Cranial Nerve Inflammation and Long COVID

October 15, 2021 Delainne B.

Nerves are the pathways for electrical impulses to flow and initiate body functions. Every thought, behavior, action and body function is the result of electrical signaling. The cranial nerves in the brain are essential to cell communication & cell function in the whole body.

Nerves are contained in a myelin sheath, similar to a conduit or the plastic coating on a wire. The purpose of the myelin sheath is to contain the current while the electrical impulses are on their journey, from the top of the neuron to the end, then on to the next nerve. Inflammation and hypoxia caused by COVID-19 can cause demyelination, or the breakdown of the myelin sheath.

Picture an old lamp cord with cracking plastic. The cracks in the plastic can allow the electricity in the cord to escape, just as the breakdown in the myelin can in the nerve shafts. And just as a lamp won't turn on with a broken cord, the nerves can fire without enough energy to activate them, resulting in ineffective function. Inflammation of those nerves produce a wide range of symptoms, especially when the longest nerve in the body, the vagus nerve is involved. When the nerves can't function, neither can the organs and body parts they control.

Involvement of the nervous system in COVID-19

Understanding the way COVID-19 can impact the central nervous system helps us understand the neurological conditions that disrupt multiple body systems including the brain, spinal cord, nerves, and muscles. Common symptoms include hormonal disruption, headaches, depression, anxiety, fatigue, cognitive difficulties, stroke, pain, and sleep disorders to name a few. The inflammatory responses triggered by COVID-19 indicate a severe disturbance of the brain's immune response. In particular, the essential defense cells of the brain, known as microglial cells, become hyper-activated resulting in inflammation and dysfunction of the nerves that make up the brain.

Neuro-COVID

The NIH has neuro-COVID research in progress. A new database will collect information from clinicians about COVID-19-related neurological symptoms, complications, and outcomes as well as COVID-19 effects on pre-existing neurological conditions. The COVID-19 Neuro Databank/Biobank (NeuroCOVID), which was created and will be maintained by NYU Langone Health, New York City, will be a resource of clinical information and specimens from people of all ages who have experienced neurological problems associated with SARS-CoV-2 infection. The database is supported by the National Institutes of Health's National Institute of Neurological Disorders and Stroke (NINDS). Learn more about these efforts here.

Additional research estimates at least 80% (some studies say up to 97%) of hospitalized COVID patients will develop Long COVID symptoms of a neurological nature. The CDC estimated that 30% of the general population will experience long COVID symptoms regardless of hospitalization or the severity of infection. Other researchers believe post COVID related complications are underreported and may be seen in greater than 80% of the population.

Hypoxia causes brain damage

COVID was initially considered a respiratory infection, but when you have symptoms and odd complications that last more than 4 weeks, you are moving into long COVID, a chronic condition. Long COVID can cause apnea, interruptions in your breathing pattern when your body doesn’t take a breath. putting you in a constant state of fight or flight and preventing you from healing. Oxygen is the only nutrient the neurons of the brain need. This can lead to Neuro COVID and silent hypoxia that causes irreversible hypoxic (oxygen deprivation) brain damage, just as situations that require CPR when someone stops breathing.

Get a wearable pulse oximeter to monitor your oxygen levels and heart rate. The data can be reviewed by your M.D.

Get a sleep study. When the brain senses low oxygen levels, it triggers an adrenaline burst to wake you up, also putting you in a constant state of fight or flight and preventing you from healing or achieving restorative sleep. If you snore, wake up suddenly with your heart beating fast, or have difficulty taking easy breaths, get a sleep study and if needed, a CPAP.

If you experience shortness of breath, ask your primary care physician to prescribe a short acting (rescue) inhaler and/or a long acting steroid inhaler to help your lungs take in the maximum amount of air.

How do I prevent Long COVID or permanent damage?

Prevention is the best approach!

Prevention through social distancing, handwashing, avoiding crowded spaces with poor ventilation, and vaccination when appropriate.
Nasal flushing, gargling, and swishing daily to wash out viral particles.

Early intervention is the key!

If you think you have been infected or re-infected, get tested or do a home test.
If you test positive, ask your doctor about anti-viral medication within the first 5 days of infection.

