Author Information
An event is serious (based on the ICH definition) when the patient outcome is:
* death
* life-threatening
* hospitalisation
* disability
* congenital anomaly
* other medically important event
A 61-year- old man developed Bell's palsy following an administration of Covid-19-vaccine-pfizer-biontech.
The man presented with two discrete episodes of Bell's palsy shortly following an administration of first and second doses of the Covid-19-vaccine-pfizer-biontech [Pfizer-BioNTech COVID-19 vaccine; dose and route not stated]. He had a history ofhypercholesterolaemia, hypertension and insulin-dependent type 2 diabetes. His medications included ezetimibe, amlodipine, insulin-glargine [Lantus] and insulin-aspart [NovoRapid]. Five hours following the first dose of the vaccine on 18 January 2021, he developed right-sided facial weakness. The next day, he presented to an emergency department. Examination revealed a right-sided lower motor neuron facial palsy with incomplete eye closure. He was diagnosed with Bell's palsy.
The man was discharged with prednisolone taper. Consequently, the palsy was completely resolved. Six weeks following the administration of first vaccine, he received second dose of the Covid-19-vaccine-pfizer-biontech. After 2 days, he developed a severe left-sided facial nerve palsy. He received a 7 day course of prednisolone. Both the doses were administered in the left arm. Following 1 week of prednisolone treatment, he presented with dribbling and dysphagia, this episode was more severe than the last. Examination showed a severe left-sided facial nerve palsy of House Brackmann grade 4 with incomplete left eye closure and the Sunnybrook Facial Grading System was 13. He was continued on the steroid for one more week. Two weeks later, he reported that the symptoms were greatly improved and almost returned to normal.
Reference
- Burrows A, et al. Sequential contralateral facial nerve palsies following COVID-19 vaccination first and second doses. BMJ Case Reports 14: No. 7, 19 Jul 2021. Available from: URL: 10.1136/bcr-2021-243829 [DOI] [PMC free article] [PubMed]