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Case Report
Coronavirus disease 2019 complicated with Bell’s palsy: a case report
Qi Fang
Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease, mainly causing respiratory symptoms. However, a few patients may also have neurological symptoms. Herein, we report a case of COVID-19 infection complicated with Bell’s palsy.
Case presentation: A 65-year-old woman was admitted due to left facial drooping. Physical examination showed left peripheral facial paralysis. Brain MRI showed no abnormality. However, the chest CT revealed the ground-glass shadows in the right lower lung. The real-time reverse transcription-polymerase chain reaction (RT-PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA were positive through throat swabs, while the common influenza virus antigens were tested negative. The symptoms of left facial paralysis relieved after antiviral treatment. She patient was discharged in the context of 3 consecutively negative RT-PCR test results for SARS-CoV-2 RNA and complete absorption of the right lung lesions.
Conclusion: This case suggests that COVID-19 may be presented with Bell’s palsy and may be a potential cause of facial paralysis.
Keywords
Bell’s palsy, Facial nerve, Coronavirus disease 2019
Figure 1
Kunal Priyadarshi
commented on 23 April, 2020
Today, I saw 17 patients in our hospital opd , out of which 3 were having Bell's palsy, which was very unusual, should I go for a covid test for them.
View 4 replies
Kunal Priyadarshi
commented on 23 April, 2020
Today, I saw 17 patients in our hospital opd , out of which 3 were having Bell's palsy, which was very unusual, should I go for a covid test for them.
Adri Hernandez
commented on 21 May, 2020
My 11 year old daughter also was diagnosed with Bell’s palsy. I find it strange that a lot of kids are the ones that have been diagnosed with Bell’s palsy. I also wondered if it was Covid but Doctor said it shouldn’t be related to each other and insisted that a test wasn’t necessary. I now wish I would of had her take one cause I think it had to something with it.
Mary parker
commented on 01 June, 2020
I started with covid symptoms 15th March which lasted 12 days. No test available at that time in uk. After the 12 days I rested for 6 days as I was exhausted from the virus but during this time I developed numbness / pins and needles in my hands and feet and increasingly easily lost my balance. Then I started with slight cough again. 2 days later I was diagnosed with chest infection and Bell’s palsy. I also had horrific pleural pain!! Few days after that my balance / core body strength got really bad. My pulse increased to 120 -130. I was worried it may be Guillain-Barre but fortunately this proved negative. I’m now almost recovered but still have the numbness/ tingling in the tips of my toes and fingers.
View 1 reply
Ernesto hurtado
replied on 17 January, 2021
Hi , your post draw my attention. I am not alone. I got infected with covid 19 dec 1 9,2020. I'm still recovering at home. I'm over 20 days since contact with my sick dad. I feel tingling pins and lack of circulating on feet and legs like you did. I was getting very scare. I haven't lost gait or balance. I'm just scare like you was or concern. Today Jan 19th i feel numb check bones and mustache area. I hope is not bells spaylsy. What's your take? Any feed back? I'm not alone your post is the closes to my symptoms. I live in Los Angeles ca USA. My email [email protected] Thank you
Mesa Bergen
commented on 07 July, 2020
Our 14 yr old daughter was just diagnosed the same (July 2020). Tested negative for covid. Other than this always active and athletic. We need more documentation (data) shared. What is the recommended treatment/prognosis? Is physical therapy need it? What type? Need to isolate/quarantine?
Adam C
commented on 09 July, 2020
l had symptoms of COVID-19 that included fever, fatigue, slight cough, etc AFTER about a week of intense irritation and pain on only the left side of my throat that was easily twice as painful as strep-throat. When the symptoms mentioned above appeared, a pain equal in strength to that of my throat began to make it's way up my ear canal, stopping finally at the top of my head maybe three days later. Throughout this whole time my fatigue has been almost incapacitating, and I noticed every time I woke up that my pillow was drenched from saliva. For about the last four days I've progressively lost all movement on the left side of my face. It began with simply not being able to hold mouthwash in without it squirting out of the left of my mouth, and currently is full paralysis on the left of my face.
