Table 1.
Characteristics of included studies.
| S # | Author | Study type | No of cases | Patient S# | Past History/comorbids | Age/sex | GBS Present? | Affected side of face | COVID-19 vaccine name/type | Which dose led to a symptom? | onset of facial symptom after last vaccination | Clinical features of facial palsy | Other complaints | Examination results | CSF analysis results | Investigation | Treatment | Treatment outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Colella et al. | LTE | 1 | 1 | None | 37/M | No | Left | Pfizer-BioNTech | 1 | 5 days | left facial droop, lagophthalmos and mild labial hypomobility with flattening of forehead's skin and nasolabial fold. | Malaise, fatigue, headache, left latero-cervical pain and monolateral muscular weakness | N/A | N/A | N/A | prednisone, eye drops and night time eye dressing | PR |
| 2 | Finsterer et al. | Case report | 1 | 1 | GBS | 32/M | Yes | Right | vector-based vaccine | 1 | 8 days | dysphagia | peripheral limb paraesthesia, muscle weakness and headache | Neurologic: Right peripheral facial palsy affecting orbicularis oris muscle, motor: B/L muscle weakness and DTR reduced | Protein: elevated | MRI brain and cervical spine: B/L few nonspecific T2-hyperintensities in the white matter | IVIg and plasmapheresis | PR |
| 3 | Repajic et al. | Case report | 1 | 1 | Bell's palsy and HTN | 57/F | No | Left | Pfizer-BioNTech | 2 | 1 day | left facial droop and lagophthalmos, left ear otalgia and aguesia | jaw pain | Neurologic: consistent with CN7 palsy; motor, sensory, gait and cerebellar examination normal. | N/A | N/A | prednisone and antivirals | CR |
| 4 | Nishizawa et al. | Case report | 1 | 1 | T2DM, HTN and hyperlipidemia | 62/F | No | Right | J&J/Janssen COVID-19 vaccine | N/A | 20 days | Right facial paralysis, lagophthalmos HB grade VI | None | Physical: consistent with facial palsy; motor, sensory, gait and cerebellar examination normal. | N/A | Head CT and brain MRI: unremarkable | N/A | N/A |
| 5 | Martin-Villares et al. | LTE | 1 | 1 | Bell's palsy | 34/F | No | Right | Moderna COVID-19 vaccine | 1 | 2 days | right facial pain, facial palsy HB grade III | None | N/A | N/A | MRI: unremarkable | Deflazacort, eye support, facial rehabilitation | CR |
| 6 | Maramattom et al. | Case series | 7 | 1 | None | 43/F | Yes | B/L | Oxford-Astrazeneca | 1 | after 20 days | facial diplegia | upper back pain, areflexic quadriparesis and respiratory failure | sensory: normal; motor strength: severely weakened muscle power and areflexia | Albuminocytological dissociation | N/A | IVIg and MV | CR |
| 2 | N/A | 67/F | Yes | B/L | same | 1 | 16 days | facial diplegia and dysphagia | distal paraesthesia, limb weakness and respiratory failure | CN: Right abducens palsy, facial diplegia, and bulbar palsy Sensory: abnormal; motor strength: severely weakened muscle power and areflexia |
Albuminocytological dissociation | MRI Brain: unremarkable | MV, IVIg and plasmapheresis | PR | ||||
| 3 | N/A | 53/F | Yes | Right | same | 1 | 12 days | facial and tongue numbness | B/L LL numbness, weakness, back pain and Respiratory failure | CN: Right facial and tongue numbness, facial diplegia. Sensory - B/L LL distal sensory impairment (pinprick and vibration), right trigeminal V2–V3 sensory impairment (touch, pinprick). Areflexia | Albuminocytological dissociation |
MRI Brain: unremarkable |
MV and IVIg | PR | ||||
