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21 November 2020 04:16:39
Bell’s palsy is caused by viral infections. The coronavirus can attack the nerves of the face leading to their inflammation, swelling or compression. (Representative)
Cases of facial nerve palsy, or Bell’s palsy, are becoming more common among patients with Covid-19. Patients, even without a confirmed diagnosis of Covid-19, report facial paralysis, indicating the possibility that even asymptomatic patients may suffer from its complications.
Bell’s palsy is caused by viral infections. The coronavirus can attack the nerves of the face leading to their inflammation, swelling or compression. The nerves are no longer able to control the facial muscles leading to a sagging face on one side, loose or weak muscles, and even temporary facial distortion.
Dr Rahul Chakor, head of neurology at Nair hospital, which served as a dedicated Covid hospital, said the number of these cases, although rare, has become more frequent now apart from other neurological problems. “But not all cases have a positive relationship for Covid-19, so in order to be able to trace a direct relationship in all cases, we need to prove that the virus caused it,” he said.
Doctors in private hospitals are seeing more cases than government hospitals possibly due to awareness among patients seeking private healthcare. Dr Rahul Pandit, an intensivist at Fortis hospital, said many cases confirmed by Covid-19 returned after discharge with neurological complications such as Guillain Barre’s syndrome, Bell’s palsy, dementia, encephalitis. Research shows that in some cases, facial paralysis can 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 have seen some cases and we did a Covid test which came back positive. In other cases, patients develop this syndrome about 10 days after Covid-19 infection, “he said. He added that the virus triggers inflammation of the facial nerves that causes temporary paralysis that lasts three to six weeks.
“We initially thought it was accidental, but now we know that Covid-19 is associated with Bell’s palsy,” Makhija added. The British Medical Journal also reported Bell’s palsy in pregnant women with Covid-19.
Doctors are treating these patients with antivirals such as Valaciclovir and corticosteroids to reduce nerve swelling.
Before the onset of the Covid-19 pandemic, herpes infection was the most common cause of Bell’s palsy. Dr Nitin Dange, a neurologist at KEM hospital, said cases of Bell’s palsy are also known to increase during the winter when viral infection increases. “But they are not fatal,” he said.
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