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1.
Indian J Ophthalmol ; 70(4): 1365-1370, 2022 04.
Article in English | MEDLINE | ID: covidwho-1760976

ABSTRACT

Purpose: To study facial nerve palsy (FNP) in post-COVID-19-mucormycosis patients and its ocular complications, report different presentations of FNP in such patients, and propose its etiopathogenesis based on presentation and clinico-radiologic localization. Methods: A prospective cohort study was carried out in patients of post-COVID-19-mucormycosis who presented at our tertiary center, over a period of 3 months. Motor and sensory examination of the facial nerve was done to diagnose FNP and localize the lesion clinically. Slit-lamp examination was done for grading corneal involvement. MRI brain, orbit, and paranasal sinuses (PNS) with contrast were studied to find involvement along the facial nerve. It was assessed whether this site of lesion corresponded with clinical localization. Data were analyzed using the percentage of total cases and Fisher's test. Results: A total of 300 patients with post-COVID-19 mucormycosis were examined, of which 30 (10%) patients were found to have FNP. All were lower motor neuron (LMN) type and were associated with corneal complications. The most common site clinically was distal to the chorda tympani (66.66%) and radiologically was infratemporal (IT) fossa (63.4%). The clinical localization significantly correlated with the radiological findings (P = 0.012). Twenty percent of patients showed incomplete involvement of facial muscles. Conclusion: FNP was found to be of LMN type. The most common site of insult was IT fossa. There was a good clinico-radiological correspondence of lesions. Isolated lesions were also found along the peripheral nerve course, presenting as incomplete facial palsy. Recognition of FNP in post-COVID-19 mucormycosis, in all its variable forms, is important to manage corneal complications.


Subject(s)
COVID-19 , Facial Paralysis , Mucormycosis , COVID-19/complications , COVID-19/diagnosis , Facial Paralysis/diagnosis , Facial Paralysis/etiology , Humans , Magnetic Resonance Imaging , Mucormycosis/complications , Mucormycosis/diagnosis , Prospective Studies
2.
Pan Afr Med J ; 40: 244, 2021.
Article in French | MEDLINE | ID: covidwho-1698872

ABSTRACT

We conducted a clinical study of a patient with no particular medical history and without a personal or family history presenting with right facial asymmetry occurred two days after COVID-19 vaccination (recombinant vaccine). Full clinical examination, laboratory assessments and magnetic resonance imaging (MRI) were normal, suggesting the diagnosis of post-vaccine peripheral facial palsy (COVID-19). The diagnosis of peripheral facial palsy following COVID-19 vaccination with complete recovery was retained.


Subject(s)
COVID-19 , Facial Paralysis , COVID-19/diagnosis , COVID-19 Vaccines/adverse effects , Facial Paralysis/diagnosis , Facial Paralysis/etiology , Humans , SARS-CoV-2 , Vaccination/adverse effects
3.
Intern Med ; 61(2): 241-243, 2022 Jan 15.
Article in English | MEDLINE | ID: covidwho-1633473

ABSTRACT

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.


Subject(s)
COVID-19 , Facial Paralysis , Facial Nerve , Facial Paralysis/diagnosis , Facial Paralysis/etiology , Humans , SARS-CoV-2
10.
Am J Otolaryngol ; 42(5): 103129, 2021.
Article in English | MEDLINE | ID: covidwho-1293531

ABSTRACT

OBJECTIVES: The symptoms of COVID-19 at the time of presentation mainly include fever, cough, respiratory distress and myalgia. On the other hand, as neurological symptoms, disruption of taste and smell and cerebrovascular pathologies are well-known, whereas other neurological symptoms and signs are being newly recognized. Sudden-onset sensorineural hearing loss (SSNHL) and idiopathic acute facial paralysis (Bell's palsy) are otologic emergencies that are frequently encountered by otorhinolaryngology specialists. Although there are many articles describing SSNHL and Bell's palsy in the literature, the literature describing their relationship to COVID-19 is limited. In our study, we aimed to present the neuro-otologic relationship of SSNHL and Bell's palsy with COVID-19. MATERIAL AND METHODS: The pretreatment real-time oronasopharyngeal PCR tests, COVID-19 symptomatology and COVID-19 infection statuses of patients who presented to our clinic with isolated SSNHL and Bell's palsy between April 2020 and April 2021 were questioned, and the data of the patients were collected. Throughout their treatment, the patients were followed-up in terms of COVID-19 infection. This is a prospective study. Moreover, to observe the change in the incidence, the data of patients visiting between January 2019 and January 2020 were also collected. The data of the patients were statistically analyzed using SPSS. RESULTS: The study included a total of 177 patients. The SSNHL group consisted of 91 patients, and the Bell's palsy group consisted of 86 patients. Neither group showed a statistically significant difference in comparison to the year without the pandemic in terms of the patient numbers (incidence), sex, age, morbidity, response to treatment or social habits. There was a statistically significant difference in age only in the Bell's palsy group, but this difference was not medically significant. CONCLUSION: As a result of our study, we did not observe a relationship between COVID-19 and cases of SSNHL and Bell's palsy. It is recommended to apply standard otologic treatment to isolated SSNHL and Bell's palsy patients whose association with COVID-19 is not determined.