| 4 | N/A | 68/F | Yes | B/L | same | 1 | 18 days | B/L facial numbness, LMN facial weakness and dysphagia | B/L UL and LL numbness, weakness, areflexic flaccid quadriplegia and respiratory failure | CN: facial diplegia, bulbar palsy, B/L facial numbnessSensory: B/L distal UL and LL numbness, (distal LL pinprick impairment), B/L sensory impairment to touch in all 3 divisions of the trigeminal nerve, areflexia | Albuminocytological dissociation |
MRI Brain: unremarkable |
MV and IVIg | PR | ||||
| 5 | N/A | 70/M | Yes | B/L | same | 1 | 11 days | facial diplegia, B/L facial numbness and bulbar palsy | B/L distal UL and LL numbness and respiratory failure | CN: facial diplegia, bulbar palsySensory: B/L distal UL and LL numbness, no objective sensory impairment and areflexia | N/A | N/A | MV and IVIg | PR | ||||
| 6 | N/A | 69/F | Yes | B/L | same | 1 | 12 days | facial diplegia and bulbar palsy | B/L distal UL and LL numbness, complete ophthalmoplegia leading to left Abducens nerve palsy | CN: facial diplegia, bulbar palsy, complete ophthalmoplegia, Sensory: B/L UL and LL distal numbness, no objective sensory impairment and areflexia | N/A | N/A | IVIg and Plasmapheresis | PR | ||||
| 7 | N/A | 69/F | Yes | B/L | same | 1 | 13 days | facial diplegia and bulbar palsy | B/L UL and LL numbness and respiratory failure | CN: facial diplegia, bulbar palsySensory: B/L UL and LL numbness, no objective sensory impairment and areflexia | albuminocytological dissociation | N/A | MV and IVIg | PR | ||||
| 7 | Allen et al. | Case series | 4 | 1 | None | 54/M | Yes | B/L | Oxford-Astrazeneca | 1 | 16 days | bifacial weakness | distal dysesthesia in feet and hands | DTR normal, no objective sensorimotor signs. Cerebellar, bulbar, extraocular movement and respiratory function normal. No dysautonomia General exam: unremarkable |
cell count: elevated; Protein: elevated | MRI brain: unremarkable | oral Prednisolone | PR |
| 2 | ulcerative colitis | 20/M | Yes | B/L | same | 1 | 26 days | Bifacial weakness | occipital headache, dysesthesia in distal LL | neck movement uncomfortable, remainder of the neurological examination normal. DTR normal, no objective sensorimotor signs. Cerebellar, bulbar, extraocular movement and respiratory function normal. No dysautonomia General exam: unremarkable |
cell count: elevated; Protein: elevated | MRI Brain: unremarkable | oral Prednisolone | PR | ||||
| 3 | asthma and osteoarthritis with B/L knee replacement | 57/M | Yes | B/L | same | 1 | 21 days | bifacial weakness, dysarthria | lumbar back pain that radiated to flanks, distal dysesthesia in feet, proximal leg weakness | subjective diplopia on extreme left gaze, normal extraocular eye movements. Symmetric weakness proximally in legs. DTR absent at the knees but normal elsewhere. | cell count: elevated; Protein: elevated | Noncontrast MRI brain: unremarkable | IVIg | PR | ||||
| 4 | HTN | 55/M | Yes | B/L | same | 1 | 29 days | facial diplegia | B/L thigh paresthesias, sacral and lumbar numbness | N/A | albuminocytological dissociation | MRI brain and whole spine with contrast: enhancement of the facial nerve | None | CR | ||||
| 8 | Iftikhar et al. | Case report | 1 | 1 | None | 36/M | No | Left | Moderna COVID-19 vaccine | 2 | 1 day | facial weakness | left deltoid weakness, difficulty in speaking and eating, mild numbness and tingling of left arm, left subjective UL weakness | N/A | N/A | CT and MRI brain: unremarkable | oral Prednisolone and artificial tears | PR |
