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Axonal excitability findings in acute inflammatory demyelinating polyneuropathy related to SARS-CoV-2

1 Department of Neurology, Akdeniz University Faculty of Medicine, Antalya, Turkey
2 Department of Emergency Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey
3 Düzen Laboratory Group, Ankara, Turkey

Correspondence Address:
Abir Alaamel,
Department of Neurology, Faculty of Medicine, Akdeniz University, Dumlupınar Bulvarı, 07058 Campus, Antalya
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/nsn.nsn_111_21

Guillain–Barré syndrome (GBS) is a disorder of the peripheral nervous system characterized by acute-onset ascendance paresis. We present a patient who was diagnosed as having facial-onset acute inflammatory demyelinating polyneuropathy after being infected with SARS-CoV-2. A 51-year-old man presented to the emergency department with facial diplegia. He then developed bilateral ascendance paralysis. He had noticed that for 1 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 was found to be positive. A nerve conduction study showed prolonged motor distal and F wave latencies with decreased motor and sensory compound muscle action potential amplitudes. Lumbar puncture revealed albuminocytologic dissociation. According to the neurologic examination and laboratory findings, the patient was diagnosed as having acute inflammatory demyelinating polyneuropathy. An axonal excitability study revealed fanning in pattern with prolonged refractoriness, which indicates nodal sodium channel disturbances. Facial-onset SARS-CoV-2–related GBS has been rarely reported; however, facial involvement seems to be one of the features of the neurologic findings.

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