Subject(s)
Bell Palsy/epidemiology , COVID-19/complications , Facial Paralysis/epidemiology , Hearing Loss, Sensorineural/epidemiology , Hearing Loss, Sudden/epidemiology , Adult , Aged , Bell Palsy/diagnosis , Bell Palsy/virology , COVID-19/diagnosis , COVID-19/epidemiology , Facial Paralysis/diagnosis , Facial Paralysis/virology , Female , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/virology , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/virology , Humans , Incidence , Male , Middle Aged , Prospective Studies , Symptom Assessment , Turkey
11.
Curr Opin Otolaryngol Head Neck Surg ; 29(4): 271-276, 2021 Aug 01.
Article in English | MEDLINE | ID: covidwho-1246812

ABSTRACT

PURPOSE OF REVIEW: In the setting of the COVID-19 global pandemic, the demand for and use of telemedicine has surged in facial plastic and reconstructive surgery. This review aims to objectively review and summarize the existing evidence for the use of telemedicine within facial plastic surgery. RECENT FINDINGS: Telemedicine has been successfully implemented among subsets of facial plastic surgery patients, with high patient and provider satisfaction. Although the technology to facilitate telemedicine exists and preliminary studies demonstrate promise, multiple technological, financial, and medical barriers may persist in the postpandemic era. SUMMARY: Telemedicine will likely continue to grow and expand within facial plastic surgery moving forward, and we should continue to critically evaluate patient selection, access to care, and strategies for effective implementation to enhance current clinical practices.


Subject(s)
Face/surgery , Reconstructive Surgical Procedures , Telemedicine , COVID-19 , Facial Injuries/diagnostic imaging , Facial Injuries/surgery , Facial Paralysis/classification , Facial Paralysis/diagnosis , Health Insurance Portability and Accountability Act , Humans , Patient Participation , Patient Satisfaction , Surgery, Plastic/education , Teleradiology , United States , Videoconferencing
12.
J Med Virol ; 93(2): 766-774, 2021 02.
Article in English | MEDLINE | ID: covidwho-1196399

ABSTRACT

We report a case series of five patients affected by SARS-CoV-2 who developed neurological symptoms, mainly expressing as polyradiculoneuritis and cranial polyneuritis in the 2 months of COVID-19 pandemic in a city in the northeast of Italy. A diagnosis of Guillain-Barré syndrome was made on the basis of clinical presentation, cerebrospinal fluid analysis, and electroneurography. In four of them, the therapeutic approach included the administration of intravenous immunoglobulin (0.4 g/kg for 5 days), which resulted in the improvement of neurological symptoms. Clinical neurophysiology revealed the presence of conduction block, absence of F waves, and in two cases a significant decrease in amplitude of compound motor action potential compound muscle action potential (cMAP). Four patients presented a mild facial nerve involvement limited to the muscles of the lower face, with sparing of the forehead muscles associated to ageusia. In one patient, taste assessment showed right-sided ageusia of the tongue, ipsilateral to the mild facial palsy. In three patients we observed albuminocytological dissociation in the cerebrospinal fluid, and notably, we found an increase of inflammatory mediators such as the interleukin-8. Peripheral nervous system involvement after infection with COVID-19 is possible and may include several signs that may be successfully treated with immunoglobulin therapy.


