Objective
To report a patient with history of recurrent Bell’s Palsy who developed Bell’s Palsy 36 hours after the administration of the second dose of the Pfizer-BioNTech COVID-19 vaccine.
Case
The patient is a 57-year-old female with past medical history of 3 episodes of Bell’s Palsy. She responded to prednisone treatment and returned to her baseline after each occurrence. Less than 36 hours following the second dose of the vaccine, the patient developed a left Bell’s Palsy. The facial droop progressed in severity over the next 72 hours.
Conclusion
Given the expedited production of the vaccine and the novelty associated with its production, there may be information pertaining to side effects and individual response that remain to be discovered. Since both the Moderna and Pfizer Vaccine trials reported Bell’s Palsy as medically attended adverse events, the association between vaccine administration and onset of symptomatic Bell’s Palsy may warrant further investigation.
Twenty-seven months into the current pandemic and 18 months after vaccinations were made available, there are still relatively limited data on the incidence of recurrent Bell's Palsy after the administration of mRNA-based vaccines. The authors continue to believe that it is through rigorous reporting that the true incidence can be tabulated eventually.
Miller Fisher Syndrome (MFS), a variant of Guillain Barre Syndrome (GBS), and amyotrophic lateral sclerosis (ALS) are two rare neuromuscular diseases that are usually unrelated. While ganglioside antibodies have a common relation with MFS and GBS, they have also been found in association, albeit less commonly, with ALS. A patient experiencing MFS and then ALS in tandem has never been documented. We discuss a case demonstrating these findings, with GQ1b elevated on both occasions. The pathophysiologic role of GQ1b is explored.
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