Oke Ibiyemi O, Oladunjoye Olubunmi O, Oladunjoye Adeolu O, Paudel Anish, Zimmerman Ryan
Internal Medicine, Reading Hospital - Tower Health, West Reading, USA.
Medical Critical Care, Boston Children's Hospital, Boston, USA.
Cureus. 2021 Mar 14;13(3):e13881. doi: 10.7759/cureus.13881.
Bell's palsy is acute peripheral facial nerve palsy; its cause is often unknown but it can be triggered by acute viral infection. Coronavirus disease 2019 (COVID-19) infection commonly presents with respiratory symptoms, but neurologic complications have been reported. A few studies have reported the occurrence of facial nerve palsy during the COVID-19 pandemic. We present a case of Bell's palsy in a 36-year-old man with COVID-19 infection and a past medical history of nephrolithiasis. He presented to the emergency room with a day history of sudden right facial weakness and difficulty closing his right eye four weeks following a diagnosis of COVID-19 infection. Physical examination revealed right lower motor neuron facial nerve palsy (House-Brackmann grade IV). Serologic screen for Lyme disease, human immunodeficiency virus (HIV), and herpes simplex virus (HSV) 1 and 2 were negative for acute infection; however, neuroimaging with MRI confirmed Bell's palsy. He made remarkable improvement following treatment with a course of valacyclovir and methylprednisolone. This case adds to the growing body of literature on neurological complications that should be considered when managing patients with COVID-19 infection.
贝尔氏面瘫是一种急性周围性面神经麻痹；其病因通常不明，但可由急性病毒感染引发。2019冠状病毒病（COVID-19）感染通常表现为呼吸道症状，但也有神经系统并发症的报道。一些研究报告了COVID-19大流行期间面神经麻痹的发生情况。我们报告一例36岁男性贝尔氏面瘫病例，该患者感染了COVID-19，既往有肾结石病史。他在被诊断为COVID-19感染四周后，因突发右侧面部无力和右眼闭合困难一天而就诊于急诊室。体格检查发现右侧下运动神经元性面神经麻痹（House-Brackmann分级为IV级）。莱姆病、人类免疫缺陷病毒（HIV）以及单纯疱疹病毒（HSV）1型和2型的血清学筛查均未发现急性感染；然而，MRI神经影像学检查确诊为贝尔氏面瘫。在接受一疗程伐昔洛韦和甲基泼尼松龙治疗后，他有显著改善。该病例为有关COVID-19感染患者管理时应考虑的神经系统并发症的文献增添了内容。