Subject(s)
COVID-19/complications , Guillain-Barre Syndrome/cerebrospinal fluid , Guillain-Barre Syndrome/diagnosis , Nervous System Physiological Phenomena , Neuritis/diagnosis , Aged , Aged, 80 and over , Ageusia/diagnosis , Ageusia/virology , COVID-19/cerebrospinal fluid , COVID-19/therapy , Facial Paralysis/diagnosis , Facial Paralysis/virology , Female , Guillain-Barre Syndrome/therapy , Humans , Immunization, Passive , Interleukin-8/cerebrospinal fluid , Italy , Male , Middle Aged , Neuritis/therapy , Neuritis/virology , Polyradiculoneuropathy/diagnosis , Polyradiculoneuropathy/virology
13.
Am J Otolaryngol ; 42(5): 103032, 2021.
Article in English | MEDLINE | ID: covidwho-1171724

ABSTRACT

PURPOSE: Publications about increased number of peripheral facial paralysis in the COVID-19 pandemic emerged in the literature. However, these studies comprised of an estimate rather than a broad analysis of exact numbers. In this study, we planned to investigate whether the pandemic really resulted in an increase in facial paralysis cases admitted to the hospital by evaluating the cases who applied to our hospital due to facial paralysis in the COVID-19 pandemic year and in the previous 4 years. MATERIALS AND METHODS: Patients who applied to our hospital due to facial paralysis between March 2016-February 2017 (Group 1), between March 2017-February 2018 (Group 2), between March 2018-February 2019 (Group 3), between March 2019-February 2020 (Group 4), and between March 2020-February 2021 (Group 5) were investigated and detailed data were noted. RESULTS: 156, 164, 149, 172 and 157 patients were admitted to the hospital due to peripheral facial paralysis in Group 1, 2, 3, 4, and 5, respectively. Of these patients, 155, 164, 145, 169, and 153 were Bell's palsy, respectively. SARS-CoV-2 RT-PCR test was positive in only 2 of the 153 patients who were diagnosed in the year of the pandemic. CONCLUSIONS: This study showed that the number of peripheral facial paralysis detected during the COVID-19 pandemic was similar to previous years. Very few number of positive SARS-CoV-2 RT-PCR test results may have been found incidentally in Bell's palsy patients. Theses stating that SARS-CoV-2 causes peripheral facial paralysis should be supported by laboratory studies and postmortem research.


Subject(s)
Bell Palsy/epidemiology , COVID-19/complications , Facial Paralysis/epidemiology , Bell Palsy/diagnosis , Bell Palsy/virology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , Facial Paralysis/diagnosis , Facial Paralysis/virology , Hospitalization , Humans , Incidence , Real-Time Polymerase Chain Reaction , Retrospective Studies , Turkey
15.
BMJ Case Rep ; 14(3)2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1112321

ABSTRACT

COVID-19 is caused by the novel SARS-CoV-2 and is a potentially fatal disease that is of great global public health concern. In addition to respiratory symptoms, neurological manifestations have been associated with COVID-19. This is attributed to the neurotropic nature of coronaviruses. The authors present a case of Bell's palsy associated with COVID-19 in a term primigravida.


Subject(s)
Bell Palsy , COVID-19 , Facial Paralysis , Guillain-Barre Syndrome/diagnosis , Prednisolone/administration & dosage , Pregnancy Complications, Infectious , Stroke/diagnosis , Valacyclovir/administration & dosage , Adult , Anti-Inflammatory Agents/administration & dosage , Antiviral Agents/administration & dosage , Bell Palsy/etiology , Bell Palsy/physiopathology , Bell Palsy/therapy , COVID-19/complications , COVID-19/physiopathology , COVID-19/therapy , Diagnosis, Differential , Facial Paralysis/diagnosis , Facial Paralysis/physiopathology , Facial Paralysis/therapy , Facial Paralysis/virology , Female , Humans , Neurologic Examination/methods , Physical Therapy Modalities , Pregnancy , Pregnancy Complications, Infectious/physiopathology , Pregnancy Complications, Infectious/therapy , Treatment Outcome
16.
Pan Afr Med J ; 38: 30, 2021.
Article in English | MEDLINE | ID: covidwho-1110741

