Bilateral Facial Nerve Palsy after Sars-Cov2 Infection in Pediatric Patient

COVID-19 infection has been associated with several neurologic manifestations including anosmia, acute ischemic stroke, Guillain-Barré syndrome, encephalopathy and cranial nerve involvement. Though multiple cases of unilateral facial nerve palsy have been reported but bilateral facial palsy is very rare. Our case was 12 years old female patient who presented with difficulty in closing mouth, drooling of saliva and change in voice. On examination, there was loss of bilateral nasolabial folds, nasal twang of speech and incomplete eye closure bilaterally. Laboratory reports suggested raised CRP and amylase along with positive Immunoglobulin IgG covid-19 antibodies. Magnetic Resonance Imaging of brain and neck showed no abnormality. The child was managed conservatively with supportive care, subsequent to which she gradually improved over next 4-6 weeks. To the best of our knowledge, this is the first pediatric case where SARS-COV2 infection was found to be associated with bilateral facial nerve palsy as a post covid complication. Therefore, bilateral facial palsy should be considered as one of the associations of COVID especially in the present era. A detailed history and examination should be done as it often gets missed due to bilateral involvement. All differential diagnosis should be ruled out by relevant laboratory & radiological tests. Most children are likely to recover well with supportive treatment.

Case report of a male child with lupus nephritis

Systemic lupus erythematosus is a chronic autoimmune inflammatory disease of unknown etiology that affects various organs, most frequently the skin, joints, kidneys, nervous, hematologic and cardiovascular systems. It affects females more often as compared to males. The kidneys are one of the most serious organs involved. Lupus nephritis may present as hypertension, proteinuria, and renal failure or it may also be asymptomatic. The recent reports suggest that childhood-onset lupus nephritis could be more severe than the late-onset disease. The occurrence of SLE in pediatric patients is very rare, especially in a male child. Here author report a case of an 8-year-old male child clinically misdiagnosed as a case of henoch schonlein purpura, who was thoroughly investigated and finally confirmed as a case of lupus nephritis.

Normal Functioning Pelvic Lump Kidney: Isolated Anomaly - Radiological Evaluation.

There is wide spectrum of Mullerian dysgenesis presenting in different ways. Routine ultrasound done of a child for pain abdomen discovered a pelvic mass supero-posterior to the urinary bladder. This was diagnosed as fused pelvic kidneys by various cross sectional imaging modalities like Computerized tomography (CT) and Magnetic resonance imaging (MRI).We present a 4-years male child who was diagnosed as a case of “lump kidneys” by plain sonography coupled with color flow imaging (CFI). The entity usually falls in the common group of VATER (vertebral, anorectal malformation, esophageal and renal) anomalies. But our present case was having isolated anomaly and this entity is of a great rarity as seen in literature.

Acute Hepatitis Like Presentation of Budd Chiari Syndrome in a Child.

The patient presented with progressively increasing ascites and pain abdomen but without any bleeding tendency, or encephalopathy. The initial diagnosis of acute hepatitis was proved wrong by contrast enhanced CT scan of abdomen which showed atretic hepatic veins. Atretic hepatic veins causing Budd Chiari Syndroem (BCS) is a rarity in literature.