Ashley
commented on 17 July, 2020
I had covid in Feb 2020 and just started experiencing Bela Palsy a week ago. Doctors can’t figure out why.
View 2 replies
Ernest Storey
replied on 30 July, 2020
I visited the US in March, live in MX. Upon arrival went to visit elder parent in hospital became very ill within a week with flu symptoms. Did not correlate it with Covid at the time. Was never tested and returned to MX within a month. This is July, just returned to US for mother’s death. I woke up this morning with a numb lip and has progressed to full blown, what I believe to be Bells Palsy. My face is drooping, my eye hurts and I am drooling.
Jackie
replied on 31 October, 2020
I was sick end of February, “COVID wasn’t here yet” ??!! Test not around. I’m rarely sick but this one was no joke. Diagnosed with Bells Palsy this week and shoulder capulittis a month ago which I was told could come from a viral illness.
Bob hennessy
commented on 19 July, 2020
Week ago experienced touchy, sensitive skin on right arm. Somewhat achy at night. Waiting for covid test results. Now experiencing mild numbness on left side of face. Have previously had Bells Palsey from Lyme disease and this appears headed for same.
Kimberly
commented on 31 August, 2020
I am 56 y/o woman who has had extreme fatigue since March 16, 2020. No fever, no cough. Fatigue is overwhelming at times. 2 days ago began facial droopiness, not able to blink left eye and numbness over my face, racing heartbeat and extreme fatigue. Went to ER and they said Bell's Palsy given steroid and anti-viral. Should I go in for a Covid 19 test or antigen testing?
View 1 reply
J K Jager
replied on 17 December, 2020
Just had exactly the same. Wondered whether Bell’s Palsy is related to Covid. Also thought of antigen test
Debbie
commented on 04 September, 2020
I had Covid late February and now since July 5th I have Bell’s Palsy with no sigh of relief yet.
James sullivan
commented on 26 September, 2020
This case report would be improved if a description of the extent of oxygenation deficit was included in the case presentation. Current treatments are limited to those with some hypoxemia and the need for oxygen support. It would be helpful to know if this patient met such qualifications for treatment during her course. This report could be improved if in the case presentation there was a description of how long the Bell’s palsy lasted. It would be helpful to know how many weeks after diagnosis was the first sign of improvement in the motor function, and how long it took for complete recovery. Also it would be helpful to know the duration and doses of the treatments given. The disease gets better in most patients so ascribing improvement in one case to one intervention should not be asserted strongly.
Lisa scoffield
commented on 15 October, 2020
I had Bell’s palsy in April 2020. Started with loss of taste and smell on day one and 5 days later Bell’s palsy was evident. Had it for four weeks and then gradually got better after treatment. Not had a Covid test but I suspected it was caused by this.
Lisa
commented on 24 October, 2020
Hi from Iowa... I went into Urgent care to get tested for covid (Husband tested positive a week ago after he came home from working in another State. I have been monitoring myself and the head aches got worse and other symptoms arising. So the Dr asked me about all symptoms so I told her my left side of my face was tingling and my eye was sticky and sometimes foggy and more.. along with some tightness in that side of chest to right below the shoulder and some in Arm...Blood Pressure alittle high at time...so she talked with ER Dr and said that she thinks its Bells Palsy symptoms and prescribed me Prednisone (deltazone) 2 in the mornings which I started today...I'm kind of concerned because I've had injections in my foot this summer for Planterfacitous...and worry about my immune system becoming even more compromised...do I go by what urgent care advises or do I see someone for another opinion if that is even an option because so many diff studies say diff things about taking Steriods if Breathing is not compromised...please advise ASAP...
