Unilateral diplopia and ptosis in a child with COVID-19 revealing third cranial nerve palsy

Elenga, Narcisse; Martin, Élise; Gérard, Max; Osei, Lindsay; Rasouly, Najibullah

doi:10.1016/j.jiph.2021.08.007

Cited by 16 publications

(16 citation statements)

References 9 publications

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“…Other cranial nerve palsies, with enhancement of the nerve at brain MRI, have been described ( 48 ). Particularly, cases of third cranial nerve palsy ( 79 – 81 ) revealed by unilateral diplopia and ptosis have been described with good outcomes after corticosteroid treatment.…”

Section: Clinical Consequences Of Sars-cov-2 Infectionmentioning

confidence: 99%

Neurological consequences of SARS-CoV-2 infections in the pediatric population

et al. 2023

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COVID-19 in the pediatric population is mostly asymptomatic. However, 1 out of 5 children presents non-specific neurologic symptoms such as headache, weakness, or myalgia. Furthermore, rarer forms of neurological diseases are increasingly being described in association to a SARS-CoV-2 infection. Encephalitis, stroke, cranial nerves impairment, Guillain-Barré syndrome or acute transverse myelitis have been reported and account for around 1% of pediatric COVID-19 cases. Some of these pathologies may occur during or after the SARS-CoV-2 infection. The pathophysiological mechanisms range from direct invasion of the central nervous system (CNS) by SARS-CoV-2 itself to postinfectious immune-mediated CNS inflammation. In most cases, patients presenting neurological pathologies related to SARS-CoV-2 infection are at greater risk of life-threatening complications and should be closely monitored. Further studies are needed to acknowledge the potential long-term neurodevelopmental consequences of the infection.

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Section: Clinical Consequences Of Sars-cov-2 Infectionmentioning

confidence: 99%

Neurological consequences of SARS-CoV-2 infections in the pediatric population

et al. 2023

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“… 8 Elenga et al and Prajwal et al showed inflammation of neurons in MRI of their cases, which could be caused by neuroinvasions via ACE-2 receptors. 11 12 ACE-2 receptors are considered as a key factor of neuro invasions, since ACE-2 is highly expressed in many neurons in human brain. 18–20 Gutiérrez-Ortiz et al reported a case with Miller-Fischer syndrome, an autoimmune disease that causes external ophthalmoplegia, ataxia and loss of tendon reflex, which is confirmed by a positive anti-GQ1b IgG antibody test.…”

Section: Discussionmentioning

confidence: 99%

Third cranial nerve palsy due to COVID-19 infection

et al. 2023

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We report a case of a previously healthy man in his 40s who presented with mild SARS-CoV-2 infection (COVID-19) concomitant with acute onset of left third cranial nerve palsy with restricted supraduction, adduction and infraduction. Our patient did not present any history of hypertension, hyperlipidaemia, diabetes mellitus or smoking. The patient recovered spontaneously without any antiviral treatment. To our knowledge, this is the second report of third cranial nerve palsy spontaneously resolved without any risk factors of vascular disease, specific image findings, nor any possible causes other than COVID-19. In addition, we reviewed 10 other cases of third cranial nerve palsy associated with COVID-19, which suggested that the aetiology varies greatly. As a clinician, it is important to recognise COVID-19 as a differential diagnosis for third cranial nerve palsy. Finally, we aimed to encapsulate the aetiologies and the prognosis of the third cranial nerve palsy associated with COVID-19.

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“…Oculomotor nerve palsies caused by inflammation usually present themselves during MRI imaging with findings confined to the oculomotor nerve and without further brain or orbital ones, as seen in said patient. This case led to the heightened suspicion of SARS-CoV-2 infection among children with unusual third nerve palsy [ 68 ].…”

Section: Adnexa Of the Eyementioning

confidence: 99%

How Does SARS-CoV-2 Affect Our Eyes—What Have We Learnt So Far about the Ophthalmic Manifestations of COVID-19?

Baj

Forma

Teresińska

et al. 2022

JCM

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The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has become a worldwide threat resulting in a pandemic in 2020. SARS-CoV-2 infection manifests itself as coronavirus disease 2019 (COVID-19) that is evidenced in a vast number of either specific or nonspecific symptoms. Except for typical (but nonspecific) symptoms such as fever, dry cough, or muscle weakness, the infected patients might also present atypical symptoms including neurological, dermatological, or ophthalmic manifestations. This paper summarizes the current state of knowledge regarding the onset, progression, and types of ophthalmic symptoms induced by SARS-CoV-2 infection recognized amongst the infected patients.

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Unilateral diplopia and ptosis in a child with COVID-19 revealing third cranial nerve palsy

Cited by 16 publications

References 9 publications

Neurological consequences of SARS-CoV-2 infections in the pediatric population

Neurological consequences of SARS-CoV-2 infections in the pediatric population

Third cranial nerve palsy due to COVID-19 infection

How Does SARS-CoV-2 Affect Our Eyes—What Have We Learnt So Far about the Ophthalmic Manifestations of COVID-19?

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