key: cord-0697978-h7t81cjd
authors: Ish, Somya; Ish, Pranav
title: Isolated peripheral facial nerve palsy post COVID-19 vaccination with complete clinical recovery
date: 2022-01-03
journal: Indian J Ophthalmol
DOI: 10.4103/ijo.ijo_2425_21
sha: a4735eddf53f1114db5ebf5e1099a10c8ca6b467
doc_id: 697978
cord_uid: h7t81cjd

nan

Dear Editor, The case of a middle-aged-man presenting with facial nerve palsy post COVID-19 vaccination [1] was published to highlight the need to maintain a high index of suspicion, do detailed clinically evaluation of the patient and treat appropriately. The authors acknowledge the comments raised [2] and address the same.

A recent large systematic review has found facial nerve palsy to be the most common cranial neuropathy associated with COVID-19, particularly in patients presenting with Guillain Barre Syndrome (GBS). [3] Similar cases are increasingly being reported with COVID-19 vaccination. [4] Thus, it is imperative to rule out GBS clinically if a patient presents with facial nerve palsy. Rather, bilateral facial diplegia can be a GBS variant in itself requiring intravenous immunoglobulin (IVIG). However, isolated unilateral facial nerve palsy is often peripheral and responds well to oral steroids.

T h e r e p o r t e d c a s e [ 1 ] h a d i s o l a t e d u n i l a t e r a l lower-motor-neuron type (peripheral) facial nerve palsy with no systemic focal sensory or motor neurological deficit. There was neither extraocular muscle palsy nor any other cranial nerve involvement. In view of the absence of any other neurological deficit, magnetic resonance imaging brain was denied by the patient.

The patient was clinically followed up closely after starting oral steroids and had a favorable response within the first week, with near-complete recovery in symptoms in 10 days as shown in the clinical image. [1] No IVIG was given to the patient. Subsequent follow-up after completing 2 weeks of oral steroids revealed a complete clinical recovery. The case was reported to immunization program authorities and Adverse Events Following Immunization Committee for information and documentation, where again the same diagnosis was accepted and recorded.

Nil.

Facial nerve palsy after COVID-19 vaccination-A rare association or a coincidence

Post-SARS-CoV-2 vaccination facial palsy requires extensive work-up and appropriate treatment

COVID-19 associated cranial nerve neuropathy: A systematic review

Guillain-Barré syndrome after AstraZeneca COVID-19-vaccination: A causal or casual association?