Covid-19 and Bell Palsy: Could it Be Neurotrophic Involvement?

Yıl 2023, , 47 - 52, 22.06.2023

Kemal Koray Bal , Sedat Alagöz , Talih Özdaş , Asiye Merve Erdoğan , Vedat Delibaş , Gulali Ocar , Okan Dılek , Feride Fatma Görgülü , Orhan Görgülü

https://doi.org/10.26650/Tr-ENT.2023.1207048

Öz

Objective: Idiopathic cases are common, and the etiology is not clearly explained. The purpose of this study is to compare the frequency, clinical-radiological characteristics and response to the treatment of peripheral facial paralysis patients who visited the otorhinolaryngology clinic during the Covid-19 pandemic and in the same period of the previous year, and to discuss this data in the light of the literature. Materials and Methods: Otoscopic examination findings, audiological results, application and post-healing grade information according to House Brackmann Staging system were obtained from all the patients’ files. Temporal Bone Computed Tomography, which is included in the routine practice of our clinic, and Cranial & Diffusion Magnetic Resonance Imaging examinations for the elimination of central causes were applied to the patients. Facial nerve tympanic, mastoid, labyrinth segment and geniculate ganglion diameters were measured separately for the diseased side and the healthy side. Results: In the study, Group 1 consisted of 42 patients (43%), and Group 2 consisted of 56 patients (57%). 56 (57%) of the patients were male and 42 (43%) were female. The left and right-side facial paralysis admissions were equal, but no statistically significant difference was found (p=0.068). Conclusions: Peripheral facial paralysis is a very common case in ear, nose, and throat practice and requires priority treatment and follow-up. Since the Covid-19 virus is a new entity for the world, we think that it has a neurotrophic affinity for the facial nerve although our knowledge about this virus is limited.

