Facial nerve neuropathy during the COVID-19 pandemic: clinical features, acupuncture treatment approaches

BACKGROUND: Facial nerve neuropathy (FNN) is a common mononeuropathy in the general stage of development of the peripheral nervous system. During the novel coronavirus disease (COVID-19) pandemic, the incidence of facial neuropathy increased from 1.3% in 2019 to 3.5% in 2020. Acute isolated neuropathy of the facial nerve may be the first and only manifestation of various infectious diseases, including COVID-19. Several experts showed that the mechanisms of facial neuropathy development after a coronavirus infection is associated with neuroinflammation.

Accepted therapeutic algorithms do not always lead to the expected results. Acupuncture potentially plays a key role in the treatment of this disease. In several cases, its superiority over drug treatment for FNN has been noted. No Russian studies on the treatment of post-COVID FNN were found.

AIM: This study aimed to study the clinical features of the course of FNN after COVID-19, develop reflexology approaches to treatment, and compare the course of FNN between patients with a history of coronavirus infection and those without a history of COVID-19 infection.

MATERIALS AND METHODS: The study group (after COVID-19) consisted of 16 patients with FNN (13 men, 3 women). The comparison group included 21 patients with FNN without a history of COVID-19 (15 men, 6 women). For a comprehensive patient assessment, clinical, neurological, and electroneuromyographic examination data were used.

RESULTS: The treatment results of 16 patients with FNN that developed up to 12 weeks after suffering from COVID-19 were analyzed. The onset of the disease was accompanied by an arterial hypertension episode, which was observed for the first time in two patients. Nerve fiber damage was mixed and severe (>52%). The dynamics of clinical and electrophysiological parameters in the study group (after COVID-19) were significantly slower compared to that of the group without a history of COVID.

CONCLUSION: FNN that develops after COVID-19 is characterized by severe nerve fibers damage and a long course. Reflexology is an effective and safe method as part of complex therapy.