Amy
commented on 03 January, 2021
I was diagnosed with COVID-19 just 5 days ago by rapid antigen test. My symptoms began with hip and knee joint pain (felt more like lactic acid buildup). Pain disappeared when fever came on (99.3-100.2). I had 2 days of nasal congestion but was placed on azithromycin and prednisone. Mild chest discomfort experienced but was relieved with breathing exercises. I continue to have maxillary nerve tingling on the left side of my face. Headaches seem to be present only when temperature is above 99.5. I have no fatigue, no loss of taste or smell, no diarrhea and only very mild GI upset which is likely d/t antibiotic; I take probiotics on a daily regimen. I have increased appetite, likely d/t boredom. A mild Cough is only present when I feel the need to clear my throat and appears dry. I’ve taken a total of 4 ibuprofen (1 daily). I’ve remained hydrated with water and Electrolyte water. I don’t take flu vaccines (last one was 1996). I have a fear of developing Bell’s palsy or Guillain barre d/t the tingling or numbness I continue to experience on the left side of my face. I’m in healthcare so I am aware of the association of viruses with both of these temporary conditions but have seen the latter last longer than expected in a patient which was very debilitating.
James
commented on 12 January, 2021
My son, age 28, has Down Syndrome. We both came down with Covid just before Christmas. His symptoms were mostly gone in a few days. Two weeks later, he came down with Bell's Palsy. Who, if anybody, is tracking this stuff? Is there some place I should report it?
Nancy Fredrickson
commented on 31 January, 2021
I had Covid in March and developed Bells Palsy
Amanda
commented on 28 February, 2021
After being in relationship with Him for Five years, he broke up with me, I did everything possible to bring him back but all was in vain, I wanted him back so much because of the love I have for him, I begged him with everything, I made promises but he refused. but one day I explained my problem to someone online and she suggested that I should rather contact a spell caster that could help me cast a spell to bring him back but I am the type that never believed in love spell, I had no choice than to try it, I mailed the spell caster, and he told me there was no problem that my ex will return to me before three days, he cast the spell and surprisingly in the second day, it was around 4pm. My ex called me, I was so surprised, I answered the call and all he said was that he was so sorry for everything that happened, that he wanted me to return to him, that he loves me so much. I was so happy and went to him, that was how we started living together happily again. Since then, I have made promise that anybody I know that have a relationship problem, I would be of help to such person by referring him or her to the only real and powerful spell caster who helped me with my own problem and who is different from all the fake ones out there. Anybody could need the help of the spell caster, his email: [email protected] you can email him or WhatsAPP him on +2347056683626 if you need his assistance in your relationship or anything. CAN NEVER STOP TALKING ABOUT YOU SIR HIS EMAIL ADDRESS IS: [email protected] CONTACT HIM NOW FOR SOLUTION TO ALL YOUR PROBLEMS.
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Case Report
Coronavirus disease 2019 complicated with Bell’s palsy: a case report
Qi Fang
Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 16 Apr, 2020
Community comments: 28
Metrics
Comments: 28
PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease, mainly causing respiratory symptoms. However, a few patients may also have neurological symptoms. Herein, we report a case of COVID-19 infection complicated with Bell’s palsy.
Case presentation: A 65-year-old woman was admitted due to left facial drooping. Physical examination showed left peripheral facial paralysis. Brain MRI showed no abnormality. However, the chest CT revealed the ground-glass shadows in the right lower lung. The real-time reverse transcription-polymerase chain reaction (RT-PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA were positive through throat swabs, while the common influenza virus antigens were tested negative. The symptoms of left facial paralysis relieved after antiviral treatment. She patient was discharged in the context of 3 consecutively negative RT-PCR test results for SARS-CoV-2 RNA and complete absorption of the right lung lesions.
Conclusion: This case suggests that COVID-19 may be presented with Bell’s palsy and may be a potential cause of facial paralysis.
Figure 1
Kunal Priyadarshi
commented on 23 April, 2020
Today, I saw 17 patients in our hospital opd , out of which 3 were having Bell's palsy, which was very unusual, should I go for a covid test for them.
View 4 replies
Elizabeth Principi
replied on 25 April, 2020
Where are you ?