ABSTRACT

SARS-CoV-2 is an infection due to a novel virus belonging to the coronavirus family. Since December 2019, first human cases of COVID-19 have been identified in Wuhan (China) and rapidly has been progressed to a global pandemic declared by the world health organization (WHO) on March 11th 2020. The major complication of COVID-19, is pneumonia, but other presentations like cardiovascular and neurological complications have been reported. Herein, we report a first case of pregnant women presented with bifacial weakness and paraesthesia (BFP) associated to a vestibulocochlear neuritis as post-COVID-19 manifestation. This is a 36-year-old Moroccan female patient with a history of SARS-CoV-2 positive 6 weeks before admission. She presented to the emergency department with rapid bifacial paralysis, bilateral lower extremity paresthesia, vertigo, nausea, vomiting and right auricular pain. An acute stroke was ruled out after neurological examination and brain MRI. Clinical presentation, neurophysiological, audiometry and videonystagmography workup additionally to CSF findings were suggestive of a variant of Guillain Barré Syndrome (GBS), which is BFP associated to right vestibulocochlear neuritis. The patient was treated with Intravenous immunoglobulins (IVIG) therapy associated with intravenous steroids. The patient made a complete recovery of the right facial palsy and the sensorineural hearing loss but still have tingling in lower limbs and left facial palsy at 2 weeks´ follow-up. BFP can be induced by COVID-19 as a postinfectious immune-mediated complication. Regarding the pathophysiology of vestibular neuritis, is probably similar to other viral infection causing nerve damage. Clinicians should consider the association of vestibulocochlear neuritis and BFP as a post SARS-CoV-2 manifestation.


Subject(s)
COVID-19/complications , Guillain-Barre Syndrome/virology , Pregnancy Complications, Infectious/virology , Vestibular Neuronitis/virology , Adult , Facial Paralysis/diagnosis , Facial Paralysis/virology , Female , Follow-Up Studies , Guillain-Barre Syndrome/diagnosis , Humans , Immunoglobulins, Intravenous/administration & dosage , Paresthesia/virology , Pregnancy , Vestibular Neuronitis/diagnosis
17.
J Med Virol ; 93(2): 766-774, 2021 02.
Article in English | MEDLINE | ID: covidwho-646665

ABSTRACT

We report a case series of five patients affected by SARS-CoV-2 who developed neurological symptoms, mainly expressing as polyradiculoneuritis and cranial polyneuritis in the 2 months of COVID-19 pandemic in a city in the northeast of Italy. A diagnosis of Guillain-Barré syndrome was made on the basis of clinical presentation, cerebrospinal fluid analysis, and electroneurography. In four of them, the therapeutic approach included the administration of intravenous immunoglobulin (0.4 g/kg for 5 days), which resulted in the improvement of neurological symptoms. Clinical neurophysiology revealed the presence of conduction block, absence of F waves, and in two cases a significant decrease in amplitude of compound motor action potential compound muscle action potential (cMAP). Four patients presented a mild facial nerve involvement limited to the muscles of the lower face, with sparing of the forehead muscles associated to ageusia. In one patient, taste assessment showed right-sided ageusia of the tongue, ipsilateral to the mild facial palsy. In three patients we observed albuminocytological dissociation in the cerebrospinal fluid, and notably, we found an increase of inflammatory mediators such as the interleukin-8. Peripheral nervous system involvement after infection with COVID-19 is possible and may include several signs that may be successfully treated with immunoglobulin therapy.


Subject(s)
COVID-19/complications , Guillain-Barre Syndrome/cerebrospinal fluid , Guillain-Barre Syndrome/diagnosis , Nervous System Physiological Phenomena , Neuritis/diagnosis , Aged , Aged, 80 and over , Ageusia/diagnosis , Ageusia/virology , COVID-19/cerebrospinal fluid , COVID-19/therapy , Facial Paralysis/diagnosis , Facial Paralysis/virology , Female , Guillain-Barre Syndrome/therapy , Humans , Immunization, Passive , Interleukin-8/cerebrospinal fluid , Italy , Male , Middle Aged , Neuritis/therapy , Neuritis/virology , Polyradiculoneuropathy/diagnosis , Polyradiculoneuropathy/virology
18.
J Clin Neurosci ; 77: 230-232, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-260331

ABSTRACT

We present a case of facial diplegia after 10 days of SARS-CoV-2 confirmed infection symptoms in a 61 year old patient without prior clinically relevant background. There are few known cases of Guillain-Barré Syndrome (GBS) related to SARS-CoV-2 infection; we propose this case as a rare variant of GBS in COVID-19 infection context, due to Its chronology, clinical manifestations and cerebrospinal fluid (CSF) findings.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/complications , Facial Paralysis/etiology , Pneumonia, Viral/complications , COVID-19 , Coronavirus Infections/virology , Facial Paralysis/diagnosis , Facial Paralysis/virology , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/etiology , Guillain-Barre Syndrome/virology , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/virology , SARS-CoV-2
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