tetano
Editor, Senior Moderator
J Med Case Rep
. 2025 Dec 29;19(1):654.
doi: 10.1186/s13256-025-05710-4. Cranial neuropathy during severe acute respiratory syndrome coronavirus 2 infection: a case report
Roya Yazdani[SUP] 1 [/SUP], Farzaneh Barzkar[SUP] 2 [/SUP], Zahra Mirzaasgari[SUP] 3 [/SUP]
Affiliations
Background: Cranial neuropathy has been reported in association with coronavirus disease 2019. Multiple reports have highlighted the possibility of Miller Fisher syndrome as a delayed immune-mediated response to severe acute respiratory syndrome coronavirus 2 infection. However, cranial neuropathy during the infectious phase of coronavirus disease 2019 with positive cerebrospinal fluid polymerase chain reaction has not been reported to date.
Case presentation: We report a 53-year-old Iranian woman who presented with right ptosis, diplopia, and headache without any respiratory symptoms of coronavirus disease 2019. Further evaluations revealed severe acute respiratory syndrome coronavirus(SARS CoV) 2 in the patient's nasopharyngeal sample and cerebrospinal fluid. The patient's neurological symptoms improved after treatment with remdesivir and corticosteroids.
Conclusion: We suggest that cranial nerve-related symptoms can occur in the context of acute severe acute respiratory syndrome coronavirus 2 infection via direct viral invasion and secondary immune-mediated injury following primary infection. Clinicians should consider coronavirus disease 2019 in patients with symptoms related to cranial nerve involvement, even without systemic or respiratory symptoms of this viral infection.
Keywords: COVID-19; Case report; Cranial neuropathy; Diplopia; Neurology; Ptosis.
. 2025 Dec 29;19(1):654.
doi: 10.1186/s13256-025-05710-4. Cranial neuropathy during severe acute respiratory syndrome coronavirus 2 infection: a case report
Roya Yazdani[SUP] 1 [/SUP], Farzaneh Barzkar[SUP] 2 [/SUP], Zahra Mirzaasgari[SUP] 3 [/SUP]
Affiliations
- PMID: 41466384
- DOI: 10.1186/s13256-025-05710-4
Background: Cranial neuropathy has been reported in association with coronavirus disease 2019. Multiple reports have highlighted the possibility of Miller Fisher syndrome as a delayed immune-mediated response to severe acute respiratory syndrome coronavirus 2 infection. However, cranial neuropathy during the infectious phase of coronavirus disease 2019 with positive cerebrospinal fluid polymerase chain reaction has not been reported to date.
Case presentation: We report a 53-year-old Iranian woman who presented with right ptosis, diplopia, and headache without any respiratory symptoms of coronavirus disease 2019. Further evaluations revealed severe acute respiratory syndrome coronavirus(SARS CoV) 2 in the patient's nasopharyngeal sample and cerebrospinal fluid. The patient's neurological symptoms improved after treatment with remdesivir and corticosteroids.
Conclusion: We suggest that cranial nerve-related symptoms can occur in the context of acute severe acute respiratory syndrome coronavirus 2 infection via direct viral invasion and secondary immune-mediated injury following primary infection. Clinicians should consider coronavirus disease 2019 in patients with symptoms related to cranial nerve involvement, even without systemic or respiratory symptoms of this viral infection.
Keywords: COVID-19; Case report; Cranial neuropathy; Diplopia; Neurology; Ptosis.