Abstract
Introduction: In the midst of the COVID-19 pandemic, there are numerous reports of SARS-CoV-2-related symptoms in many medical subspecialties. Unfortunately, there seems to be little focus on indirect victims of COVID-19, such as diseases/ailments secondary to COVID-19-related lockdown in relevant countries. Observation: We report a case of idiopathic facial paralysis (Bell's Palsy) that occurred in an otherwise-healthy 49-year-old French chef during nationwide lockdown, possibly fostered by severe concerns regarding his professional prospects. Other manifestations of severe anxiety were also observed such as tension-type headache and psoriasis outbreaks. Prednisone and valaciclovir were initiated, in association with simple counselling. Commentary and conclusion: As HSV-1 reactivation in the facial nerve is suspected in the pathophysiology of idiopathic facial paralysis, this case could constitute an example of lockdown-related disease and an illustration of indirect manifestations of the COVID-19 pandemic. Such indirect diseases are likely to increase as the pandemic continues to take its toll both medically and socio-economically.
Highlights
In the midst of the Coronavirus Disease 2019 (COVID-19) pandemic, a growing number of publications from numerous medical subspecialties have started to explore the multiple facets of the Severe Acute Respiratory distress Syndrome Coronavirus 2 (SARS-CoV-2) infection, in an attempt to foster better understanding and earlier diagnosis of the disease.Apart from the obvious medical impact of the pandemic, its socio-economical impact should not be underestimated, especially in countries that have resorted to nationwide lockdown to control the spread of the disease, as in France for example
We report a case of a healthy 49-year-old French chef, who suffered from right idiopathic facial paralysis (Bell’s Palsy) in a context of severe lockdown-related anxiety
As such facial paralysis is considered secondary to reactivation of Herpes Simplex Virus 1 (HSV-1) in the facial nerve [2,3] and in analogy with stress-related herpes labialis outbreaks [4] this case could constitute a lockdown-related illness, an illustration of the indirect medical impact of the COVID-19 pandemic
Summary
In the midst of the Coronavirus Disease 2019 (COVID-19) pandemic, a growing number of publications from numerous medical subspecialties have started to explore the multiple facets of the Severe Acute Respiratory distress Syndrome Coronavirus 2 (SARS-CoV-2) infection, in an attempt to foster better understanding and earlier diagnosis of the disease. We report a case of a healthy 49-year-old French chef, who suffered from right idiopathic facial paralysis (Bell’s Palsy) in a context of severe lockdown-related anxiety (stemming mainly from concerns regarding his professional prospects). On April 14, 2020, upon follow-up, the patient reported continuous severe right-side pressing occipital and hemicranial pain for the past 5 days, with associated pericranial tenderness and right trapezius trigger points found upon clinical examination, suggestive of infrequent episodic tension-type headache as per the International Classification of Headache Disorders 3rd version criteria (ICHD-3 2.1.1) [7] that the patient managed with codeine Psoriasis outbreaks on both arms were noted (Fig. 3). Evolution of the COVID-19 pandemic in France January 24 À First case of SARS-CoV-2 infection in France March 14 À Level 3 epidemic in France; bars and restaurants are closed for an indefinite period March 17 À Nationwide lockdown instituted LOCKDOWN
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