Bell's palsy in a patient after contracting COVID-19 with signs of aberrant nerve regeneration

Alrajhi, Furat; Seraj, Hadeel; Taher, Nada; Alnabihi, Ahmed Naji

doi:10.1016/j.ajoc.2022.101679

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Several cases spanning over a century to the present day have documented excessive tearing in patients with facial nerve injuries of various origins [13][14][15][16][17][18][19][20][21][22]. These cases range from historical accounts, such as a postoperative injury in a young girl [13], to more recent occurrences, including patients experiencing facial nerve injury and/or crocodile tears syndrome following COVID-19 infection [19][20][21][22]. Other instances include a 63-year-old male with a three-year history of right facial nerve palsy who despite treatment, continued to experience epiphora [23].…”

Section: Review a Brief Review Of Select Casesmentioning

confidence: 99%

Epiphora and Hyperlacrimation as Paradoxical Manifestations of Facial Nerve Injury: Mechanistic Insights

Peltzer,

Bhatt,

Kamel

et al. 2024

Cureus

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The incidence of facial nerve paralysis is approximately 30 per 100,000 persons annually. Although it is often idiopathic, as in Bell's palsy, it can also result from infections, trauma, or neoplasms. Facial nerve paralysis may present with partial or total facial paresis, lagophthalmos, denervation of the lacrimal gland, and other ocular abnormalities. While dry eye is a commonly expected outcome of facial nerve injury, some patients may paradoxically experience epiphora and hyperlacrimation. In this review, we examine this phenomenon and its mechanisms in facial nerve injury. Several mechanisms have been proposed for epiphora and hyperlacrimation, including aberrant axonal regeneration, which is known to cause crocodile tears syndrome; ocular irritation due to dry eye, resulting in increased reflex lacrimation due to disruption of the tear film; and impaired drainage of tears caused by paralysis of the orbicularis oculi muscle and malposition of the eyelids. Understanding the pathophysiology of these symptoms is crucial in guiding the management of patients with facial nerve injury. Further experimental and clinical studies focusing on the quantification of tear production and localization of nerve damage will help improve our understanding of the neuroanatomical correlates of this paradoxical manifestation.

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Section: Review a Brief Review Of Select Casesmentioning

confidence: 99%

Epiphora and Hyperlacrimation as Paradoxical Manifestations of Facial Nerve Injury: Mechanistic Insights

Peltzer,

Bhatt,

Kamel

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…Facial paralysis was the presenting symptom in 37% of cases and 21.7% showed only partial recovery. 19 The high rate of partial recovery along with case reports showing other complications such as aberrant nerve regeneration, 20 Wernicke's encephalopathy, 21 and sudden hearing loss 22 convey the complexity and morbidity of COVID-19 associated facial nerve palsy. A systematic review found a pool of 32 patients who had been treated for Bell's palsy, and a combination of antivirals and steroids led to a faster resolution of symptoms than steroids or antivirals alone.…”

Section: Cranial Nerve Palsiesmentioning

confidence: 99%

Neuromuscular Disorders Associated With COVID-19

Morgan

Hollist

et al. 2023

J Exp Neurosci

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The coronavirus disease 2019 (COVID-19) pandemic has had an enormous impact on practically every aspect of daily life, and those with neuromuscular disorders have certainly not been spared. The effects of COVID-19 infection are far-reaching, going well beyond respiratory symptoms alone. From simple myalgias to debilitating critical illness neuromyopathies, we continue to learn and catalog the diverse pathologies presented by the severe acute respiratory syndrome coronavirus 2 (SARS -CoV-2) as it relates to the neuromuscular system. Complications have been documented both as a direct result of primary infection but also in those with pre-existing neuromuscular disorders from myasthenia gravis to devastating critical illness neuromyopathies. In this review, we will discuss the relationship between COVID-19 infection and critical illness neuromyopathy, peripheral nerve palsies, myalgias, positional compressive neuropathy, myasthenia gravis, and Guillain-Barré syndrome.

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Increased odds ratio for Bell’s palsy following COVID -19 infection or vaccination in a large Health Center

Katz,

Sayman

2023

Preprint

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Objective: Bell’s palsy is a paralysis of the facial muscles on one side of the face caused by a viral infection. Studies have indicated an increase of Bell’s palsy following infection or vaccination for COVID-19. The study examined the association of these variables with Bell’s palsy in a large hospital cohort. Materials and Methods: Using the deidentified data i2b2 of subjects visiting the University of Florida during October 2015- October 2022 we have identified subjects with an ICD-10 diagnoses of COVID -19, Bell’s palsy and vaccination for COVID-19. Results: From a total population of 1314924, 38005 had a history of COVID-19, 2072 had a diagnosis of Bell’s palsy, 112 both Bell’s Palsy and COVID-19 and 196279 were vaccinated. Diagnosis of COVID-19 was associated with increased risk for Bell’s palsy (odds ratio 1.87, 95% CI 1.54 -2.26 p<0.0001). COVID -19 vaccination was associated with increased risk for Bell’s palsy at odds ratio1.98 (95%CI 1.79-2.18, p<0.0001). COVID -19 infection or vaccination were associated with an increased risk for Bell’s palsy. Conclusions:Although causality cannot be attributed to cross sectional studies, these findings may indicate that exposure to the viral antigen may be related to the neurological sequalae of COVID- 19. Clinical Relevance: The Dental professionals should be aware of Bell’s palsy and the potential link of the appearance of Bell’s palsy post COVID-19 infection or vaccination

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Bell's palsy in a patient after contracting COVID-19 with signs of aberrant nerve regeneration

Cited by 3 publications

References 20 publications

Epiphora and Hyperlacrimation as Paradoxical Manifestations of Facial Nerve Injury: Mechanistic Insights

Epiphora and Hyperlacrimation as Paradoxical Manifestations of Facial Nerve Injury: Mechanistic Insights

Neuromuscular Disorders Associated With COVID-19

Increased odds ratio for Bell’s palsy following COVID -19 infection or vaccination in a large Health Center

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