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.
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)