RESUMEN
OBJECTIVE: To elucidate the aetiopathogenesis of facial neuritis in coronavirus disease 2019 associated mucormycosis. METHODS: A retrospective review was conducted of coronavirus disease 2019 associated mucormycosis patients who presented with peripheral facial nerve palsy from January 2021 to July 2021. The clinico-radiological details of four patients were assessed to examine the potential mechanism of facial nerve involvement. RESULTS: Serial radiological evaluation with contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging revealed infratemporal fossa involvement in all cases, with the inflammation extending along fascial planes to reach the stylomastoid foramen. Ascending neuritis with an enhancement of the facial nerve was demonstrated in all cases. CONCLUSION: The likely explanation for facial palsy in patients with coronavirus disease 2019 associated mucormycosis, backed by radiology, is the disease abutting the facial nerve at the stylomastoid foramen and causing ascending neuritis of the facial nerve.
Asunto(s)
COVID-19 , Enfermedades del Nervio Facial , Parálisis Facial , Mucormicosis , Neuritis , Radiología , COVID-19/complicaciones , Nervio Facial/diagnóstico por imagen , Nervio Facial/patología , Parálisis Facial/etiología , Humanos , Imagen por Resonancia Magnética/efectos adversos , Mucormicosis/complicaciones , Mucormicosis/diagnóstico por imagen , Neuritis/complicaciones , Neuritis/patologíaAsunto(s)
Infecciones por Coronavirus/complicaciones , Parálisis Facial/etiología , Síndrome de Guillain-Barré/etiología , Neumonía Viral/complicaciones , Betacoronavirus , COVID-19 , Angiografía Cerebral , Angiografía por Tomografía Computarizada , Infecciones por Coronavirus/diagnóstico , Electrodiagnóstico , Nervio Facial/diagnóstico por imagen , Parálisis Facial/diagnóstico , Parálisis Facial/fisiopatología , Parálisis Facial/terapia , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/fisiopatología , Síndrome de Guillain-Barré/terapia , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Factores Inmunológicos/uso terapéutico , Pulmón/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Conducción Nerviosa , Pandemias , Neumonía Viral/diagnóstico , SARS-CoV-2 , Tomografía Computarizada por Rayos XRESUMEN
The complete features of the neurological complications of coronavirus disease 2019 (COVID-19) still need to be elucidated, including associated cranial nerve involvement. In the present study we describe cranial nerve lesions seen in magnetic resonance imaging (MRI) of six cases of confirmed COVID-19, involving the olfactory bulb, optic nerve, abducens nerve, and facial nerve. Cranial nerve involvement was associated with COVID-19, but whether by direct viral invasion or autoimmunity needs to be clarified. The development of neurological symptoms after initial respiratory symptoms and the absence of the virus in the cerebrospinal fluid (CSF) suggest the possibility of autoimmunity.