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1.
Intern Med ; 61(19): 2957-2959, 2022 Oct 01.
Article in English | MEDLINE | ID: covidwho-1968933

ABSTRACT

Loss of taste is a relatively common symptom of coronavirus disease 2019 (COVID-19) and has also been considered a rare Guillain-Barré syndrome (GBS) symptom. We herein report a case of a facial diplegia and paresthesia (FDP) variant of GBS that initially presented as a loss of taste occurring two weeks after COVID-19 mRNA vaccination. The patient recovered completely after intravenous immunoglobulin therapy. Clinicians should consider the possibility of post-vaccination FDP manifesting as facial palsy and should be aware that GBS, including the FDP variant, can initially present as an isolated loss of taste.


Subject(s)
Ageusia , COVID-19 , Guillain-Barre Syndrome , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/etiology , Humans , Immunoglobulins, Intravenous/therapeutic use , Paresthesia/etiology , RNA, Messenger
2.
Swiss Med Wkly ; 151: w30066, 2021 09 27.
Article in English | MEDLINE | ID: covidwho-1687285

ABSTRACT

OBJECTIVES: We present a patient with bifacial weakness and paraesthesia subtype of Guillain-Barré syndrome (GBS), which occurred 1 month after a SARS-CoV-2 infection. While GBS as complication of SARS-CoV-2 infection has been described many times, only a few cases of post-COVID-19 bifacial weakness and paraesthesia are known to date. RESULTS: A 59-year-old man presented with thoracoradicular pain, paraesthesias of hands and feet, as well as progressive bilateral facial palsy. Neurological examination revealed a hyporeflexia of his lower limbs and hypoaesthesia of his hands and feet. Clinical and electrophysiological findings as well as CSF analysis were consistent with bifacial weakness and paraesthesia. The patient's condition improved promptly after 5 days of intravenous immunoglobulin therapy. DISCUSSION: We suspect bifacial weakness and paraesthesia to be a possible post-infectious complication of COVID-19. Hence, it is a differential diagnosis of facial nerve palsy in association with SARS-CoV-2 infection. Considering the rarity of GBS and bifacial weakness and paraesthesia, it appears unlikely that bigger trials elucidating the causal relation between them and SARS-CoV-2 infection will be available in the future.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Guillain-Barre Syndrome/diagnosis , Humans , Male , Middle Aged , Pain , Paresthesia/etiology , SARS-CoV-2
3.
J Eur Acad Dermatol Venereol ; 36(6): 790-796, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1673165

ABSTRACT

Scalp dysesthesia is an abnormal sensation of the scalp in the absence of cutaneous disease. It is characterized by a burning and/or itching sensation and can be related to a variety of neurogenic or psychogenic causes. This condition is extremely bothersome and is also common- especially among the geriatric population, in women, in patients with diabetes mellitus, and patients with psychiatric history. However, despite its prevalence in many populations, there are limited data about its causes and characteristics. Given its limited cutaneous manifestations, it is also easily misdiagnosed and an underrecognized cause of scalp pruritus in the dermatological community. Therefore, education on scalp dysesthesia is paramount to helping physicians identify and provide appropriate treatment for these patients. This review focuses predominantly on the neurogenic causes (with a brief review of psychogenic itch) of scalp dysesthesia and the therapeutics that have been found to be effective for this condition. Neurogenic causes of scalp dysesthesia occur with damage to the central or peripheral pathways of itch sensation, resulting in modification and heightened sensitivity of nerves that result in abnormal sensations in the absence of or out of proportion to external stimuli. A comprehensive review of etiologies is provided here, ranging from lesions to the central nervous system caused by cervical spine disease, trigeminal trophic syndrome, tumor, stroke, and multiple sclerosis, to small-fiber neuropathies caused by diabetes, brow lifts, keloid, and burn scarring. Recently, there have also been reports of scalp dysesthesias associated with post-infectious COVID-19. Treatment options tailored toward disease severity and different causes of disease will also be discussed. By elucidating the different mechanisms and therapeutic treatments of scalp dysesthesia, we hope to provide clinicians with the tools to identify and treat this condition as well as encourage further research into its etiologies and therapeutics.


Subject(s)
COVID-19 , Skin Diseases , Aged , Female , Humans , Paresthesia/etiology , Pruritus/etiology , Scalp , Skin Diseases/complications
5.
AJNR Am J Neuroradiol ; 41(9): 1707-1711, 2020 09.
Article in English | MEDLINE | ID: covidwho-1024489

ABSTRACT

We report a case of bifacial weakness with paresthesia, a recognized Guillain-Barré syndrome subtype characterized by rapidly progressive facial weakness and paresthesia without ataxia or other cranial neuropathies, which was temporally associated with antecedent coronavirus 2019 (COVID-19). This case highlights a potentially novel but critically important neurologic association of the COVID-19 disease process. Herein, we detail the clinicoradiologic work-up and diagnosis, clinical course, and multidisciplinary medical management of this patient with COVID-19. This case is illustrative of the increasingly recognized but potentially underreported neurologic manifestations of COVID-19, which must be considered and further investigated in this pandemic disease.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Facial Paralysis/etiology , Guillain-Barre Syndrome/complications , Paresthesia/etiology , Pneumonia, Viral/complications , COVID-19 , Humans , Male , Pandemics , SARS-CoV-2 , Young Adult
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