Abstract Details

Title Can’t Move My Face Or Feel My Body: A COVID-19 Associated Guillain Barre variant.

Topic General Neurology

Presentation(s) General Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 052

Objective To raise awareness regarding atypical presentations of GBS associated with COVID-19.

Background Bilateral facial nerve palsy with paresthesia has been seen in atypical Guillain Barre variants associated with the post viral syndrome of SARS-CoV2. It also accounts for only 2% of all cases of facial nerve palsy and is a rare phenomenon. We bring forth a case of a patient with isolated facial nerve paralysis and sensory disturbances after recent COVID-19 infection.

Design/Methods Case study

Results 51 year old Hispanic man with hypertension and recent COVID-19 infection presented with eight days of body wide numbness, bilateral weakness of face, and subjective imbalance due to not being able to feel his feet. Diagnosed with a mild case of Sars-Cov2 a month prior to presentation, with symptoms of sore throat and fever that had resolved with supportive therapy. Examination notable for facial diplegia, diminished taste and sensation to all sensory modalities and hyporeflexia and full strength in all extremities. Investigations revealed enhancement of the bilateral facial nerves on MRI brain and albuminocytologic dissociation (normal glucose, elevated protein at 140, nucleated cells less than 1) on cerebrospinal fluid analysis. Work up for conditions such as diabetes, tuberculosis, Lyme, syphilis, sarcoidosis, auto-immune or paraneoplastic syndromes was negative. Infectious work up was negative for COVID 19 PCR and positive IgG Antibody. He remained without any autonomic instability, respiratory issues, progressive weakness and was treated with five days of IVIG. Facial paralysis, sensory disturbances and imbalance improved and he was discharged home after treatment.

Conclusions The SARS-CoV-2 pandemic has brought to light an interesting contributor to the broad differential associated with bilateral facial nerve palsy and atypical GBS variants. Our case highlights that SARS-CoV-2 encompasses a spectrum of neurological presentations which are responsive to traditional treatments.

Authors/Disclosures
Batool A. Hussain, MD, MBBS (UC Davis Neurology) PRESENTER	Dr. Hussain has nothing to disclose.
Anna Zolyan, MD	Dr. Zolyan has nothing to disclose.
Alejandra Garland Becerra, MD	Dr. Garland Becerra has nothing to disclose.

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