ABSTRACT
BACKGROUND: Covid-19 has serious sequelae that may be poorly understood, underreported, and, as a result, not diagnosed promptly, such as variations in clinical manifestations of hyperinflammation among people infected with SARS-CoV-2. ophthalmoplegia can be one of these manifestations. METHODS: We are reporting a 55-year-old male patient with unilateral diplopia considering it as a case of multisystem inflammatory syndrome in adults. We also reviewed the literature systematically for the previously reported studies/cases with third, fourth and sixth cranial nerve palsies due to or after Covid-19. RESULTS: The literature search yielded 17 studies reporting 29 patients. 71.4% of the patients were males with a mean age of 42.23 years. Ophthalmological symptoms took 9.7 days to appear after the respiratory involvement. All patients had diplopia as part of their visual symptoms. 41.4% of the patients had unilateral sixth nerve palsy, 24% had bilateral sixth nerve involvement, 17% had fourth nerve involvement, and 27.6% had third nerve involvement. CONCLUSION: Ophthalmoplegia is considered presenting symptom of Covid-19. Further research is needed to detect all neuro-ophthalmological manifestations of Covid-19.
Subject(s)
Abducens Nerve Diseases , COVID-19 , Cranial Nerve Diseases , Oculomotor Nerve Diseases , Ophthalmoplegia , Male , Adult , Humans , Middle Aged , Female , Oculomotor Nerve Diseases/etiology , COVID-19/complications , SARS-CoV-2 , Abducens Nerve Diseases/etiology , Abducens Nerve Diseases/diagnosis , Diplopia/etiology , Ophthalmoplegia/diagnosis , Ophthalmoplegia/etiology , Cranial Nerve Diseases/diagnosisABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although many reports have detailed a range of neurological symptoms in SARS-CoV-2-infected patients, studies of neuro-ophthalmological manifestations are still scarce. CASE PRESENTATION: We report a 9-year-old girl with abducens nerve palsy after COVID-19 with no evidence of other neurological disease on neuroimaging. At 2-month follow-up clinical conditions were improved. CONCLUSIONS: The palsy may have occurred due to a possible post-infectious immune-mediated mechanism underlying the neuropathy, as opposed to direct viral infiltration. Despite being rare, this complication must be taken into account.
Subject(s)
Abducens Nerve Diseases , COVID-19 , Nervous System Diseases , Abducens Nerve Diseases/diagnosis , Abducens Nerve Diseases/etiology , COVID-19/complications , Child , Female , Humans , Nervous System Diseases/complications , SARS-CoV-2ABSTRACT
The authors report the case of an otherwise healthy 65-year-old man who presented with an acute right abducens nerve palsy 3 days after receiving the second dose of the AstraZeneca coronavirus disease 2019 (COVID-19) vaccine. Abducens nerve palsies typically results from microvascular disease or compressive tumors, although they are known to arise following routine vaccinations. Given the lack of preexisting risk factors, normal computed tomography scan results, and the timing of the symptoms, the abducens nerve palsy was believed to be related to the vaccination. This report highlights the potential neurologic adverse effects associated with COVID-19 vaccines. [J Pediatr Ophthalmol Strabismus. 2021;58(6):e49-e50.].
Subject(s)
Abducens Nerve Diseases , COVID-19 , Abducens Nerve Diseases/chemically induced , Abducens Nerve Diseases/diagnosis , Aged , COVID-19 Vaccines , Humans , Male , SARS-CoV-2ABSTRACT
We present the case of a 23-year-old young man with left-eye abducens nerve palsy following the COVID-19 vaccination. Given the temporal relationship between vaccination and the onset of symptoms, the lack of systemic history, and unremarkable magnetic resonance imaging, the patient's abducens nerve palsy was related to his vaccination. The ophthalmologist should be aware of this neurotropic sequela of COVID-19 vaccination in young adults.
Subject(s)
Abducens Nerve Diseases , COVID-19 , Abducens Nerve , Abducens Nerve Diseases/diagnosis , Abducens Nerve Diseases/etiology , Adult , COVID-19 Vaccines , Humans , Male , SARS-CoV-2 , Vaccination/adverse effects , Young AdultABSTRACT
Neurological manifestations of novel coronavirus disease 3019 (COVID-19) remain unclear. We report the case of a 44-year-old febrile man who presented with double vision and headache 2 d after initial symptoms of fatigue, generalized muscle weakness, and loss of appetite. He was subsequently diagnosed with COVID-19 and transient abducens nerve paresis. He did not present with any respiratory symptoms or additional specific neurological findings. We recommend that with the rising number of cases across the world, physicians develop a greater index of suspicion for COVID-19 in patients with cranial neuropathies, even in those with mild disease without typical respiratory symptoms.
Subject(s)
Abducens Nerve Diseases , COVID-19 , Abducens Nerve , Abducens Nerve Diseases/diagnosis , Abducens Nerve Diseases/etiology , Adult , COVID-19/complications , Diplopia/complications , Diplopia/etiology , Humans , Male , Paresis/complicationsABSTRACT
We present a case of an abducens nerve palsy in a previously healthy young man in the setting of SARS-CoV-2 infection. Magnetic resonance imaging obtained 5 weeks after the onset of diplopia demonstrated an atrophic left lateral rectus muscle, which was hyperintense on T2 weighting, consistent with denervation. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to his viral illness, because the patient had no preexisting vascular risk factors or evidence of other neurologic disease on neuroimaging. Cranial nerve palsies may represent part of the neurologic spectrum of COVID-19.