Cases of facial nerve paralysis, or Bell’s palsy, are getting more common among Covid-19 patients. Patients, even with no confirmed diagnosis of Covid-19, are reporting facial paralysis, indicating the possibility that asymptomatic patients may also be suffering from its complications.
Bell’s palsy is caused by viral infections. The coronavirus can attack nerves in the face leading to their inflammation, swelling or compression. The nerves can no longer control the muscles in the face leading to drooping face from one side, loose or weak muscles and distortion in face albeit temporary.
Dr Rahul Chakor, head of neurology in Nair hospital, which functioned as a Dedicated Covid hospital, said the number of such cases although rare have become more frequent now apart from other neurological problems. “But not all cases have a Covid-19 positive report, so for us to draw a direct relation in all cases, we need to demonstrate the virus caused it,” he said.
Doctors in private hospitals are seeing more cases than government hospitals perhaps due to awareness among patients seeking private healthcare. Dr Rahul Pandit, intensivist in Fortis hospital, said a lot of Covid-19 confirmed cases have returned after discharge with neurological complications like Guillain Barre Syndrome, Bell’s palsy, dementia, encephalitis. Research shows in some cases facial paralysis may be the first symptoms of Covid-19, even before fever or loss of smell and taste.
Neurologist Dr Prashant Makhija saw three cases of Bell’s palsy last week. “Some may develop facial paralysis before they are even diagnosed with Covid. I saw a few cases, and we did a Covid test which came positive. In other cases, patients develop this syndrome about 10 days after Covid-19 infection,” he said. He added that the virus triggers inflammation in facial nerves that cause temporary paralysis lasting for three to sometimes six weeks.
“Initially we thought it was incidental, but now we know Covid-19 is associated with Bell’s palsy,” Makhija added. The British Medical Journal has reported Bell’s palsy in pregnant women with Covid-19 too.
Doctors are treating such patients with anti-virals like Valaciclovir and corticosteroids to reduce nerve swelling.
Before the Covid-19 pandemic began, Herpes infection was the most common cause of Bell’s palsy. Dr Nitin Dange, neurologist in KEM hospital, said Bell’s palsy cases are also known to rise during winter when viral infection spikes. “But they are not fatal,” he said.
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