Anahtar Kelimeler

Bell palsy, COVID-19, facial nerve, radiology, steroids

Kaynakça

• Millen SJ, Daniels D, Meyer G. Gadolinium-enhanced magnetic resonance imaging in facial nerve lesions. Otolaryngol Head Neck Surg 1990;102(1): 26-33. google scholar
• Murphy TP. MRI of the facial nerve during paralysis. Otolaryngol Head Neck Surg 1991;104(1):47-51. google scholar
• Michaels L. Histopathological changes in the temporal bone in Bell's palsy. Acta Otolaryngol Suppl 1990;470:114-7. google scholar
• Matsumoto M, Pulec J, Patterson M et al. Facial nerve biopsy for etiologic clarification of Bell's palsy. Ann Otol Rhinol Laryngol Suppl 1988;137:22-7. google scholar
• Murakami S, Mizobuchi M, Nakashiro Y et al. Bell's palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle. Ann Intern Med 1996;124(1 Pt 1):27-30. google scholar
• Burgess RC, Michaels L, Bale JF Jr., Smith RJ. Polymerase chain reaction amplification of herpes simplex viral DNA from the geniculate ganglion of a patient with Bell's palsy. Ann Otol Rhinol Laryngol 1994;103(10):775-9. google scholar
• Sugita T, Murakami S, Yanagihara N, Fujiwara Y, Hirata Y, Kurata T. Facial nerve paralysis induced by herpes simplex virus in mice; animal model of acute and transient facial paralysis. Ann Otol Rhinol Laryngol 1995;104(7):574-81. google scholar
• 8.Murakami S, Hato N, Mizobuchi M, Doi T, Yanagihara N. Role of herpes simplex virus of facial paralysis in mice. Ann Otol Rhinol Laryngol 1996;105(1):49-53. google scholar
• Hato N, Hitumoto Y, Honda N. Immunological aspects of facial nerve paralysis induced by herpes simplex virus in mice. Ann Otol Rhinol Laryngol 1998;107(8):633-7. google scholar
• Codeluppi L, Venturelli F, Rossi J, Fasano A, Toschi G, Pacillo F. Facial palsy during the COVID-19 pandemic. Brain Behav 2021;11(1):e01939. google scholar
• Brisca G, Garbarino F, Carta S, Palmieri A, Vandone M, Severino M. et al. Increased Childhood Peripheral Facial Palsy in the Emergency Department During COVID-19 Pandemic. Pediatr Emerg Care 2020;36(10):e595-6. google scholar
• Lima MA, Silva MTT, Soares CN, Coutinho R, Oliveira HS 7, Afonso L, et al. Peripheral facial nerve palsy associated with COVID-19. J Neurovirol 2020;26(6):941-4. google scholar
• Figueiredo R, Falcao V, Pinto MJ, Ramalho C. Peripheral facial paralysis as presenting symptom of COVID-19 in a pregnant woman. BMJ Case Rep 2020;13(8):e237146. doi: 10.1136/bcr-2020-237146. google scholar
• Ribeiro BNF, Marchiori E. Facial palsy as a neurological complication of SARS-CoV-2. Arq Neuropsiquiatr 2020;78(10):667. google scholar
• Casas E, Barbosa A, Rubio-Garcfa E, Cebrian J, Dfaz-Perez C, de la Fuente E, et al. Paralisis facial periferica aislada en un paciente con COVID-19 [Isolated peripheral facial paralysis in a patient with COVID-19]. Rev Neurol 2020;71(1):40-1. google scholar
• Mehta S, Mackinnon D, Gupta S. Severe acute respiratory syndrome coronavirus 2 as an atypical cause of Bell's palsy in a patient experiencing homelessness. CJEM 2020:22(5):608-10. google scholar
• Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with Coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2019;77(66):683-90. google scholar
• Virani A, Rabold E, Hanson T, Haag A, Elrufay R, Cheema T, et al. Guillain-Barre syndrome associated with SARS-CoV-2 infection. IDCases 2020;20:e00771. google scholar
• Caress JB, Castoro RJ, Simmons Z, Scelsa NS, Lewis RA, Ahlawat A, et al. COVID-19-associated Guillain-Barre syndrome: The early pandemic experience. Muscle Nerve 2020;62(4):485-91. google scholar
• Toscano G, Palmerini F, Ravaglia S, Ruiz L, Invernizzi P, Cuzzoni MG, et al. Guillain-Barre Syndrome Associated with SARS-CoV-2. N Engl J Med 2020;382(26):2574-6. google scholar
• Paybast S,Gorji R,Mavandadi S. Guillain-Barre Syndrome as a Neurological Complication of Novel COVID-19 Infection: A Case Report and Review of the Literature. Neurologist. 2020;25(4):101-3. google scholar
• Abdullahi A, Candan SA, Soysal TM, Elibol N, Dada O, Truijen S, et al. Is Guillain-Barre Syndrome Associated With COVID-19 Infection? A Systemic Review of the Evidence. Front Neurol 2021;11:566308. google scholar
• Zanin L, Saraceno G, Panciani PP, Renisi G, Signorini L, Migliorati K, et al. SARS-CoV-2 can induce brain and spine demyelinating lesions. Acta Neurochir (Wien) 2020;162(7):1491-4. google scholar
• Valiuddin HM, Kalajdzic A, Rosati J, Boehm K,Hill D. Update on Neurological Manifestations of SARS-CoV-2. West J Emerg Med 2020;21(6):45-51. google scholar
• Correa DG, Hygino da Cruz LC Jr, Lopes FCR, de Carvalho Rangel C, de Araüjo Henriques Tessarollo AL, Godeiro Coelho KC et al. Magnetic resonance imaging features of COVID-19-related cranial nerve lesions. J Neurovirol 2021;27(1):171-7 google scholar
• Komori M, Yamada K, Hinohira Y, Aritomo H, Yanagihara N. Width of the normal facial canal measured by high-resolution cone-beam computed tomography. Acta Otolaryngol 2013;133(11):1227-32. google scholar
• Herman P, Vincent C, Parietti WC, Loundon N, Couloigner V, Tankere F, et al. Consensus statement. Corticosteroid therapy in ENT in the context of the COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis 2020;137(4):315-7. google scholar
• Wan Y, Cao S, Fang Q et al. Coronavirus disease 2019 complicatedwith Bell' s palsy: a case report. Res Sq 2020;1-7. google scholar
• Goh Y, Beh DLL, Makmur A, Somani j, Chen AC. Facial nerve palsyin COVID-19 infection. Neurology 2020;95(8):364-7. google scholar
• Mutlu A, Kalcioglu MT, Gunduz AY, Bakici B,Yilmaz U, Cag Y. Does the SARS-CoV-2 pandemic really increase the frequency of peripheral facial palsy? Am J Otolaryngol. 202;42(5):103032. google scholar