COVID-19 as a rare cause of facial nerve neuritis in a pediatric patient

Abstract

COVID-19 has been noted to present with neurological symptoms in nearly 30% of patients. While children are more likely to be asymptomatic, neurological involvement has been observed. We present the case of a 23-month-old previously healthy female who was brought to the emergency room for a new-onset facial droop. The patient tested positive for COVID-19 but was otherwise asymptomatic. Magnetic resonance imaging of the brain with and without contrast revealed abnormal enhancement along the canalicular segment of the right cranial VII extending to the first genu suggestive of cranial nerve neuritis. Given that our case involves a pediatric patient with no significant comorbidities presenting with facial drop, COVID-19 should be considered on the differential when evaluating causes of new onset peripheral nerve palsies.

Keywords: COVID-19; facial nerve palsy; magnetic resonance imaging; neuritis; neuroradiology; pediatric.

Fig. 1

Axial T1-weighted post contrast image showing abnormal enhancement along the canalicular component of the right seventh cranial nerve extending to the first genu (white arrow)

Fig. 2

Coronal T1-weighted post contrast image showing abnormal enhancement along the canalicular component of the right seventh cranial nerve extending to the first genu (white arrow)

Fig. 3

Axial T1-weighted post contrast image showing normal enhancement along the tympanic portion of facial nerve bilaterally (white arrows)