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

Keywords: COVID-19; SARS-COV-2; Polyneuropathies; Neuropathy; Guillain-Barre syndrome; Myelitis


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).


1. Rayegani SM, Raeissadat SA, Fakharian A, Babaee M, Nezamabadi M, Boland Nazar NS, et al. Role of rehabilitation medicine in the COVID-19 pandemic: An Iranian consensus. Eur J Phys Rehabil Med 2020. [Epub ahead of print].
2. Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19. Lancet Neurol 2020; 19(9): 767-83.
3. Alberti P, Beretta S, Piatti M, Karantzoulis A, Piatti ML, Santoro P, et al. Guillain-Barre syndrome related to COVID-19 infection. Neurol Neuroimmunol Neuroinflamm 2020; 7(4): e741.
4. Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: A case report.
J Clin Neurosci 2020; 76: 233-5.
5. Oguz-Akarsu E, Ozpar R, Mirzayev H, Acet-Ozturk NA, Hakyemez B, Ediger D, et al. Guillain-barre syndrome in a patient with minimal symptoms of COVID-19 infection. Muscle Nerve 2020; 62(3): E54-E57.
6. Su XW, Palka SV, Rao RR, Chen FS, Brackney CR, Cambi F. SARS-CoV-2-associated Guillain-Barre syndrome with dysautonomia. Muscle Nerve 2020; 62(2): E48-E49.
7. Carod-Artal FJ. Neurological complications of coronavirus and COVID-19. Rev Neurol 2020; 70(9): 311-22.
Case Report(s)