Peripheral Facial Paralysis After COVID-19 Vaccination

Abstract

Acute peripheral facial paralysis (PFP) is an acute facial weakness of various etiologies. Idiopathic Bell’s palsy is the most common cause. Viruses such as herpes zoster and human immunodeficiency virus, autoimmune diseases, Lyme disease, Kawasaki disease, Guillain-Barre and Melkersson-Rosenthal syndrome, ear trauma, temporal bone fractures, barotrauma, otitis media, cholesteatoma, sarcoidosis, are other ethiological causes. Also inactivated or live attenuated vaccines like influenza vaccine can be associated with several neurological complications, such as Guillain–Barre syndrome and chronic inflammatory demyelinating polyneuropathy and PFP. The coronavirus (COVID-19) pandemic has been a threat to millions of people all over the world and the development of effective and safe vaccines against this virus has been the first aim of researchers. Coronavac which is an inactivated COVID-19 vaccine form is used to immunize patients in some of the countries.
Case Report: A 72-year-old female with hypertension developed right-sided facial muscle weakness the days after the second injection of the Coronavac vaccine. She had no history of COVID-19 infection and PCR testing was negative. She had not mentioned cold exposure. Examinations showed right PFP House Brackman stage 5 with partial eyelid closure but no other muscle activation. Her cranial computerized tomography was normal, she was advised to use oral treatment of glucocorticoid, artificial tear drops, and get rehabilitation for paralysis. Electromyographic (EMG) findings at the end of the first month indicated partial axonal damage of the right facial nerve.
Conclusions: This case is an anecdotal incident and no cause and effect can be concluded at this time. But Coronavac may be the cause of peripheral facial palsy in our patient.

Keywords

• facial paralysis
• covid
• vaccination

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