Multiple Cranial Neuropathies After COVID-19 Vaccination
Neurology
; 98(18 SUPPL), 2022.
Article
in English
| EMBASE | ID: covidwho-1925433
ABSTRACT
Objective:
To present a patient with acute-onset of multiple cranial neuropathies associated with recent COVID-19 vaccination.Background:
Vaccine-associated neurologic adverse effects have been well-described over the decades;the influenza vaccine as well as others have been thought to precede Guillain-BarréSyndrome (GBS), Miller-Fisher Syndrome (MFS), and similar processes. Hyper-inflammatory responses have been frequently reported with SARS-CoV-2 infection and immunization, along with various neurologic pathologies. In this case report we describe a cranial polyneuropathy (3, 6, 7 and 12) associated with the COVID-19 vaccine. Design/Methods:
Case Report with Video/PhotosResults:
A 52-year-old R-handed female presented with acute-onset, rapidly progressive deficits including left upper lid ptosis, left eye ophthalmoplegia, leftward tongue deviation, left facial paresis and dysarthria. History includes congenital left eye cataract s/p lens exchange, remote strabismus surgery and slight ptosis at baseline. She denied recent illness or injuries, though had completed single-dose vaccination for SARSCoV-2 11 days prior to symptom onset. Exam revealed new L eye esotropia with restriction in abduction and supraduction. Also noted was worsening of baseline ptosis, weak tongue protrusion with right-sided fasciculations and leftward deviation. Patient endorsed dysphagia and dysarthria. Workup consisted of three unexplanatory MRIs during week of symptom onset, lumbar puncture, evaluation by ENT and neuro-ophthalmology as well as other serum and CSF studies to investigate other autoimmune causes. Consent-obtained videos and photographs were taken for documentation/educational purposes. Follow-up visits revealed slow improvement starting three months after symptom onset.Conclusions:
We outline a case of a female patient who presented with progressive, multiple cranial neuropathies with onset 11 days after single-dose SARS-CoV-2 vaccination. This constellation of symptoms in the setting of COVID-19 vaccination suggests propensity towards autoimmune neurologic processes. Further investigation is needed to determine the true incidence of similar polyneuropathies with the COVID-19 vaccine and to guide providers and patients to make informed decisions.
influenza vaccine; SARS-CoV-2 vaccine; abduction; adult; case report; cataract; cerebrospinal fluid; clinical article; conference abstract; congenital disorder; convergent strabismus; coronavirus disease 2019; cranial neuropathy; documentation; dysarthria; dysphagia; facial nerve paralysis; fasciculation; female; follow up; Guillain Barre syndrome; human; human tissue; hyperinflammation; immunization; incidence; injury; lumbar puncture; middle aged; neuroophthalmology; nonhuman; ophthalmoplegia; photography; polyneuropathy; ptosis (eyelid); Severe acute respiratory syndrome coronavirus 2; side effect; strabismus surgery; surgery; tongue; vaccination; videorecording
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Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Vaccines
Language:
English
Journal:
Neurology
Year:
2022
Document Type:
Article
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