valacyclovir and Guillain-Barre-Syndrome

A man in his 70s presented with a 4-day history of bilateral frontal headache and heaviness of the face. He was unable to close either of his eyes, to wrinkle his forehead bilaterally and to raise either corner of his mouth. The patient was admitted with a diagnosis of bilateral facial palsy. From history, epidemiology, physical and laboratory findings, Bell's palsy was considered more probable than viral infection, Guillain-Barré syndrome and sarcoidosis. Oral administration of prednisolone, valacyclovir and mecobalamin were initiated promptly, which improved his symptoms. In areas in which Lyme disease is not endemic, we believe that Bell's palsy is the most probable cause of isolated bilateral facial palsy. Patients with bilateral facial paralysis under the suspicion of Bell's palsy should be immediately started on steroid therapy.

Topics: Bell Palsy; Facial Paralysis; Guillain-Barre Syndrome; Humans; Male; Prednisolone; Valacyclovir

COVID-19 is caused by the novel SARS-CoV-2 and is a potentially fatal disease that is of great global public health concern. In addition to respiratory symptoms, neurological manifestations have been associated with COVID-19. This is attributed to the neurotropic nature of coronaviruses. The authors present a case of Bell's palsy associated with COVID-19 in a term primigravida.

Topics: Adult; Anti-Inflammatory Agents; Antiviral Agents; Bell Palsy; COVID-19; Diagnosis, Differential; Facial Paralysis; Female; Guillain-Barre Syndrome; Humans; Neurologic Examination; Physical Therapy Modalities; Prednisolone; Pregnancy; Pregnancy Complications, Infectious; Stroke; Treatment Outcome; Valacyclovir

We herein report the case of a 19-year-old woman with facial diplegia and paresthesias (FDP) preceded by flu-like symptoms. We diagnosed the patient with a regional variant of Guillain-Barré syndrome due to decreased tendon reflexes, albuminocytological dissociation in the cerebrospinal fluid and demyelinating features on nerve conduction studies. The patient also had IgM anti-GalNAc-GD1a antibodies, and treatment with glucocorticoids was effective for treating the facial diplegia, but not paresthesia. Therefore, facial palsy may have a different pathophysiology from paresthesia or other symptoms of FDP, which responds to glucocorticoid therapy.

Topics: Acyclovir; Adult; Antiviral Agents; Autoantibodies; Facial Paralysis; Female; Gangliosides; Glucocorticoids; Guillain-Barre Syndrome; Humans; Immunoglobulin M; Methylprednisolone; Paresthesia; Recovery of Function; Treatment Outcome; Valacyclovir; Valine

This report presents a case of infectious mononucleosis with severe neurological complications in a previously healthy young female. Both peripheral and cranial nerves were affected causing paralysis and need for assisted ventilation. There was a clear correlation between the symptoms and the serological findings, indicating that the causative agent was Epstein-Barr virus. The patient was treated with acyclovir, methylprednisolone and immunoglobulins. Two months later she had recovered completely. Epstein-Barr virus infection must be considered among the possible causes in patients with cranial nerve affection or Guillain-Barré syndrome.

Topics: Acyclovir; Adolescent; Anti-Inflammatory Agents; Antiviral Agents; Cranial Nerve Diseases; Epstein-Barr Virus Infections; Female; Guillain-Barre Syndrome; Humans; Immunoglobulins, Intravenous; Methylprednisolone; Valacyclovir; Valine