SARS-CoV-2 induced abducens nerve palsy: A case report and response to methylprednisolone

IF 1.1 Q4 INFECTIOUS DISEASES

IDCases Pub Date : 2025-01-01 DOI:10.1016/j.idcr.2025.e02201

João Hugo Abdalla Santos , Ligia Fernandes Abdalla , Cleitiene de Souza Sierpinski , Camila Feldberg Porto , Felipe Gomes Naveca

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Abstract

Introduction

The abducens nerve (sixth cranial nerve) is a motor nerve that innervates the lateral rectus muscle, playing a key role in ocular abduction. Palsy of this nerve leads to convergent strabismus and diplopia. Common causes include strokes, trauma, inflammation, and infections, though in some cases, the etiology remains undetermined. With the emergence of COVID-19, neurological manifestations such as cranial neuropathies, including abducens nerve palsy, have been reported.

Case presentation

We present a case of a previously healthy 48-year-old male diagnosed with SARS-CoV-2 infection who developed abducens nerve palsy in the left eye. Following the resolution of respiratory symptoms, strabismus persisted. Treatment with methylprednisolone was initiated, resulting in partial recovery within one week and complete resolution after three months.

Conclusion

SARS-CoV-2-induced abducens nerve palsy can be reversible with conservative treatment using methylprednisolone. Early recognition and appropriate management are crucial for achieving a favorable prognosis.

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SARS-CoV-2诱导外展神经麻痹1例及甲泼尼龙治疗效果

外展神经（颅第六神经）是支配外直肌的运动神经，在眼外展中起关键作用。神经麻痹可导致会聚性斜视和复视。常见的病因包括中风、创伤、炎症和感染，但在某些情况下，病因尚不确定。随着新冠肺炎的出现，已出现包括外展神经麻痹在内的颅神经病变等神经学表现。我们报告了一例先前健康的48岁男性，诊断为SARS-CoV-2感染，并发左眼外展神经麻痹。呼吸系统症状消退后，斜视仍然存在。开始使用甲基强的松龙治疗，一周内部分恢复，三个月后完全缓解。结论经甲强的松龙保守治疗，sars - cov -2诱导的外展神经麻痹是可逆的。早期识别和适当的管理是获得良好预后的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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