Bell's Palsy Associated with SARS-CoV-2 Infection in a 2-Year-Old ChildFunding Research reported in this publication was supported (in part) by the New Jersey Alliance for Clinical and Translational Science and the National Center for Advancing Translational Sciences (NCATS), a component of the National Institute of Health (NIH) under award number UL1TR003017. The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Bell's palsy (BP) is an acute, unilateral facial nerve palsy (FNP) that is a diagnosis of exclusion, sometimes associated with infectious causes. In this article, we described a previously healthy 2-year-old child patient who presented with left-sided facial droop, positive severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) real-time reverse transcription polymerase chain reaction (RT-PCR), positive SARS-CoV-2 immunoglobulin (Ig)-G antibody, and negative cerebrospinal fluid (CSF) SARS-CoV-2 (PCR and serology). This is the second reported pediatric case of BP in the setting of SARS-CoV-2, and the first in a child without comorbidities. Due to the positive antibody test, we presented the idea that SARS-CoV-2 could be a triggering factor of the FNP, possibly occurring in the later stages of disease.
Received: 05 November 2020
Accepted: 21 November 2020
27 January 2021 (online)
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- 1 Psillas G, Antoniades E, Ieridou F, Constantinidis J. Facial nerve palsy in children: a retrospective study of 124 cases. J Paediatr Child Health 2019; 55 (03) 299-304
- 2 Cook SP, Macartney KK, Rose CD, Hunt PG, Eppes SC, Reilly JS. Lyme disease and seventh nerve paralysis in children. Am J Otolaryngol 1997; 18 (05) 320-323
- 3 Karatoprak E, Yilmaz S. Prognostic factors associated with recovery in children with Bell's palsy. J Child Neurol 2019; 34 (14) 891-896
- 4 Nepal G, Rehrig JH, Shrestha GS. et al. Neurological manifestations of COVID-19: a systematic review. Crit Care 2020; 24 (01) 421
- 5 Elkhouly A, Kaplan AC. Noteworthy neurological manifestations associated with COVID-19 infection. Cureus 2020; 12 (07) e8992
- 6 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; 2: 1-3
- 7 Wan Y, Cao S, Fang Q, Wang M, Huang Y. Coronavirus disease 2019 complicated with Bell's palsy: a case report. Research Square 2020; (e-pub ahead of print). DOI: 10.21203/rs.3.rs-23216/v1.
- 8 Theophanous C, Santoro J, Itani R. Bell's palsy in a pediatric patient with hyper IgM syndrome and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Brain Dev 2020; (e-pub ahead of print) DOI: 10.1016/j.braindev.2020.08.017.
- 9 Moriguchi T, Harii N, Goto J. et al. A first case of meningitis/encephalitis associated with SARS-coronavirus-2. Int J Infect Dis 2020; 94: 55-58
- 10 Bernard-Valnet R, Pizzarotti B, Anichini A. et al. Two patients with acute meningoencephalitis concomitant with SARS-CoV-2 infection. Eur J Neurol 2020; 27 (09) e43-e44
- 11 Lei Q, Li Y, Hou HY. et al. Antibody dynamics to SARS-CoV-2 in asymptomatic COVID-19 infections. Allergy 2020; (e-pub ahead of print). DOI: 10.1111/all.14622.
- 12 Findings from Investigation and Analysis of re-positive cases. Accessed October 5, 2020 at: https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030&act=view&list_no=367267&nPage=1external
- 13 Xu F, Lee FK, Morrow RA. et al. Seroprevalence of herpes simplex virus type 1 in children in the United States. J Pediatr 2007; 151 (04) 374-377
- 14 Greco A, Gallo A, Fusconi M, Marinelli C, Macri GF, de Vincentiis M. Bell's palsy and autoimmunity. Autoimmun Rev 2012; 12 (02) 323-328
- 15 Carrillo-Larco RM, Altez-Fernandez C, Ravaglia S, Vizcarra JA. COVID-19 and Guillain-Barre syndrome: a systematic review of case reports. Wellcome Open Res 2020; 5: 107-107
- 16 Warner MJ, Hutchison J, Varacallo M. Bell palsy. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2020
- 17 Arco M. NJ coronavirus death toll increases to 12,214 with 164,497 total cases. Stage 2 of reopening 1 week away. . Accessed November 11, 2020 at: https://www.nj.com/coronavirus/2020/06/nj-coronavirus-death-toll-increases-to-12214-with-164497-total-cases-stage-2-of-reopening-1-week-away.html
- 18 Zammit M, Markey A, Webb C. A rise in facial nerve palsies during the coronavirus disease 2019 pandemic. J Laryngol Otol 2020; 1–4: 1-4