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Case Reports: Adverse drug reactions and complications
Concurrent facial and trigeminal nerve palsies in a child following COVID-19 vaccination with the Pfizer vaccine
  1. Carine Moezinia1,2,
  2. Eleanor B Harbinson2 and
  3. Robert M Maweni2
  1. 1Department of Medicine, Royal Free Hospital, London, UK
  2. 2Department of Otorhinolaryngology, Wexham Park Hospital, Slough, UK
  1. Correspondence to Dr Carine Moezinia; cmoezinia{at}gmail.com

Abstract

We present the case of a teenaged boy who attended our Ear, Nose and Throat Emergency clinic with a left-sided lower motor neuron (LMN) facial nerve paralysis associated with sensory loss in the distribution of the ophthalmic (V1) and maxillary (V2) divisions of the trigeminal nerve. This happened 3 days following a first dose of the Pfizer-BioNTech BNT162b2 vaccine. He had a House-Brackmann grade V facial palsy, with marked inability to close the left eye. He was treated with a 10-day course of oral steroids and referred to ophthalmology for eye care. He had an MRI scan of the head, which revealed no space occupying lesions or other abnormalities. Over the 6-week period of follow-up, the patient’s V1 and V2 sensation gradually resolved, along with improvement of his LMN facial nerve palsy to House-Brackmann grade 3. Despite the potential temporal relationship, it is not possible to establish a causal relationship between the patient’s symptoms and the Pfizer-BioNTech BNT162b2 vaccine, thus further research is required.

  • COVID-19
  • Ear, nose and throat
  • Eye
  • Cranial nerves

http://dx.doi.org/10.1136/bcr-2022-253302

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    Footnotes

    • Contributors CM and RM saw the patient in the clinic. CM wrote the original draft. EH performed data analysis and data collection. CM, EH and RM edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.