View 1 reply
Kunal Priyadarshi
replied on 26 April, 2020
I am at aiims Bhubaneswar, India.
View 2 replies
Elizabeth Principi
replied on 27 April, 2020
Thanks
Elizabeth Principi
replied on 27 April, 2020
Thanks
Martine Hooper
replied on 16 May, 2020
Hello Kunal, posted my own facial palsy story below. Am currently awaiting acovid test and soon hopefully the antigen test. Did you test your patients for covid out of curiosity? I am a Dr of chemistry/cancer toxicology and am interested to help the scientific community.
Debbie Odaniel
replied on 02 July, 2020
I was sick. I took a vivid 19 test at a drive thru testing. It came back negative the same day I started developing Bells palsy symptoms. I now have complete paralysis on the left side of my face. Pain in my lower right under my ribs.
Sedina
replied on 06 July, 2020
I am 51 year old female with overall malaise for several days with ear and throat pain who awoke today with facial paralysis. I went to doctor and was diagnosed with Bell’s palsy. Dr suggested Covid testing, but here in rural Georgia, appointments must be made and the website is down. When I called the number, I was told that I would have to wait system to be repaired. I am not feeling well enough to drive some distance, so I will be delayed in getting tested. I am researching to see if others have had Bell’s palsy and if it is a result of the Covid virus.
Kunal Priyadarshi
commented on 23 April, 2020
Today, I saw 17 patients in our hospital opd , out of which 3 were having Bell's palsy, which was very unusual, should I go for a covid test for them.
Adri Hernandez
commented on 21 May, 2020
My 11 year old daughter also was diagnosed with Bell’s palsy. I find it strange that a lot of kids are the ones that have been diagnosed with Bell’s palsy. I also wondered if it was Covid but Doctor said it shouldn’t be related to each other and insisted that a test wasn’t necessary. I now wish I would of had her take one cause I think it had to something with it.
Mary parker
commented on 01 June, 2020
I started with covid symptoms 15th March which lasted 12 days. No test available at that time in uk. After the 12 days I rested for 6 days as I was exhausted from the virus but during this time I developed numbness / pins and needles in my hands and feet and increasingly easily lost my balance. Then I started with slight cough again. 2 days later I was diagnosed with chest infection and Bell’s palsy. I also had horrific pleural pain!! Few days after that my balance / core body strength got really bad. My pulse increased to 120 -130. I was worried it may be Guillain-Barre but fortunately this proved negative. I’m now almost recovered but still have the numbness/ tingling in the tips of my toes and fingers.
View 1 reply
Ernesto hurtado
replied on 17 January, 2021
Hi , your post draw my attention. I am not alone. I got infected with covid 19 dec 1 9,2020. I'm still recovering at home. I'm over 20 days since contact with my sick dad. I feel tingling pins and lack of circulating on feet and legs like you did. I was getting very scare. I haven't lost gait or balance. I'm just scare like you was or concern. Today Jan 19th i feel numb check bones and mustache area. I hope is not bells spaylsy. What's your take? Any feed back? I'm not alone your post is the closes to my symptoms. I live in Los Angeles ca USA. My email [email protected] Thank you
Mesa Bergen
commented on 07 July, 2020
Our 14 yr old daughter was just diagnosed the same (July 2020). Tested negative for covid. Other than this always active and athletic. We need more documentation (data) shared. What is the recommended treatment/prognosis? Is physical therapy need it? What type? Need to isolate/quarantine?
Adam C
commented on 09 July, 2020
l had symptoms of COVID-19 that included fever, fatigue, slight cough, etc AFTER about a week of intense irritation and pain on only the left side of my throat that was easily twice as painful as strep-throat. When the symptoms mentioned above appeared, a pain equal in strength to that of my throat began to make it's way up my ear canal, stopping finally at the top of my head maybe three days later. Throughout this whole time my fatigue has been almost incapacitating, and I noticed every time I woke up that my pillow was drenched from saliva. For about the last four days I've progressively lost all movement on the left side of my face. It began with simply not being able to hold mouthwash in without it squirting out of the left of my mouth, and currently is full paralysis on the left of my face.
