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COVID-19 associated cranial nerve neuropathy: A systematic review.
Biomolecules and Biomedicine ( IF 3.1 ) Pub Date : 2021-08-11 , DOI: 10.17305/bjbms.2021.6341
Josef Finsterer 1 , Fulvio Alexandre Scorza 2 , Carla Scorza 2 , Ana Fiorini 3
Affiliation  

The involvement of cranial nerves is being increasingly recognised in COVID-19. This review aims to summarize and discuss the recent advances concerning the clinical presentation, pathophysiology, diagnosis, treatment, and outcomes of SARS-CoV-2 associated cranial nerve mononeuropathies or polyneuropathies. Therefore, a systematic review of articles from PubMed and Google Scholar was conducted. Altogether 36 articles regarding SARS-CoV-2 associated neuropathy of cranial nerves describing 56 patients were retrieved. Out of these 56 patients, cranial nerves were compromised without the involvement of peripheral nerves in 32 of the patients, while Guillain-Barre syndrome (GBS) with cranial nerve involvement was described in 24 patients. A single cranial nerve was involved either unilaterally or bilaterally in 36 patients, while in 19 patients multiple cranial nerves were involved. Bilateral involvement was more prevalent in the GBS group (n=11) as compared to the cohort with isolated cranial nerve involvement (n=5). Treatment of cranial nerve neuropathy included steroids (n=18), intravenous immunoglobulins (IVIG) (n=18), acyclovir/valacyclovir (n=3), and plasma exchange (n=1). The outcome was classified as "complete recovery" in 21 patients and as "partial recovery" in 30 patients. One patient had a lethal outcome. In conclusion, any cranial nerve can be involved in COVID-19, but cranial nerves VII, VI, and III are the most frequently affected. The involvement of cranial nerves in COVID-19 may or may not be associated with GBS. In patients with cranial nerve involvement, COVID-19 infections are usually mild. Isolated cranial nerve palsy without GBS usually responds favorably to steroids. Cranial nerve involvement with GBS benefits from IVIG.

中文翻译:

COVID-19 相关颅神经神经病变:系统评价。

在 COVID-19 中越来越多地认识到颅神经的参与。本综述旨在总结和讨论有关 SARS-CoV-2 相关颅神经单神经病或多发性神经病的临床表现、病理生理学、诊断、治疗和结果的最新进展。因此,对 PubMed 和 Google Scholar 的文章进行了系统评价。共检索到 36 篇关于 SARS-CoV-2 相关颅神经神经病变的文章,描述了 56 名患者。在这 56 名患者中,有 32 名患者颅神经受损,但周围神经未受累,而 24 名患者出现颅神经受累的格林-巴利综合征 (GBS)。36 例患者单侧或双侧受累单个颅神经,而在 19 名患者中,多发性颅神经受累。与孤立性颅神经受累的队列(n=5)相比,GBS 组(n=11)的双侧受累更为普遍。颅神经神经病变的治疗包括类固醇(n=18)、静脉注射免疫球蛋白(IVIG)(n=18)、阿昔洛韦/伐昔洛韦(n=3)和血浆置换(n=1)。结果被归类为 21 名患者的“完全康复”和 30 名患者的“部分康复”。一名患者出现了致命的后果。总之,任何颅神经都可能与 COVID-19 相关,但颅神经 VII、VI 和 III 最常受影响。COVID-19 中颅神经受累可能与 GBS 相关,也可能不相关。在颅神经受累的患者中,COVID-19 感染通常是轻微的。没有 GBS 的孤立性颅神经麻痹通常对类固醇反应良好。GBS 的颅神经受累受益于 IVIG。
更新日期:2021-08-11
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