Concurrent tonic pupil and trochlear nerve palsy in COVID-19

被引:0
作者
Carlos M. Ordás
Javier Villacieros-Álvarez
Ana-Isabel Pastor-Vivas
Álvaro Corrales-Benítez
机构
[1] Universidad Rey Juan Carlos,Department of Neurology, Hospital Rey Juan Carlos
[2] Hospital Rey Juan Carlos,Department of Ophthalmology
来源
Journal of NeuroVirology | 2020年 / 26卷
关键词
COVID-19; Adie’s pupil; Tonic pupil; Trochlear palsy; Postinfectious syndrome;
D O I
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中图分类号
学科分类号
摘要
Since COVID-19 was first reported, different neurological complications have been acknowledged, but their description is constantly evolving. We report a case of concurrent tonic pupil and trochlear nerve palsy in this context. A 62-year-old man reported a 5-day history of binocular vertical diplopia and blurred vision in his left eye, noticing that his left pupil was dilated. He had suffered a flu-like syndrome 2 weeks before. Clinical exam showed a right trochlear nerve palsy and a left mydriatic pupil. MRI, X chest ray, and analytical results were normal. Antibodies for SARS-CoV-2 were positive (low IgM and high IgG titers). Antiganglioside antibodies were negative. A 0.125% pilocarpine test confirmed Adie’s pupil diagnosis. The patient was treated with a tapered prednisone dose with resolution of his diplopia but no change in Adie’s pupil. This is the first case reporting Adie’s pupil as a postinfectious manifestation of COVID-19. An immune-mediated mechanism is presumed.
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页码:970 / 972
页数:2
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