If you get sick, focus on early intervention and utilize the antihistamine, anti-inflammatory, and anticoagulant protocols as well as other resources that are available.

Keep learning and advocating!

If your doctor doesn’t have answers, keep looking.
Remember western medical doctors are trained in medication and surgery and they may not have all of the answers.
You need to take charge of your recovery through education and self-advocacy.
Consider complimentary alternatives such as Chinese medicine, acupuncture, nutrition, counselling or other types of care if you need extra help.

What are the medication protocols for long COVID prevention and treatment?

Talk to your doctor about the top 4 concerns: Histamines, Inflammation, Depression, and Blood Clotting

The antihistamine protocol: Seasonal allergy medicines like Allegra or Zyrtec (H1 blockers) and antacids like famotidine or Pepcid (H2 blockers) to counter the histamine cascade.
The anti-inflammatory protocol: Such as steroids in severe cases, or NSAIDs like ibuprofen or other prescription medications to reduce inflammation, pain, and the risk of damage to nerves and organs.
The antidepressant protocol: SSRI and SNRI medications to reduce depression, anxiety or fatigue.
The anticoagulant protocol: Aspirin, baby aspirin or prescription medications to prevent micro-clotting or deep vein thromboses (DVT) that can cause neural damage, organ damage, or stroke by blocking the flow of blood to vital organs.

Things you can do to help yourself

Minimizing physical & psychological stressors is essential in recovery from Long COVID.

Nutrition: Try to eat protein and fresh vitamin rich foods daily and avoid chemicals, preservatives, sugars, fast foods, prepared foods and high histamine foods.
Don’t skip meals. Your body needs protein, vitamin C, and vitamin D to heal from any injury or illness. A low histamine or low carbohydrate (sugar) diet is recommended by doctors treating Long COVID (PASC), and many people report a reduction in symptoms within 1-3 days of the diet change, including decreases in sneezing, itching or hives, irritable bowel syndrome, body pain, along with a reduction in swelling and inflammation.
Hydration: A minimum of eight 8 oz glasses of plain water daily is recommended.
Avoid drinks with chemical additives. You can easily make a fresh electrolyte drink yourself by adding a dash of mineral rich Epsom salt and a piece a fruit like a raspberry for flavor instead of spending money on commercial drinks like Gatorade that contain chemicals and sit in plastic bottles for long periods of time. Remember that caffeine and alcohol have dehydrating effects.
Sleep hygiene: Getting 7-9 hours of sleep so your body can repair itself. You need at least 4 hours of uninterrupted sleep to get into the restorative phase of sleep.
Avoid stimulating activities after dinner like thrilling movies or books, arguments, negative news or frustrating stimuli.
If you wake up frequently or with a startle, you may be experiencing drops in your oxygen level, which signal your brain to release adrenaline to force you to take a breath. This could be a temporary inflammation issue or more enduring sleep apnea. Ask your doctor for a sleep study to evaluate your need for a CPAP or BiPAP, a machine that pushes air into your lungs when it senses an apneic episode (periods of not breathing).
Stress management: Stress affects every component of your life.
The only thing you can control about stress is your reaction to it. Try to avoid or minimize your exposure to stressful situations: Turn off the news, make family visits that end unpleasantly short, wait for the morning to have intense discussions, let go of things that annoy you but don’t really matter in the big scheme of things, avoid intense conversations or entertainment in the evening.
Exercise within tolerance: Pace yourself and do not push your body to extremes in any way.
For some this may mean seated breathing exercises, walking to the mailbox. Rest when your body says to slow down. Gradually build on your activity endurance as your body cues you to progress. This can be hard to gauge, because when you feel good you naturally do more, but if you do too much you may experience symptom flare ups 1-3 days later as the post exertion inflammation builds. Some people describe this as post exertional malaise, others experience severe recovery set backs.
Breathwork: You can literally stop the fight or flight reaction by taking slow deep breaths.
Deep slow breathing shuts down the adrenaline flow, slows your heart rate, lowers your blood pressure and decreases stress related histamine release. When you do this, your blood reroutes back to your brain and nervous system to allow you to think clearly. It also allows your body to use its energy and oxygen to heal your inflamed nerves and organs.

Long COVID Support

Keep moving, keep breathing.

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