| 9 | Bonifacio et al. | LTE | 5 | 1 | N/A | 66/M | Yes | B/L | Oxford-Astrazeneca | 1 | 17 days | facial weakness, tongue and mouth numbness | paraesthesia of hands and feet | marked B/L LMN facial weakness. Tone, power and reflexes normal, but absent right ankle jerk. Light touch and pinprick sensation reduced symmetrically in B/L LL, gait ataxia | albuminocytological dissociation | MRI: unremarkable except for B/L smooth contrast enhancement along whole facial nerve | IVIg | PR |
| 2 | N/A | 43/M | Yes | B/L | same | 1 | 17 days | severe facial weakness, dysphagia, dysguesia, tongue paraesthesia | myalgia, pins and needles in extremities, severe neck pain, urinary retention | severe B/L LMN facial weakness. Limb tone normal, mild weakness in right hip flexion. Reflexes were later lost. Flexor planter responses, Patchy, asymmetrical glove and stocking reduction in pinprick sensation, sensory ataxia. | cell count: elevated; Protein: elevated | MRI: unremarkable except for B/L smooth contrast enhancement along whole facial nerve | IVIg | PR | ||||
| 3 | N/A | 51/M | Yes | Right, progessed to B/L | same | N/A | 14 days | facial weakness | severe cramping leg pain, feet and hands numbness, spread to ankles | complete B/L LMN facial weakness. Tone, power and reflexes normal. Sensation impaired in all limbs, sensory ataxia. | albuminocytological dissociation | MRI: unremarkable except B/L smooth contrast enhancement along whole facial nerve | None | PR | ||||
| 4 | COVID-19 infection 5 weeks prior | 71/F | Yes | B/L | same | N/A | 15 days | facial weakness and dysguesia | lower back and abdominal pain, mild proximal leg weakness. | severe B/L LMN facial weakness, slight B/L weakness in hip flexion. Absent knee and left ankle reflexes, normal sensory | albuminocytological dissociation | MRI: unremarkable | None | PR | ||||
| 5 | N/A | 53/M | Yes | B/L | same | N/A | 14 days | facial and perioral paraesthesia progressing to severe simultaneous B/L facial weakness | lower back discomfort, radicular pain, LL parasthesia | severe LMN B/L facial weakness, normal power elsewhere. UL reflexes depressed; LL normal. Mild distal LL sensory loss to vibration and pinprick. |
Albuminocytological dissociation | CT: unremarkable | None | PR | ||||
| 10 | Nasuelli et al. | Case report | 1 | 1 | HTN and hyperuricemia | 59/M | Yes | B/L | Oxford-Astrazeneca | 1 | 10 days | facial diplegia, progressed to HB grade V | four limb distal paraesthesia, postural instability | physical exam: gait ataxia, global areflexia, distal UL and LL paraesthesia. No CN, vegetative, or sphincter involvement No spine sensory level. |
albuminocytological dissociation | Brain and cervical MRI: unremarkable | IVIg and rehabilitation | PR |
| 11 | Burrows et al. | Case report | 1 | 1 | T2DM, HTN and hyperlipidemia | 61/M | No | Right | Pfizer-BioNTech | 1 | 5 h | right facial weakness | N/A | Right LMN facial palsy, lagophthalmos, no forehead movement | N/A | N/A | Prednisolone | CR |
| Left | 2 | 2 days | Severe left facial nerve palsy, dribbling and dysphagia | N/A | severe left facial nerve palsy HB grade IV, left lagophthalmos, SB grade 13, remainder of neurological exam and gait normal |
N/A | N/A | Prednisolone | PR | |||||||||
| 12 | Obermann et al. | Case report | 1 | 1 | N/A | 21/F | No | Right | Pfizer-BioNTech | 1 | 2 days | facial muscle paralysis | minimal muscle tenderness at injection site | N/A | unremarkable | MRI: unremarkable | oral Prednisolone, face muscle training, eye Protecting ointment and overnight eye patch. | PR |
