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Cranial neuropathies contribute to a broader spectrum of disorders known as peripheral polyneuropathies. Recent literature highlights the ability of various viruses, such as the Sars-Cov2 virus and Varicella-Zoster-Virus, to induce several diseases and syndromes specifically affecting cranial nerves. The Sars-Cov2 virus has been shown to have an affinity for the nervous system, likely due to its interaction with ACE-2 receptors, which can lead to facial palsy, Guillain–Barré Syndrome or trigeminal neuralgia. Conversely, the Varicella-Zoster-Virus can cause the Ramsay-Hunt Syndrome, affecting facial and vestibular-cochlear nerves. The current study aims to investigate the impact of various viruses on cranial polyneuropathies of otolaryngological significance. We thus presented a retrospective review of consecutive clinical cases from 28 patients with multiple cranial neuropathies deriving from viral infection, followed by a review of current literature with regards to etiologies, clinical presentations, and management strategies. As results, the nerves most frequently involved were the vestibular-cochlear nerve (n=16), the facial nerve (n=8), the trigeminal nerve (n=5) and the vagus nerve (n=2). Concerning viral antibodies, VZV was the most detected (78,6%), CMV was identified in association with other viruses (28,6%), HSV1 was detected in 2 subjects (7,1%). Molecular nasal swab analysis revealed COVID infection in 4 out of 28 patients (14,3%). Concerning healing results, 22 patients experienced complete recovery, 3 patients achieved only partial recovery, while 3 showed no improvement in neural deficit. Prompt recognition and effective management of such polyneuropathies are crucial in preventing disease progression and potentially reversing neurological impairment, given their association with significant morbidity.
Sacchetto et al. (Tue,) studied this question.