact correlation between these two entities.

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Section: Resultsmentioning

confidence: 99%

Surge of Bell's Palsy in the era of COVID‐19: Systematic review

Gupta

Jawanda²

2022

Euro J of Neurology

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“…In a recent case series, 19 of 214 hospitalized patients (8.9%) with COVID-19 had peripheral nervous system manifestations, including taste impairment, smell impairment, vision impairment, and nerve pain ( 2 ). To the best of our knowledge, there are only five case reports on bilateral facial nerve palsy without other neurological findings: two of them are thought to be variants of GBS ( 9 , 11 ), another two are thought to be bilateral Bell's palsy after COVID-19 ( 12 , 13 ), and the last one is a case of bilateral facial paralysis after a mixed infection with COVID-19 and EBV ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Post COVID-19 Bilateral Facial Nerve Palsy

et al. 2022

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Coronavirus disease 2019 (COVID-19) patients have been increasingly reported to develop various neurological manifestations. We herein present a rare case of bilateral facial nerve palsy in a patient that occurred 5 weeks after the onset of COVID-19. The patient had no motor or sensory deficits in his extremities, and there were no other diseases that may have resulted in bilateral facial palsy. Based on these findings, we concluded that the facial palsy in this case may have been triggered by COVID-19.

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“…Tools had 8 items for case reports and 10 for case series. Included case reports ( n = 39) had a mean score of 6.385 ± 1.41 with scores ranging from 2 to 8 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 10 case series had a mean score of 5.60 ± 2.01, and scores ranged from 3 to 9. 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 The detailed results of the quality assessment are provided in Supporting Information: File S1 .…”

Section: Methodsmentioning

confidence: 99%

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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Facial Diplegia as a Rare Late Neurologic Manifestation of SARS-CoV-2 Infection

Cited by 9 publications

References 6 publications

Surge of Bell's Palsy in the era of COVID‐19: Systematic review

Surge of Bell's Palsy in the era of COVID‐19: Systematic review

Post COVID-19 Bilateral Facial Nerve Palsy

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

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