POLYNEUROPATHIES OF THE ENT DISTRICT FOLLOWING VIRAL INFECTIONS IN
POST-COVID ERA: A CASE SERIES WITH NARRATIVE REVIEW
Abstract
Cranial neuropathies contribute to a broader spectrum of disorders known
as peripheral polyneuropathies. Recent literature highlights the ability
of various viruses, such as the Sars-Cov2 virus and
Varicella-Zoster-Virus, to induce several diseases and syndromes
specifically affecting cranial nerves. The Sars-Cov2 virus has been
shown to have an affinity for the nervous system, likely due to its
interaction with ACE-2 receptors, which can lead to facial palsy,
Guillain–Barré Syndrome or trigeminal neuralgia. Conversely, the
Varicella-Zoster-Virus can cause the Ramsay-Hunt Syndrome, affecting
facial and vestibular-cochlear nerves. The current study aims to
investigate the impact of various viruses on cranial polyneuropathies of
otolaryngological significance. We thus presented a retrospective review
of consecutive clinical cases from 28 patients with multiple cranial
neuropathies deriving from viral infection, followed by a review of
current literature with regards to etiologies, clinical presentations,
and management strategies. As results, the nerves most frequently
involved were the vestibular-cochlear nerve (n=16), the facial nerve
(n=8), the trigeminal nerve (n=5) and the vagus nerve (n=2). Concerning
viral antibodies, VZV was the most detected (78,6%), CMV was identified
in association with other viruses (28,6%), HSV1 was detected in 2
subjects (7,1%). Molecular nasal swab analysis revealed COVID infection
in 4 out of 28 patients (14,3%). Concerning healing results, 22
patients experienced complete recovery, 3 patients achieved only partial
recovery, while 3 showed no improvement in neural deficit. Prompt
recognition and effective management of such polyneuropathies are
crucial in preventing disease progression and potentially reversing
neurological impairment, given their association with significant
morbidity.