Multifocal Neurologic Manifestation of Coronavirus Disease 2019 Infection: Report of 2 Cases

Abstract

Background: The most common neurological symptoms of coronavirus disease 2019 (COVID-19) were hypogeusia and hyposmia; neuropathy was recently reported in patients with COVID-19. It is not yet clear if the virus has the potential to affect the nervous system or it is just a co-incidental finding. In this study, we report 2 patients with a history of COVID-19 presenting neurological symptoms and weakness, who did not meet the Guillain‐Barre syndrome (GBS) criteria.

Case Report: The first patient was a 56-year-old man who developed flu-like symptoms and was isolated for fourteen days after being diagnosed with COVID-19 through positive polymerase chain reaction (PCR) test and lung computed tomography (CT) scan. Three weeks later, the patient developed right-sided peripheral facial palsy, four-limb paresthesia, and progressive lower limb weakness. The second patient was a 62-year-old man with more or less the same presentation as patient number 1 except for lack of facial involvement and normal lower limbs’ sensory nerve conduction study (NCS).

Conclusion: Here, we have reported 2 cases that developed neuropathic symptoms following the COVID-19 symptoms in the recovery period. The majority of the research regarding neuropathies in patients with COVID-19 studied the facial nerve involvement and GBS, and a sensory-predominant polyneuropathy is not yet reported, as far as we know. With the suspicion of an acute myelitis and sensory neuropathy, the patients were prescribed intravenous immunoglobulin (IVIg).