[Ophthalmic manifestations in COVID-19-associated multiple mononeuropathy of the cranial nerves (clinical observation)]. / Oftal'mologicheskie proyavleniya pri mnozhestvennoi mononevropatii kranial'nykh nervov, assotsiirovannoi s COVID-19 (klinicheskoe nablyudenie).

Clinical manifestations of the new coronavirus infection can vary greatly and affect different organs and systems. Despite the lack of convincing data on the possible direct damage to the structures of the eyeball by the SARS-CoV-2 virus, indirect involvement of the organ of vision both in the acute period of the disease, during the period of convalescence, and as a part of the post-COVID syndrome is common in clinical practice. The condition of the ocular surface is not given much attention during the treatment of the main disease, especially in severe cases, which can lead to serious complications and visual acuity loss after recovery. Timely measures can prevent the loss of visual acuity. This article presents a description and discusses a rare case of multiple neuropathy of the cranial nerves associated with COVID-19, with bilateral involvement of the olfactory (I), trigeminal (V), facial (VII) and sublingual (XII) nerves, as well as the right optic nerve (II), which required staged rehabilitation.

COVID-19 associated multiple cranial neuropathies

The polymorphism of the clinical manifestations of coronavirus infection often creates great diagnostic difficulties for the practitioners, especially in patients with a predominance of neurological symptoms. Of the latter, cranial neuropathies take a particular place, as they may be either one of the first symptoms or appear during the disease progression. Impairment of smell and taste is considered an early manifestation of SARS-CoV-2 infection. Similar to the involvement of the olfactory bulb, multiple cranial nerves involvement (for example, VII, VI, and III) has been described. Patients with COVID-19 associated multiple cranial neuropathies are more likely to experience partial recovery of impaired function. We present and discuss a rare case of COVID-19 associated multiple cranial neuropathies with a sequential involvement of the olfactory (I), right visual (II), frontal branch of the trigeminal (V), facial (VII), and hypoglossal (XII) nerves. Data on clinical manifestations and diagnostic criteria for this form of pathology are presented.