Isolated Abducens Nerve Palsy in a Patient With COVID-19 : A Case Report and Literature Review

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved..

INTRODUCTION: The pandemic of coronavirus disease 2019 (COVID-19) stands as a major global health and social burden. As cases are growing, several other symptoms, besides the typical respiratory ones, are emerging. The involvement of the nervous system is increasingly recognized with manifestations ranging from hyposmia to meningoencephalitis and cranial neuropathies.

CASE REPORT: We report the case of a 41-year-old female patient who presented to the emergency department complaining of diplopia and headache over the last 2 days. She denied any medical history, as well as any other neurological or respiratory symptom. A detailed neurological and ophthalmological examination revealed a limitation to the abduction of the right eye due to palsy of the right lateral rectus muscle causing painless, horizontal diplopia in the right gaze. The computed tomography of the brain was normal. Based on the detected lymphopenia, she was tested for COVID-19 and was positive. The cerebrospinal fluid analysis showed no abnormalities, while also a repeated head computed tomography was similarly normal. The patient received no specialized medical treatment, and after 6 days, she was discharged home having a minimal degree of persistent diplopia. Two weeks later, brain magnetic resonance imaging was performed that was similarly unrevealing.

CONCLUSIONS: Isolated abducens nerve palsy can be the only presenting symptom in COVID-19. Although several pathophysiological mechanisms have been proposed, the exact nature of this manifestation has not been clarified yet. Vigilance is required by neurologists to detect and manage patients with such subtle clinical presentations.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:27

Enthalten in:

The neurologist - 27(2022), 3 vom: 01. Mai, Seite 139-142

Sprache:

Englisch

Beteiligte Personen:

Manolopoulos, Apostolos [VerfasserIn]
Katsoulas, Georgios [VerfasserIn]
Kintos, Vasileios [VerfasserIn]
Koutsokera, Maria [VerfasserIn]
Lykou, Christina [VerfasserIn]
Lapaki, Konstantina-Maria [VerfasserIn]
Acquaviva, Pascua T [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Journal Article
Review

Anmerkungen:

Date Completed 09.05.2022

Date Revised 29.09.2023

published: Electronic

Citation Status MEDLINE

doi:

10.1097/NRL.0000000000000382

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM333925076