| 13 | McKean et al. | Case report | 1 | 1 | dyslipidaemia | 48/M | Yes | Left, progressed to B/L | Oxford-Astrazeneca | 1 | 10 days | LMN facial weakness, initially HB grade III, progressed to grade V | severe mid-thoracic back pain | Progressive ascending paraesthesia, B/L LL weakness with foot drop, inability to bear weight, hand weakness and LL areflexia, impaired sensation to pain | cell count: elevated; Protein: elevated | MRI and CT brain: normal | IVIg, oral Prednisolone and physiotherapy | PR |
| 14 | Rossetti et al. | Case report | 1 | 1 | anxiety, depression, drinker and drug addict | 38/M | Yes | B/L | J&J/Janssen COVID-19 vaccine | 1 | 14 days | facial weakness, tongue and lips numbness and tingling, dysarthria, difficulty drinking from a straw and controlling his lips, cheeks, and tongue while eating | B/L hand and foot paresthesias | general exam: headaches, mild gait unsteadiness, generalized fatigue, exertional dyspneadysarthria, B/L LMN facial weakness, mild lagophthalmos B/L, inability to smile or puff cheeks against resistance. DTR reduced | albuminocytological dissociation | MRI brain: focal enhancement of the B/L internal auditory canal fundi and B/L cisternal segments of the trigeminal nerves | IVIg | PR |
| 15 | Čenščák et al. | Case report | 1 | 1 | bronchial asthma | 42/M | Yes | Right | Pfizer-BioNTech | 1 | 25 days | lagopthalmos | hands and feet paraesthesia, unsteady gait, weak knees, lumbalgia | right mimic muscle weakening and lagophthalmos up to 2 mm, handgrip and right arm elevation weak reflexes C5-8 minimal,L2-S2 absent, slow movement in lower limbs, hypoesthesia 10 cm above the wrist, B/L vibration sense mildly weak takes 3–4 steps by leaning, knees buckling and ataxia |
albuminocytological dissociation | MRI LS spine with post-contrast: increased roots of cauda equina | IVIg and rehabilitation | PR |
| 16 | Prasad et al. | Case report | 1 | 1 | morbidly obese | 41/M | Yes | B/L | J&J/Janssen COVID-19 vaccine | 1 | 15 days | left facial droop, difficulty eating, right facial weakness | subjective weakness, distal paraesthesia, limb areflexia | CN: B/L LMN facial nerve palsy, more prominent on the left. B/L DTR absent at the patella and Achilles, mute plantar responses | albuminocytological dissociation | CT and MRI brain: colloid cyst MRI LS with contrast: thickening of cauda equina |
IVIg and rehabilitation | PR |
| 17 | Christensen et al. | Case report | 1 | 1 | T2DM and Diabetic foot | 73/M | Yes | B/L | Moderna COVID-19 vaccine | N/A | 7 days | tingling in tip of tongue and around mouth, progressive B/L facial paresis and dysarthria | B/L sensory disturbances in LL, tingling in fingertips and dorsum of hands, left thoracic back pain radiating to the neck and jaw, could not walk | reflexes weakened, sensory ataxia in lower extremities. | unremarkable | MRI: unremarkable | None | PR |
| 18 | Rutkove et al. | Case report | 1 | 1 | None | 58/M | Yes | B/L | J&J/Janssen COVID-19 vaccine | N/A | 14 days | facial weakness | modest appendicular weakness, small subarachnoid hemorrhages |
N/A | albuminocytological dissociation | N/A | N/A | N/A |
| 19 | Mason et al. | Case report | 1 | 1 | migraine headaches alcohol: 3 drinks per week |
35/F | Yes | Right, progessed to B/L | Moderna COVID-19 vaccine | N/A | 28 days | facial weakness and asymmetry, dysarthria, dysphagia, lagophthalmos | occipital headaches, mild right arm weakness | could not raise eyebrows, B/L lagophthalmos, unable to frown or smile. B/l N/Asolabial fold flattening, right handgrip weak CRanial nerves, touch, vibration, reflexes normal |
