Bell`s Palsy as the Presenting Symptom of SARS-Cov-2 Infection in 2 Pediatric Patients: Case Report and Literature Review
2Pediatric Neurology Unit, Soroka University Medical Center
3Department of Pediatric Emergency Medicine, Soroka University Medical Center
4Independent Researcher, Soroka University Medical Center
5Pediatric Infectious Disease Unit, Soroka University Medical Center
6The Faculty of Health Sciences, Ben-Gurion University of the Negev
Background: Coronavirus disease-19 (COVID-19) mainly presents as a febrile illness with or without respiratory symptoms. Recently, evidence has emerged worldwide of neurological symptoms during and following COVID-19. Reports regarding facial nerve palsy (Bell’s palsy) during Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections are rare.
Case reports: We report two pediatric patients, a 9-year old and a 12-year old girls, who presented with Bell`s palsy and were tested positive for SARS-CoV-2. Both patients had no respiratory symptoms or other neurologic complication. They were treated with oral steroids and artificial tears and fully recovered within the course of a few weeks.
Methods: A systematic literature search was performed using the PubMed database. The search was limited to reports between December 2019 and August 2020. Search terms included “Covid-19","Corona", "SARS-CoV-2" combined with the terms "Facial Nerve Palsy" or "Bell`s Palsy".
Results: Five reports were identified, all of sporadic cases of COVID-19 and Bell`s palsy in adults. All reported patients suffered from headache or from pain in facial areas.
Conclusions: Our report highlights the fact that pediatric COVID-19 patients may present with Bell’s palsy as a presenting symptom or complication. Furthermore, pediatricians should include SARS-CoV-2 in their differential diagnosis for Bell’s palsy etiology. Further research concerning COVID-19 related neurological manifestations is necessary to better understand and treat this illness.