Objective: This study aimed to describe the case of a 61-year-old woman who developed Meige syndrome following a COVID infection, to review the different post-COVID movement disorders and the mechanism by which they can occur.

Background: Meige syndrome is a rare movement disorder characterized by facial hyperkinesias and craniocervical dystonias typically presenting in middle-aged women. It is usually idiopathic, but secondary forms exist following dopamine-blocker use, with structural lesions or in association with other movement disorders. The exact pathophysiology of the disease is unknown, but some environmental and genetic factors are thought to be implicated. Botulinum A injections are the mainstay of treatment, but other reported treatments have included certain medications and even deep brain stimulation.

Literature in neurological findings following coronavirus infections remains scant. The most reported movement disorder is myoclonus. To date, no cases of Meige have been reported. Although the mechanism by which COVID may cause these neurological findings is not clear, most researchers speculate an underlying immunological cause. Other groups hypothesized a diencephalic dysfunction due to transneural penetration of COVID, structural damage, and adverse drug reactions.

Method: A literature review was conducted using the terms ‘’Meige’’ ‘’blepharospasm’’ ‘’dystonia’’ ‘’oromandibular dyskinesia’’ ‘’COVID’’ ‘’SARS-COV2’’ and ‘’coronavirus’’. A total of 11 articles were retained.

Results: A 61-year-old woman with an unremarkable neurological history and no prior dopamine depleting agent exposure presented with blepharospasms 7 days following an asymptomatic COVID infection, which evolved over a period of 2-3 months into functional blindness and speech difficulties. 5 months after initial presentation, she developed mandibular and cervical dystonia. Her bloodwork and magnetic resonance were negative. She was treated with Botulinum A injections, Clonazepam and Zolpidem.

Conclusion: We believe this represents the first reported case of Meige syndrome following COVID infection. Due to the underreported nature of post-COVID movement disorders, it is plausible that the occurrence of COVID acted as an environmental trigger causing Meige syndrome in our patient through epigenetic or immune-mediated interactions.

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