COVID-19 AND NEUROMUSCULAR DISEASES: EP.19 Facial Onset Acute Inflammatory Demyelinating Polyneuropathy Related to SARS-CoV-2

Guillain–Barré is a disorder of the peripheral nervous system characterized by acute onset ascendance paresis. We present a case diagnosed with facial onset acute inflammatory demyelinating polyneuropathy after being infected with SARS-CoV-2. A 51-year-old man presented with facial diplegia to the emergency room. Then he developed bilateral ascending paralysis. He noticed that for one month he had smell and taste disturbances. SARS-CoV-2 infection was suspected. Nasopharyngeal swab polymerase chain reaction test was negative but anti-SARS-CoV-2 antibody found to be positive. Nerve conduction study showed prolonged motor distal and F wave latencies with decreased motor and sensory CMAP amplitudes. Lumbar puncture revealed albumino-cytologic dissociation. According to neurological examination and laboratory findings, the case diagnosed as acute inflammatory demyelinating polyneuropathy. Axonal excitability study revealed fanning in pattern with prolonged refractoriness which indicates nodal sodium channel disturbances. Even if facial onset SARS-CoV-2 related Guillain–Barré cases have been rarely reported, facial involvement seems to be one of the features of the neurological findings.