albuminocytological dissociation | contrast MRI Brain and CT Angiography: unremarkable | IV methylprednisolone and acyclovir | PR |
| 20 | Corrêa et al. | Case report | 1 | 1 | None | 42/M | Yes | Left | Oxford-Astrazeneca | 1 | 7 days | left otalgia, facial muscles weakness, forehead muscles paralysis, lagophthalmos and labial hypomobility | None | N/A | unremarkable | Brain MRI with gadolinium: enhanced canalicular and labyrinthine portions of the left facial nerve and left geniculate ganglion | oral Prednisone | CR |
| 21 | Oo et al. | Case series | 2 | 1 | NSTEMI and seasonal influenza | 51/M | Yes | B/L | Oxford-Astrazeneca | 1 | 14 days | diplopia, dysphagia and bifacial weakness | lower back pain, Respiratory failure, LL motor deficit, progressive ascending LL sensorimotor deficit and areflexia | diplopia, bifacial weakness, moderate neck weakness, and flaccid areflexic quadriparesis with prominent proximal LL weakness. Pinprick sensation was distally reduced on the right LL |
albuminocytologic dissociation | N/A | IVIg, MV and plasmapheresis | PR |
| 2 | Renal Cell Carcinoma Atrial Fibrillation Hypercholesterolemia |
66/M | Yes | Right | Oxford-Astrazeneca | 1 | 21 days | NA | lower back pain, progressive ascending sensorimotor involvement -proximal LL weakness |
Peoximal paraparesis, prominent right facial LMN weakness, and areflexia | Albuminocytologic dissociation | N/A | IVIg and rehabilitation | PR | ||||
| 22 | Yu et al. | Case report | 1 | 1 | left Bell's palsy | 36/F | No | Right | Sinovac | 1 | 2 days | facial weakness and droop, eye discomfort, disappeared forehead wrinkles, lagophthalmos | None | CN: HB grade Ⅲ isolated right CN 7 palsy motor, sensory, and cerebellar examinations normal. | N/A | CT Brain: unremarkable | Prednisone, artificial tears, fluorometholone eye drops and acupuncture therapy | PR |
| 23 | Caro et al. | LTE | 1 | 1 | N/A | 50/M | No | left | Pfizer-BioNTech | 1 | 9 days | facial droop and effacement of left Nasolabial fold | tenderness at injection site. | complete left facial paralysis, lagopthalmos, unable to raise eye brow or left labial fissure. | N/A | MRI: intra cranial space occupying lesions and ischemic changes | Prednisone and articial tears. | |
| 24 | Ish et al. | LTE | 1 | 1 | None | 50/M | No | Right | Covaxine | 2 | 7 days | right lagopthalmos with redness and watering | None | Lagopthalmos with lower lid ectropion temporally. Drooping of angle of mouth, loss of nasolabial fold and wrinkiling of forehead. | N/A | N/A | topical antibiotics, lubricating eye drops and oral prednisone | |
| 25 | Karimi et al. | Case series | 5 | 1 | None | 38/M | Yes | Right, progessed to B/L | Sputnik V | 2 | 14 days | B/L facial numbness and weakness | numbness and parasthesias in distal UL | B/L Facial palsy HB grade IV | cell count: elevated; Protein: elevated | MRI: unremarkable | plasmapheresis | |
| 2 | None | 38/M | Yes | B/L | Sputnik V | 1 | 6 days | B/L facial paralysis | LL weakness, decreased B/L sensation up to ankles and areflexia with flexor plantar responses. | B/L facial palsy HB grade IV and mild decreased LL light touch sensation and proprioception, distal to the ankle joints. Absent DTR | cell count: elevated; Protein: elevated | MRI brain and CS: few nonspecific B/L T2-hyperintensities viewed in the white matter | plasmapheresis | |||||
