Critical Summary: the olfactory nerves (dendrites) serve as a passageway into and out of the intracranial space. Most importantly in COVID, this is a verified pathway for the virus to enter CSF, possibly causing neurologic inflammation similar to the respiratory inflammation already observed. This same pathway can also be used to deliver nebulized medications into circulating CSF to combat inflammation.
Now, onto my usual blabbering:
Last evening as I was giving the news one final glance, I ran across this article:
The story summarizes findings in some COVID patients of varying degrees of brain inflammation, including a particularly severe form known as Acute Necrotizing Encephalopathy (ANE). Doctors and researchers, at least in the “WIRED” article, seem puzzled as to how COVID could cross the blood/brain barrier and cause an intracranial cytokine storm.
Based on research, I know the answer: viruses can enter the cranial environment through a common pathway that CSF can leak out: the olfactory nerve.
Edit to add: It’s probably not coincidental that COVID19 and other upper respiratory viral infections involve impaired sense of smell/taste.
This is just a few research papers that confirm this phenomenon:
Olfactory Nerve—A Novel Invasion Route of Neisseria meningitidis to Reach the Meninges
The olfactory nerve: a shortcut for influenza and other viral diseases into the central nervous system
Nose to brain transport pathways an overview:potential of nanostructured lipid carriers in nose to brain targeting
screenshot graphic from the last reference:
While this seems…disturbing…the same pathway also provides a method of delivering medications directly into the CSF without lumbar puncture. This involves nebulization (creating a superfine mist using a medical grade device) of medicated solutions that can be inhaled. This is common in the treatment of asthma, and while the target area for asthma is the lungs, research shows that any inhaled medication will show up in CSF within 20 minutes.
Shocker alert: in November 2019 I developed an rather severe “influenza-like illness”. I lost my sense of smell, spiked night fevers, and had a persistent dry cough that lasted for a month. The cough ended up being the most aggravating symptom…next to a very familiar feeling that my “brain was on fire”, a symptom I had struggled with years back. My insurance company did me a backhanded favor by having an actuarial hissy fit when my PCP prescribed an inhalational steroid for airway inflammation. Frustrated at the insurance companies resultant obstinance, I ditched that hassle and bought over-the-counter fluticasone nasal spray, which I then placed in a nebulizer along with glutathione (a very beneficial antioxidant). I need to be clear: this therapy needs to be performed under a physician’s supervision, especially in “IIH” patients as certain medications, especially fluticasone, can spike ICP. Don’t do this at home…oh, wait…can’t do it anywhere else right now…
It worked. My cough was gone within 2 days and the “brain-on-fire” sensation with it.
I’m still curious about my “influenza-like illness”.
At any rate, the point of all this is that the olfactory nerves are a likely pathway of COVID as well as other viruses and toxins into the brain (stick a bookmark in that). This could be the pathway that is resulting in the neurologic inflammation seen in some COVID patients. This pathway works in both directions as research has shown, thus medications to combat neurologic inflammation might be delivered not only to treat, but prevent inflammation.
Maybe not just for the immediate COVID challenge, but for IIH sufferers in general.
Prayers for Comfort and Healing,
The Shuntwhisperer and Trina
April 20, 2020