Guillain-Barré syndrome with bilateral facial diplegia secondary to severe acute respiratory syndrome coronavirus-2 infection: a case report.

BACKGROUND: The new coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) owing to its similarity to the previous severe acute respiratory syndrome (SARS), is characterized by causing, in most patients, nonspecific symptoms similar to those of the common flu. It has been reported that many coronavirus disease 2019 (COVID-19) patients presented neurological symptoms that involve the central and peripheral nervous systems. In addition, there have been several reports of patients who presented Guillain-Barré syndrome related to  COVID-19 , with sensory and motor compromise in the extremities. CASE PRESENTATION: In this report, we describe a rare case of Guillain-Barré syndrome in a 50-year-old Hispanic male with bilateral facial palsy as the only neurological manifestation, following SARS-CoV-2 infection. A complete neurophysiological study showed severe axonal neuropathy of the right and left facial nerves. CONCLUSION: Regardless of severity, clinicians must to be aware of any neurological manifestation generated by COVID-19 and start performing more neurophysiological tests to determine if the infection induces an axonal, myelin, or mixed involvement of the peripheral nervous system.

Carotid web: septo o banda carotídea: presentación de dos casos / Carotid web: "septo o banda carotidea": Two case reports

RESUMEN Carotid web es un término usado para describir en imágenes una anomalía vascular del desarrollo del sistema braquiocefálico. Se trata de una causa poco reconocida de accidente cerebrovascular, especialmente en pacientes jóvenes. Su frecuencia en la población general no se ha determinado y se asocia con eventos cerebrovasculares isquémicos de tipo embólico. En este reporte describimos dos casos de web carotídeo sintomático, uno que se manifiesta como un ataque isquémico transitorio (AIT) y el otro como infarto cerebral. Hasta el momento, no existe un método diagnóstico establecido como óptimo; la angiografía por resonancia magnética y por tomo-grafía se presentan como una opción confiable y alternativa a la angiografía convencional. Una vez identificado el carotid web, la evidencia es escasa con respecto a su manejo; algunas opciones con las que contamos son antiagregación, anticoagulación y manejo invasivo con endarterectomía y colocación de stent. Se dispone de poca literatura en español sobre web carotídeo. A efectos de una mejor comprensión proponemos el término de septo o banda carotídea para denominar a esta anomalía vascular.

SUMMARY Carotid web is a term used to describe by images a vascular abnormality of development of the brachiocephalic system. It is an under-recognized cause of stroke, especially in young patients. Its frequency in the general population has not been determined and is associated with ischemic cerebrovascular events of embolic type. Two cases of symptomatic carotid web are reported, one manifested as a transient ischemic attack (TIA) and the other as a cerebral infarction. There is not an established optimal diagnostic method, MRI and CT angiography are presented as a good option and alternative to conventional angiography. Once the carotid web has been identified, the evidence is scarce regarding its management, there are some options such as antiplatelets, anticoagulation and invasive management with endarterectomy and stent placement, there is little information in Spanish literature on carotid web so we propose the term septo o banda carotidea to name this vascular abnormality.