Premium
Bilateral facial nerve palsy associated with COVID‐19 and Epstein–Barr virus co‐infection
Author(s) -
Cabrera Muras A.,
CarmonaAbellán M. M.,
Collía Fernández A.,
Uterga Valiente J. M.,
Antón Méndez L.,
GarcíaMoncó J. C.
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14561
Subject(s) - medicine , palsy , coinfection , prednisone , facial nerve , differential diagnosis , pneumonia , virus , surgery , pathology , virology , alternative medicine
COVID‐19 can occasionally be associated with cranial nerve involvement, but facial palsy, particularly if bilateral, is exceptional. We here report a patient who presented with severe bilateral facial palsy and evidence of SARS‐CoV‐2 infection preceded by upper respiratory symptoms. He also had serological evidence of coinfection with Epstein‐Barr virus, which could have also played a role in his neurological manifestations. PCR in the cerebrospinal fluid was negative for both EBV and SARS‐CoV‐2, which suggests an indirect, immune‐mediated mechanism rather than direct, viral‐induced damage. The patient was treated with prednisone 60 mg/24h with a tapering schedule and had a favorable outcome, with an almost complete recovery in 3 weeks. SARS‐CoV‐2 adds to the list of infectious agents causative of bilateral facial palsy. Coinfection with SARS‐CoV‐2 is not rare and should be considered in the differential diagnosis.