Otoneurological Complication In Covid 19 Patients Reported:
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A 77-year-old man suffering from hypertension and T2D was diagnosed with COVID-19 and recovered from acute respiratory distress syndrome (ARDS) a 1 month ago presented with spinning sensation associated with generalised weakness and two episodes of vomiting. He had no history of decrease in hearing or tinnitus. After confirming stable vitals, evaluation for dizziness was performed. Head impulse test was positive on the left, showing saccadic correction. Head shake test was negative and detailed neurological examination was performed and was normal. He swayed to left on attempting tandem gait. On cranial nerve examination, he had normal smell sensation, direct and consensual light reflex were intact, extraocular movements were normal and full, sensation over face was intact and so was facial nerve function. Pure tone audiogram showed bilaterally symmetrical moderate sensorineural hearing loss suggestive of presbycusis. It was diagnosed as acute vestibular neuronitis. MRI with diffusion-weighted imaging of brain was performed and was normal and He was treated with prochlorperazine 5mg three times a day and vestibular rehabilitative exercises from the second day. Re-evaluation after 5days and again after 10 days showed improvement in symptoms. Head impulse test returned to normal. No sway was noted on sharpened Romberg’s testing. Isolated neurological deficits can occur along facial nerve and vestibular nerve in covid patients and can be a primary presentation or delayed feature of COVID-19.

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