| 3 | HTN | 48/F | Yes | B/L | Sputnik V | 1 | 17 days | B/L facial paralysis | generalized weakness with bulbar symptoms, dyspnea, and autonomic disorder. | Absent DTR. | N/A | N/A | Plasmapheresis and IVIg | |||||
| 4 | HTN | 44/M | Yes | B/L | Oxford-Astrazeneca | 1 | 14 days | B/L facial numbness | LL parasthesia and weakness | flaccid tetraparesis | cell count: elevated | N/A | IVIg | |||||
| 5 | HTN/CABG | 79/M | Yes | B/L | Oxford-Astrazeneca | 1 | 7 days | B/L facial paralysis | UL and LL parasthesia and weakness | B/L Facial palsy HB grade IV with UL and LL weakness and DTR absent. | N/A | N/A | Plasmapheresis | |||||
| 26 | Kanabar et al. | Case series | 2 | 1 | MS | 61/F | Yes | B/L left > right. | Oxford-Astrazeneca | 1 | 10 days | B/L LMN facial weakness (HB grade IV on the left and grade III on the right) | LL weakness, decreased B/L sensation up to ankles | N/A | N/A | N/A | IVIg | |
| 2 | N/A | 56/M | Yes | B/L | Oxford-Astrazeneca | 1 | 7 days | B/L facial paralysis | severe back and LL radicular pain, LL numbness | B/L LMN facial weakness (HB grade IV on the left and grade III on the right) and decreased vibration sensation at the ankles. Areflexic plantar response. | N/A | N/A | IVIg | |||||
| 27 | Cellina et al. | Case report | 1 | 1 | N/A | 35/F | No | left | Moderna COVID-19 vaccine | 1 | 12 h | facial droop, dysphagia and lagophthalmos | None | slight asymmetry of the left corner of the mouth, | N/A | MRI:enhancement of left facial nerve. | oral Prednisone | |
| 28 | Walter et al. | LTE | 1 | 1 | None | 30/F | No | left | Pfizer-BioNTech | 2 | 2 months | left facial paralysis | ataxia | left facial paralysis, discreet right CN XII paralysis and massive ataxia of all extremities | Albuminocytological dissociation | MRI brain: weak flair hyperintensity of the brainstem, mesencephalon and cerebellar around the fourth ventricle without contrast. MRI of cervical and thoracic spine: unremarkable | IV cortisone with methylprednisolone | |
| 29 | Li Dang et al. | case report | 1 | 1 | N/A | 63/M | Yes | B/L | Oxford-Astrazeneca | 1 | 14 days | severe B/L facial weakness | sensory ataxia, facial diplegia involving forehead, proximal LL weakness | profound sensory ataxia, facial diplegia involving the forehead, proximal LL weakness, B/L LL areflexia and impaired distal LL proprioception, inability to walk without assistance and B/L lagophtalmos | albuminocytoloigcal dissociation | MRI contrast: B/L enhancement of CN III and CN VII, consistent with facial diplegia and partial B/L CN III palsy | IVIg | |
| 30 | Kharoubi et al. | Case report | 1 | 1 | Smoker | 42/M | No | Right | Recommbinant vaccine | 1 | 2 days | right facial assymtery | None | peripheral facial paralysis (Charles-Bell positive) HB grade III | N/A | N/A | Prednisone with eye care | |
| 31 | Badoiu et al. | LTE | 1 | 1 | N/A | 53/F | Yes | B/L | Oxford-Astrazeneca | 1 | 13 days | Asymmetric facial diplegia | tetrameric distal paraesthesia, progressive limb weakness. | mini mental motor deficit, hypopalasthesia, areflexia all 4 limbs, minimal ataxic gait. B/L latent blink reflex | albumino-cytological dissociation | MRI: unremarkable. | plasmapheresis | |
| 32 | Kulsirichawaroj et al. | Case report | 1 | 1 | None | 16/F | No | Right, progessed to B/L | Pfizer-BioNTech | 1 | 3 h | right facial numbness and drooling, right lagophthalmous, aguesia and difficulty furrowing right eyebrow | None | right facial hypoesthesia, complete right facial palsy, reduced taste in anterior 2/3rd of mouth and absent right gag reflex | N/A | MRI brain and CN: abnormal enhancement of right CN VII | IVIg | |
