Nikhil Prasad Fact checked by:Thailand Medical News Team Mar 23, 2025 1 day, 10 hours, 40 minutes ago
Medical News: In a compelling new medical case from Brazil, doctors have uncovered yet another alarming complication of COVID-19 - damage to a critical eye nerve that controls movement - raising further concerns about the virus’s impact on the nervous system. A team of physicians from Hospital Adventista de Manaus, Universidade Federal do Amazonas, Universidade Estadual do Amazonas, and Fundação Oswaldo Cruz have reported how a previously healthy man developed abducens nerve palsy, a condition that caused his left eye to turn inward, leading to disturbing double vision.
COVID-19 Infection Triggers Eye Nerve Damage
Their findings describe how the neurological issue appeared shortly after the patient contracted COVID-19 and how timely steroid treatment, specifically high-dose methylprednisolone, led to a full recovery. This
Medical News report sheds light on yet another way SARS-CoV-2 can affect the human body beyond its respiratory impacts.
A Sudden Case of Eye Trouble After COVID Infection
The patient, a 48-year-old man from a small town in Brazil's Amazonas region, first experienced typical COVID-19 symptoms like fever, cough, and muscle aches. But within days, his condition worsened - he developed shortness of breath and sudden-onset double vision. His eyes appeared crossed, and he felt dizzy, forcing him to seek urgent medical attention. Initially treated at a local hospital, he was eventually transferred to a larger facility in Manaus, where chest scans showed classic signs of COVID-related lung damage. A confirmatory RT-PCR test revealed that he was indeed infected with SARS-CoV-2, despite being fully vaccinated.
What baffled doctors was the persistence of his eye condition - medically termed abducens nerve palsy - even after his respiratory symptoms improved. The sixth cranial nerve, responsible for moving the eye outward, appeared to have been affected by inflammation possibly caused by the virus itself or the body’s immune response.
Investigation and Diagnosis
Doctors ruled out other causes of nerve damage such as diabetes, hypertension, stroke, and other viral infections. Brain imaging showed no evidence of tumors, stroke, or bleeding. Blood tests and eye examinations pointed towards inflammation of the sixth cranial nerve without any apparent structural cause.
As part of the investigation, the patient was initially given antiviral therapy including acyclovir, but his symptoms did not improve. Only after neurologists diagnosed him with post-COVID inflammatory nerve damage was he treated with methylprednisolone - a powerful anti-inflammatory steroid.
The Role of Methylprednisolone
The patient received high-dose intravenous methylprednisolone - 1 gram per day for three consecutive days. Just one week later, he began to show signs of recovery. Follow-up appointments revealed that his eye movement gradually improved, and within three months, he fully regained normal vision with no lingering symptoms.
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The case highlights how methylprednisolone - already used in treating inflammatory conditions like multiple sclerosis and severe COVID-19 cases - may also be effective in addressing rare but serious neurological complications triggered by the virus.
Researchers noted that the steroid likely helped suppress the exaggerated immune response caused by the virus, reducing inflammation and allowing the nerve to heal. This approach may offer a lifeline for other patients suffering from similar post-COVID complications.
Growing Evidence of Neurological Impact
Although rare, COVID-19 has increasingly been linked to a variety of neurological issues, including nerve palsies, seizures, encephalitis, and strokes. Experts believe that the virus may enter the nervous system through ACE2 receptors, which are also found on brain and nerve cells. Additionally, the virus can trigger widespread inflammation and damage blood vessels, leading to nerve dysfunction.
This case adds to the growing body of evidence that COVID-19’s impact on the nervous system is real, diverse, and not always temporary. Previous reports have documented spontaneous recovery in some patients with similar nerve issues, but the rapid improvement seen in this case supports the value of prompt steroid therapy.
Cautious Optimism and Need for More Research
The outcome of this case offers hope. However, doctors caution that steroid use must be carefully managed due to potential side effects like high blood sugar, immune suppression, and blood pressure spikes. Treatment plans should be tailored to each patient, with close monitoring to avoid complications.
The authors emphasize that more research, including clinical trials, is urgently needed to establish clear guidelines for treating post-COVID neurological problems, especially with medications like methylprednisolone. They also note the importance of early diagnosis and treatment to ensure better outcomes.
In conclusion, while COVID-19 is widely known for its respiratory symptoms, this case highlights its alarming potential to cause nerve damage and vision problems even in healthy individuals. The positive response to timely steroid therapy is encouraging, but it also underscores the need for vigilance in recognizing the lesser-known consequences of this virus.
The study findings were published in the peer reviewed journal: IDCases.
https://www.sciencedirect.com/science/article/pii/S2214250925000563
For the latest COVID-19 News, keep on logging to Thailand Medical News.
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