Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

Crises epilépticas reativas por hiperlipidemia em cão Maltês / Reactive seizures due to hyperlipidemia in a maltese dog

Background: Primary hyperlipidemia is a condition that affects some specific breeds. It has been previously describedin Miniature Shnauzer, Beagles, Shetland Shepdog and West Highland White Terrier. There are no reports of primaryhyperlipidemia in Maltese dogs. It is a hereditary disorder of lipoprotein metabolism. The etiology is unknown and maybe related to a genetic problem in lipoprotein lipase or to the absence of apaprotein CII. Clinical signs include spontaneousarterosclerosis, retinal lipemia, cutaneous xanthomas, abdominal pain, lethargy, vomiting and / or diarrhea. Neurologicalmanifestations such as seizures and behavioral changes may also occur. The aim of this report is to describe a case ofreactive seizures due to hyperlipidemia in a dog.Case: A 5-year-old male Maltese dog was admitted with a history of seizures. Hypertension and abdominal distensionwith large amounts of intestinal gases were found in general physical examination. Neurological examination revealedimpaired nasal septum sensory perception, which was slightly bilaterally reduced, and pain on cervical palpation and inthe brachial plexus region. Based on history and clinical examination, it was possible to locate the lesion in the thalamocortical region and to suspect idiopathic epilepsy, reactive seizures, and symptomatic epilepsy due to meningoencephalitisof unknown origin. The diagnosis of primary hyperlipidemia was made by exclusion with the aid of laboratory tests andultrasound. After the establishment of a fat restriction diet, bezafibrate, phenobarbital, and omega-3 supplementation, theanimal improved significantly with the reduction of epileptic seizures.Discussion: The initial clinical suspicion was hyperadrenocorticism as the primary cause of hyperlipidemia. This suspicion was based on the presence of polyphagia, polydipsia, polyuria and abdominal distension, together with laboratory...

Crises epilépticas reativas por hiperlipidemia em cão Maltês / Reactive seizures due to hyperlipidemia in a maltese dog

Background: Primary hyperlipidemia is a condition that affects some specific breeds. It has been previously describedin Miniature Shnauzer, Beagles, Shetland Shepdog and West Highland White Terrier. There are no reports of primaryhyperlipidemia in Maltese dogs. It is a hereditary disorder of lipoprotein metabolism. The etiology is unknown and maybe related to a genetic problem in lipoprotein lipase or to the absence of apaprotein CII. Clinical signs include spontaneousarterosclerosis, retinal lipemia, cutaneous xanthomas, abdominal pain, lethargy, vomiting and / or diarrhea. Neurologicalmanifestations such as seizures and behavioral changes may also occur. The aim of this report is to describe a case ofreactive seizures due to hyperlipidemia in a dog.Case: A 5-year-old male Maltese dog was admitted with a history of seizures. Hypertension and abdominal distensionwith large amounts of intestinal gases were found in general physical examination. Neurological examination revealedimpaired nasal septum sensory perception, which was slightly bilaterally reduced, and pain on cervical palpation and inthe brachial plexus region. Based on history and clinical examination, it was possible to locate the lesion in the thalamocortical region and to suspect idiopathic epilepsy, reactive seizures, and symptomatic epilepsy due to meningoencephalitisof unknown origin. The diagnosis of primary hyperlipidemia was made by exclusion with the aid of laboratory tests andultrasound. After the establishment of a fat restriction diet, bezafibrate, phenobarbital, and omega-3 supplementation, theanimal improved significantly with the reduction of epileptic seizures.Discussion: The initial clinical suspicion was hyperadrenocorticism as the primary cause of hyperlipidemia. This suspicion was based on the presence of polyphagia, polydipsia, polyuria and abdominal distension, together with laboratory...(AU)