Bilateral Optic Neuritis and Facial Palsy Following COVID-19 Infection

Behera, Geeta; Gera, Pratik; Stephen, Mary; Jose, Anson; Thabah, Molly Mary; Wadwekar, Vaibhav

doi:10.7759/cureus.28735

Cited by 7 publications

(10 citation statements)

References 13 publications

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“…21 Optic neuritis, an inflammatory condition affecting the optic nerve, has been reported at higher rates during the COVID-19 pandemic 23 and cases of both unilateral and bilateral optic neuritis reported. 24,25 A proportion of optic nerve involvement described in COVID-19 occurs in the setting of a CNS specific antibody directed toward myelin oligodendrocyte glycoprotein (MOG). MOG antibody associated disease is a CNS inflammatory condition characterised by isolated or bilateral optic neuritis or can present with multi-focal parenchymal inflammation and demyelination affecting the brain and spinal cord.…”

Section: Immune Mediated Disordersmentioning

confidence: 99%

“…40 The pathogenesis of headache in COVID-19 is likely to be secondary to a systemic pro-inflammatory state, involving up-regulation of cytokines and neuropeptides. Higher serum IL-6, a pro-inflammatory cytokine, has been associated with headache in COVID-19 24,25 and is thought to be able to cause nerve inflammation, activate local nociceptive sensory neurons and potentially induce central sensitisation. Calcitonin gene-related peptide (CGRP), a neuropeptide known to play a role in the pathogenesis of migraine and the target of many novel migraine treatments, is also known to increase with inflammatory cytokines such as IL-6 and this important pathway may also play a role in COVID-19 associated headache.…”

Section: Complications Of Severe Systemic Diseasementioning

confidence: 99%

“…Optic neuritis, an inflammatory condition affecting the optic nerve, has been reported at higher rates during the COVID‐19 pandemic 23 and cases of both unilateral and bilateral optic neuritis reported 24,25 . A proportion of optic nerve involvement described in COVID‐19 occurs in the setting of a CNS specific antibody directed toward myelin oligodendrocyte glycoprotein (MOG).…”

Section: Potential Pathogenesis Of Covid‐19 Related Neurological Comp...mentioning

confidence: 99%

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An eye to the future: Acute and long‐term neuro‐ophthalmological and neurological complications of COVID‐19

Wesselingh

2023

Clinical Exper Ophthalmology

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COVID‐19 has had a significant impact on the global population and has produced compelling evidence of non‐pulmonary organ dysfunction, including the nervous system. It is vital that specialists in ophthalmology and neurology are informed of the potential complications of COVID‐19 and gain a deeper understanding of how COVID‐19 can cause diseases of the nervous system. In this review we detail four possible mechanisms by which COVID‐19 infection may result in neurological or neuro‐ophthalmological complications: (1) Toxic and metabolic effects of severe pulmonary COVID‐19 disease on the neural axis including hypoxia and the systemic hyper‐inflammatory state, (2) endothelial dysfunction, (3) dysimmune responses directed again the neuroaxis, and (4) direct neuro‐invasion and injury by the virus itself. We explore the pathological evidence for each of these and how they may link to neuro‐ophthalmological disorders. Finally, we explore the evidence for long‐term neurological and neuro‐ophthalmological complications of COVID‐19, with a focus on neurodegeneration.

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Section: Immune Mediated Disordersmentioning

confidence: 99%

Section: Complications Of Severe Systemic Diseasementioning

confidence: 99%

Section: Potential Pathogenesis Of Covid‐19 Related Neurological Comp...mentioning

confidence: 99%

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An eye to the future: Acute and long‐term neuro‐ophthalmological and neurological complications of COVID‐19

Wesselingh

2023

Clinical Exper Ophthalmology

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“…34,35 One case has been described in association with a previous facial nerve palsy. 36 Radiological evidence of ON in the literature is variable. Micielli et al describe a case with nerve and perineural enhancement.…”

Section: Optic Neuritismentioning

confidence: 99%

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

Dinkin

Sathi

2023

Semin Neurol

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We set out to describe in detail the afferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, new variants of COVID-19 continue to pose an international threat, and patients with rare neuro-ophthalmic complications are likely to continue to present for care.Afferent complications from COVID-19 include homonymous visual field loss, with or without higher cortical visual syndromes, resulting from stroke, intracerebral hemorrhage, or posterior reversible leukoencephalopathy. Optic neuritis has frequently been reported, sometimes along with acute disseminated encephalomyelopathy, often in association with either myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) or less commonly aquaporin-4 seropositivity or in newly diagnosed multiple sclerosis. Ischemic optic neuropathy has rarely been reported. Papilledema, resulting either from venous sinus thrombosis or idiopathic intracranial hypertension in the setting of COVID-19, has also been described.Observed afferent neuro-ophthalmic associations need to be confirmed though larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.

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“…Differential diagnosis is extensive, and a detailed history, physical examination, and investigation are necessary to determine the cause. Common causes include infection, [5] autoimmune diseases, [6] trauma, [7] vasculitis, [8] tumor, [9] etc. BFP is characterized by bilateral nerve paralysis with symptoms occurring simultaneously or within 30 days.…”

Section: Introductionmentioning

confidence: 99%

Bilateral facial palsy caused by HIV infection: A case report and literature review

Lin

2023

Medicine

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Objective: Bilateral facial palsy (BFP) has been identified as a possible neurological complication of human immunodeficiency virus (HIV) infection, but only a limited number of cases have been reported in the literature. The purpose of this study was to deepen our understanding of the etiology of BFP. Case report: We report the case of a 46-year-old married bisexual man with BFP associated with HIV infection. The patient underwent serological testing for HIV and was positive. In the absence of any other evidence of underlying systemic disease, facial palsy is thought to be secondary to HIV infection. After antiretroviral therapy, the patient recovered completely from facial palsy within 3 months. Results: HIV infection often involves BFP. The pathophysiology of this clinical presentation is thought to be related to the immune response to the systemic transmission of the virus. Conclusions: Most patients with BFP have underlying systemic causes, particularly autoimmune diseases. The exclusion of HIV infection in patients with BFP is essential for the early diagnosis and management of HIV.

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Bilateral Optic Neuritis and Facial Palsy Following COVID-19 Infection

Cited by 7 publications

References 13 publications

An eye to the future: Acute and long‐term neuro‐ophthalmological and neurological complications of COVID‐19

An eye to the future: Acute and long‐term neuro‐ophthalmological and neurological complications of COVID‐19

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

Bilateral facial palsy caused by HIV infection: A case report and literature review

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