| 33 | Kim et al. | Case report | 1 | 1 | N/A | 48/F | No | Left | Oxford-Astrazeneca | 1 | 14 days | left facial paresis | band like pain in chest. | left facial paresis | N/A | N/A | IVIg and Prednisolone | |
| 34 | Mirmosayyeb et al. | Case series | 2 | 1 | N/A | 27/F | No | Left | Sputnik V | 1 | 5 days | left lagophthalmous, rightward deviation of left upper lip and unable to drink with straw | Pain at injection site and malaise. | facial nerve hemiparalysis | N/A | N/A | Prednisolone with valcyclovir | |
| 2 | N/A | 58/M | No | Left | Sputnik V | 1 | 10 days | sudden left facial weakness and lagophthalmos, left mouth droop, drooling, aguesia, slurring of speech, tearing, inability to chew, smile, and move the left eyebrow | hyperthermia, myalgia, and pain in the injection site. | left facial paresis and lagopthalmos | N/A | N/A | Prednisolone and valacyclovir | |||||
| 35 | Mussatto et al. | case report | 1 | 1 | HIV and CKD | 60/M | No | Left | Pfizer-BioNTech | 1 | 42hrs | left facial droop and left lagophthalmos | NA | left facial weakness with forehead involved, inability to raise left eyebrow, sensation and strength intact in B/L UL and LL, mild exposure keratopathy, 5 mm lagophthalmos | N/A | N/A | oral Prednisone and valacyclovir | |
| 36 | Andreozzi et al. | Case series | 2 | 1 | Hashimoto thyroiditis | 59/M | No | B/L | Oxford-Astrazeneca | 1 | 15 days | B/L facial numbness | acute spontaneous burning pain of lower back, LL paraesthesia | complete facial diplegia and lagophtalmos: B/L loss of frontal forehead creases, could not raise eyebrows, and could not whistle or smile, mild dysarthria. | albuminocytologic dissociation | CT: unremarkable | IVIg | |
| 2 | Atrial fibrillation | 43/M | Yes | B/L | Oxford-Astrazeneca | 1 | 7days | subacute facial pain and numbness with lagophthalmos | None | left prevalent facial diplegia; symmetrical weakness MRC grade 4+ in distal UL and LL muscles | albuminocytologic dissociation | N/A | IVIg | |||||
| 37 | Loza et al. | Case report | 1 | 1 | migraine | 60/F | Yes | B/L | J&J/Janssen COVID-19 vaccine | 1 | 18 days | B/L facial weakness and numbness | back and leg pain, headache, nausea, vomiting, and diplopia | Left eye esotropia, B/L ocular abduction deficit, areflexia and LL weakness | cell count: elevated; Protein: elevated | MRI LS:enhancement of cauda equina; Brain MRI:normal | IVIg |
Abbreviations: M, Male; F, Female; GBS, Guillian-Barre Syndrome; LTE, Letter to the Editor; CSF, Cerebrospinal fluid; N/A, Not Applicable; PR, Partial Recovery; CR, Complete Recovery; B/L, Bilateral; HTN, Hypertension, T2DM, Type 2 Insulin Independent Diabetes Mellitus; MRI, Magnetic Resonance Imaging; CT, Computed Tomography; LS, Lumbar Spine; CS, Cervical Spine; IVIg, Intravenous Immunoglobulin; IV, Intravenous; MV, Mechanical Ventilation; HB, House-Brackmann grading system; SB, Sunnybrook Facial Grading System; UL, Upper Limb; LL, Lower Limb; CN, Cranial Nerve; CN III, Occulomotor Nerve; CN VII, Facial Nerve, CN XII, Hypoglossal Nerve; LMN, Lower Motor Neuron; MS, Multiple Sclerosis; NSTEMI, Non ST Elevation Myocardial Infarction; CABG, Coronary Artery Bypass Graft; HIV, Human Immunodeficiency Virus; CKD, Chronic Kidney Disease; DTR, Deep Tendon Reflexes; J&J, Johnson & Johnson; MRC, Medical Research Council.