Ashley
commented on 17 July, 2020
I had covid in Feb 2020 and just started experiencing Bela Palsy a week ago. Doctors can’t figure out why.
View 2 replies
Ernest Storey
replied on 30 July, 2020
I visited the US in March, live in MX. Upon arrival went to visit elder parent in hospital became very ill within a week with flu symptoms. Did not correlate it with Covid at the time. Was never tested and returned to MX within a month. This is July, just returned to US for mother’s death. I woke up this morning with a numb lip and has progressed to full blown, what I believe to be Bells Palsy. My face is drooping, my eye hurts and I am drooling.
Jackie
replied on 31 October, 2020
I was sick end of February, “COVID wasn’t here yet” ??!! Test not around. I’m rarely sick but this one was no joke. Diagnosed with Bells Palsy this week and shoulder capulittis a month ago which I was told could come from a viral illness.
Bob hennessy
commented on 19 July, 2020
Week ago experienced touchy, sensitive skin on right arm. Somewhat achy at night. Waiting for covid test results. Now experiencing mild numbness on left side of face. Have previously had Bells Palsey from Lyme disease and this appears headed for same.
Kimberly
commented on 31 August, 2020
I am 56 y/o woman who has had extreme fatigue since March 16, 2020. No fever, no cough. Fatigue is overwhelming at times. 2 days ago began facial droopiness, not able to blink left eye and numbness over my face, racing heartbeat and extreme fatigue. Went to ER and they said Bell's Palsy given steroid and anti-viral. Should I go in for a Covid 19 test or antigen testing?
View 1 reply
J K Jager
replied on 17 December, 2020
Just had exactly the same. Wondered whether Bell’s Palsy is related to Covid. Also thought of antigen test
Debbie
commented on 04 September, 2020
I had Covid late February and now since July 5th I have Bell’s Palsy with no sigh of relief yet.
James sullivan
commented on 26 September, 2020
This case report would be improved if a description of the extent of oxygenation deficit was included in the case presentation. Current treatments are limited to those with some hypoxemia and the need for oxygen support. It would be helpful to know if this patient met such qualifications for treatment during her course. This report could be improved if in the case presentation there was a description of how long the Bell’s palsy lasted. It would be helpful to know how many weeks after diagnosis was the first sign of improvement in the motor function, and how long it took for complete recovery. Also it would be helpful to know the duration and doses of the treatments given. The disease gets better in most patients so ascribing improvement in one case to one intervention should not be asserted strongly.
Lisa scoffield
commented on 15 October, 2020
I had Bell’s palsy in April 2020. Started with loss of taste and smell on day one and 5 days later Bell’s palsy was evident. Had it for four weeks and then gradually got better after treatment. Not had a Covid test but I suspected it was caused by this.
Lisa
commented on 24 October, 2020
Hi from Iowa... I went into Urgent care to get tested for covid (Husband tested positive a week ago after he came home from working in another State. I have been monitoring myself and the head aches got worse and other symptoms arising. So the Dr asked me about all symptoms so I told her my left side of my face was tingling and my eye was sticky and sometimes foggy and more.. along with some tightness in that side of chest to right below the shoulder and some in Arm...Blood Pressure alittle high at time...so she talked with ER Dr and said that she thinks its Bells Palsy symptoms and prescribed me Prednisone (deltazone) 2 in the mornings which I started today...I'm kind of concerned because I've had injections in my foot this summer for Planterfacitous...and worry about my immune system becoming even more compromised...do I go by what urgent care advises or do I see someone for another opinion if that is even an option because so many diff studies say diff things about taking Steriods if Breathing is not compromised...please advise ASAP...
