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Cureus . Bell's Palsy as a Late Neurologic Manifestation of COVID-19 Infection

tetano

Editor, Senior Moderator
Cureus


. 2021 Mar 14;13(3):e13881.
doi: 10.7759/cureus.13881.
Bell's Palsy as a Late Neurologic Manifestation of COVID-19 Infection


Ibiyemi O Oke[SUP] 1 [/SUP], Olubunmi O Oladunjoye[SUP] 1 [/SUP], Adeolu O Oladunjoye[SUP] 2 3 [/SUP], Anish Paudel[SUP] 1 [/SUP], Ryan Zimmerman[SUP] 4 [/SUP]



Affiliations

Abstract

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.

Keywords: bell?s palsy; covid-19 infection; facial weakness; neurologic manifestation.
 
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