FACIAL PARALYSIS AS A NEUROLOGICAL MANIFESTATION OF COVID-19 INFECTION


About a third of COVID-19 patients have neurological manifestations. These include headache, dizziness, loss of smell, delirium, stroke, Guillain-Barre syndrome, meningitis and encephalopathy.

Recently a case of facial paralysis was reported from Singapore (with a travel history from Spain). 27-year old man was admitted with myalgia, cough, headache and fever for 4 days. RT PCR test for SARS CoV-2 was positive. On day 6 of illness, he developed a lower motor neuron type of facial palsy on the left side. MRI of brain showed enhancement of left facial nerve. CSF PCR for SARS CoV-2 and other viruses were negative. He was treated with prednisolone, valacyclovir, ropinavir-ritonavir combination. SARS-CoV2 viral load rapidly diminished with treatment.

Conclusion

1. Facial palsy (Bell’s palsy) can be seen as a neurological manifestation of COVID-19 infection.

2. The mechanism seems to be inflammatory effects, rather than direct spread of SARS CoV2 virus.

(Source: Neurology, May 21, 2020)

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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