Peripheral facial nerve palsy associated with COVID-19

Lima, Marco Antônio; Silva, Marcus Tulius T.; Soares, Cristiane; Coutinho, Renan Amaral; Oliveira, Henrique Soares Dutra; Afonso, Livia; Espíndola, Otávio de Melo; Leite, Ana Cláudia Celestino Bezerra; Araújo, Abelardo

doi:10.1007/s13365-020-00912-6

Cited by 117 publications

(140 citation statements)

References 22 publications

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“…As is evident by the fact that 303/430 (70%) patients we identified had CSF SARS-CoV-2 PCR testing performed, it is feasible to perform PCR testing for SARS-CoV-2 in CSF [ [5] , [6] , [7] , [8] , [9] , [10] , 15 , 17 , 22 , 24 , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [68] , [69] , [70] , [71] , 73 , 74 , [76] , [77] , [78] , 81 , 84 , 88 , 89 , 95 , 97 , 98 , 101 , 103 , 105 , 108 , 109 , 111 , 113 , 116 , 119 , 122 , 123 , 125 ,…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Lewis

Frontera

Placantonakis

et al. 2021

Journal of the Neurological Sciences

137

134

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We sought to review the literature on cerebrospinal fluid (CSF) testing in patients with COVID-19 for evidence of viral neuroinvasion by SARS-CoV-2. Methods: We performed a systematic review of Medline and Embase between December 1, 2019 and November 18, 2020 to identify case reports or series of patients who had COVID-19 diagnosed based on positive SARS-CoV-2 polymerase chain reaction (PCR) or serologic testing and had CSF testing due to a neurologic symptom. Results: We identified 242 relevant documents which included 430 patients with COVID-19 who had acute neurological symptoms prompting CSF testing. Of those, 321 (75%) patients had symptoms that localized to the central nervous system (CNS). Of 304 patients whose CSF was tested for SARS-CoV-2 PCR, there were 17 (6%) whose test was positive, all of whom had symptoms that localized to the central nervous system (CNS). The majority (13/17, 76%) of these patients were admitted to the hospital because of neurological symptoms. Of 58 patients whose CSF was tested for SARS-CoV-2 antibody, 7 (12%) had positive antibodies with evidence of intrathecal synthesis, all of whom had symptoms that localized to the CNS. Of 132 patients who had oligoclonal bands evaluated, 3 (2%) had evidence of intrathecal antibody synthesis. Of 77 patients tested for autoimmune antibodies in the CSF, 4 (5%) had positive findings. Conclusion: Detection of SARS-CoV-2 in CSF via PCR or evaluation for intrathecal antibody synthesis appears to be rare. Most neurological complications associated with SARS-CoV-2 are unlikely to be related to direct viral neuroinvasion.

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Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Lewis

Frontera

Placantonakis

et al. 2021

Journal of the Neurological Sciences

137

134

View full text Add to dashboard Cite

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“…Unfortunately, the patients’ CSF samples were not tested for SARS-CoV-2 RNA. In a case series of 8 patients with COVID-19-associated peripheral facial palsy, all CSF studies were without inflammation (as in our cases), and 5 had PCR testing for SARS-CoV-2 in the CSF with negative results in all [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Central and peripheral nervous system complications of COVID-19: a prospective tertiary center cohort with 3-month follow-up

et al. 2021

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Objective To systematically describe central (CNS) and peripheral (PNS) nervous system complications in hospitalized COVID-19 patients. Methods We conducted a prospective, consecutive, observational study of adult patients from a tertiary referral center with confirmed COVID-19. All patients were screened daily for neurological and neuropsychiatric symptoms during admission and discharge. Three-month follow-up data were collected using electronic health records. We classified complications as caused by SARS-CoV-2 neurotropism, immune-mediated or critical illness-related. Results From April to September 2020, we enrolled 61 consecutively admitted COVID-19 patients, 35 (57%) of whom required intensive care (ICU) management for respiratory failure. Forty-one CNS/PNS complications were identified in 28 of 61 (45.9%) patients and were more frequent in ICU compared to non-ICU patients. The most common CNS complication was encephalopathy (n = 19, 31.1%), which was severe in 13 patients (GCS ≤ 12), including 8 with akinetic mutism. Length of ICU admission was independently associated with encephalopathy (OR = 1.22). Other CNS complications included ischemic stroke, a biopsy-proven acute necrotizing encephalitis, and transverse myelitis. The most common PNS complication was critical illness polyneuromyopathy (13.1%), with prolonged ICU stay as independent predictor (OR = 1.14). Treatment-related PNS complications included meralgia paresthetica. Of 41 complications in total, 3 were para/post-infectious, 34 were secondary to critical illness or other causes, and 4 remained unresolved. Cerebrospinal fluid was negative for SARS-CoV-2 RNA in all 5 patients investigated. Conclusion CNS and PNS complications were common in hospitalized COVID-19 patients, particularly in the ICU, and often attributable to critical illness. When COVID-19 was the primary cause for neurological disease, no signs of viral neurotropism were detected, but laboratory changes suggested autoimmune-mediated mechanisms.

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“…In particular, both in our study and among the reported cases, the presence of patients with complaints such as sudden vision loss, sudden hearing loss, sudden-onset severe peripheral vertigo, and sudden movement limitation in the eye suggests that COVID-19 involves aggressive neurotropism and neuroinvasion. The current literature contains reports on cranial nerve involvement in patients with COVID-19; e.g., dysphagia caused by N. glossofarengeus, N. vagus and N. hypoglossus damage (12), as well as presence of damage to N. vestibulocochlearis (14), N. facialis (15)(16)(17), N. oculomotorius (18,19), N. abducens (20,21), N. trochlearis (22), N. opticus (23) and N. olfactorius (14,15,17,24). COVID-19 has also been reported to cause neurological syndromes such as Guillain-Barré syndrome and Miller Fisher syndrome (6,20,25).…”

Section: Discussionmentioning

confidence: 99%

Cranial nerve involvement in COVID-19

Doblan

Kaplama

et al. 2021

Preprint

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Introduction: The COVID-19 disease emerged in Wuhan province of China in November 2019 and spread across the world in a short time, resulting in a pandemic. The first case in Turkey was detected on March 11, 2020. The aim of the current study was to reveal the effects of COVID-19 on cranial nerves by monitoring people infected with the disease based on repeated examinations and surveys. Material and Method: The data of 356 patients with a positive COVID-19 polymerase chain reaction (PCR) test who received treatment between June 2020 and August 2020 in our hospital were prospectively evaluated after the study was approved by the relevant ethics committee. Results: Of the 356 patients included in the study, 47 under the age of 18 years were excluded due to their unreliable examination and anamnesis findings. In addition, seven patients that died while in hospital were excluded from the study due to the lack of examination and survey records during their hospitalization. The data of the remaining 302 patients were statistically analyzed. Symptoms of cranial nerve involvement were observed in 135 patients. Conclusion: The COVID-19 disease caused by the SARS-CoV2 virus commonly results in cranial nerve symptoms. The fact that these findings are more common and severe in COVID-19 than previous SARS and MERS outbreaks suggests that it has a more neurotrophic and more aggressive neuroinvasion. While the negative effects of the virus on sensory functions resulting from cranial nerve involvement are evident, motor functions are rarely affected.

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Peripheral facial nerve palsy associated with COVID-19

Cited by 117 publications

References 22 publications

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Central and peripheral nervous system complications of COVID-19: a prospective tertiary center cohort with 3-month follow-up

Cranial nerve involvement in COVID-19

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