Amy
commented on 03 January, 2021
I was diagnosed with COVID-19 just 5 days ago by rapid antigen test. My symptoms began with hip and knee joint pain (felt more like lactic acid buildup). Pain disappeared when fever came on (99.3-100.2). I had 2 days of nasal congestion but was placed on azithromycin and prednisone. Mild chest discomfort experienced but was relieved with breathing exercises. I continue to have maxillary nerve tingling on the left side of my face. Headaches seem to be present only when temperature is above 99.5. I have no fatigue, no loss of taste or smell, no diarrhea and only very mild GI upset which is likely d/t antibiotic; I take probiotics on a daily regimen. I have increased appetite, likely d/t boredom. A mild Cough is only present when I feel the need to clear my throat and appears dry. I’ve taken a total of 4 ibuprofen (1 daily). I’ve remained hydrated with water and Electrolyte water. I don’t take flu vaccines (last one was 1996). I have a fear of developing Bell’s palsy or Guillain barre d/t the tingling or numbness I continue to experience on the left side of my face. I’m in healthcare so I am aware of the association of viruses with both of these temporary conditions but have seen the latter last longer than expected in a patient which was very debilitating.
James
commented on 12 January, 2021
My son, age 28, has Down Syndrome. We both came down with Covid just before Christmas. His symptoms were mostly gone in a few days. Two weeks later, he came down with Bell's Palsy. Who, if anybody, is tracking this stuff? Is there some place I should report it?
Nancy Fredrickson
commented on 31 January, 2021
I had Covid in March and developed Bells Palsy
Amanda
commented on 28 February, 2021
After being in relationship with Him for Five years, he broke up with me, I did everything possible to bring him back but all was in vain, I wanted him back so much because of the love I have for him, I begged him with everything, I made promises but he refused. but one day I explained my problem to someone online and she suggested that I should rather contact a spell caster that could help me cast a spell to bring him back but I am the type that never believed in love spell, I had no choice than to try it, I mailed the spell caster, and he told me there was no problem that my ex will return to me before three days, he cast the spell and surprisingly in the second day, it was around 4pm. My ex called me, I was so surprised, I answered the call and all he said was that he was so sorry for everything that happened, that he wanted me to return to him, that he loves me so much. I was so happy and went to him, that was how we started living together happily again. Since then, I have made promise that anybody I know that have a relationship problem, I would be of help to such person by referring him or her to the only real and powerful spell caster who helped me with my own problem and who is different from all the fake ones out there. Anybody could need the help of the spell caster, his email: [email protected] you can email him or WhatsAPP him on +2347056683626 if you need his assistance in your relationship or anything. CAN NEVER STOP TALKING ABOUT YOU SIR HIS EMAIL ADDRESS IS: [email protected] CONTACT HIM NOW FOR SOLUTION TO ALL YOUR PROBLEMS.
Elizabeth Principi
replied on 25 April, 2020
Where are you ?
View 1 reply
Kunal Priyadarshi
replied on 26 April, 2020
I am at aiims Bhubaneswar, India.
View 2 replies
Elizabeth Principi
replied on 27 April, 2020
Thanks
Elizabeth Principi
replied on 27 April, 2020
Thanks
Martine Hooper
replied on 16 May, 2020
Hello Kunal, posted my own facial palsy story below. Am currently awaiting acovid test and soon hopefully the antigen test. Did you test your patients for covid out of curiosity? I am a Dr of chemistry/cancer toxicology and am interested to help the scientific community.
Debbie Odaniel
replied on 02 July, 2020
I was sick. I took a vivid 19 test at a drive thru testing. It came back negative the same day I started developing Bells palsy symptoms. I now have complete paralysis on the left side of my face. Pain in my lower right under my ribs.
Sedina
replied on 06 July, 2020
I am 51 year old female with overall malaise for several days with ear and throat pain who awoke today with facial paralysis. I went to doctor and was diagnosed with Bell’s palsy. Dr suggested Covid testing, but here in rural Georgia, appointments must be made and the website is down. When I called the number, I was told that I would have to wait system to be repaired. I am not feeling well enough to drive some distance, so I will be delayed in getting tested. I am researching to see if others have had Bell’s palsy and if it is a result of the Covid virus.