Bilateral facial palsy with paresthesias, variant of Guillain-Barré syndrome following COVID-19 vaccine: A case series of 9 patients

Castiglione, Juan Ignacio; Crespo, J.M.; Lecchini, Lucila; Silveira, FO; Luis, MB; Cotti, N; Simison, CJ; Aguirre, Florencia; Piedrabuena, MA; Alonso, RN; Azcona, CL; Sosa, PS; Maldonado, E; Barroso, Fabio

doi:10.1016/j.nmd.2022.05.003

Cited by 18 publications

(14 citation statements)

References 8 publications

(8 reference statements)

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“…For example, one article reported five BFWdp cases, ref [ 7 ], but we excluded three of them because of symptoms in the limbs: right hip flexion weakness, sensory ataxia, and bilateral hip flexion weakness. Finally, 18 cases from seven articles were analyzed in this review [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. A flow diagram illustrating the full enrollment process is shown in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Two were from the UK, two were from the US, two were from Italy, and one was from Argentina. The study from Argentina analyzed the largest number of cases (nine BFWdp cases); however, it provided limited information on the clinical course, such as initial symptoms and their subsequent progression [ 6 ].…”

Section: Resultsmentioning

confidence: 99%

“…Bilateral facial weakness with distal paresthesia (BFWdp) is a rare GBS variant, has been nosologically defined by consensus, and occurs in less than 1% of GBS cases [ 4 ]. Recent studies (mostly case reports or case series) have consistently identified patients with subsequent BFWdp or similar events after COVID-19 vaccination [ 5 , 6 , 7 ]. Therefore, the incidence of localized GBS could be underestimated, and it would be a distinct finding if BFWdp cases are frequently observed after COVID-19 vaccination.…”

Section: Introductionmentioning

confidence: 99%

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Bilateral Facial Weakness with Distal Paresthesia Following COVID-19 Vaccination: A Scoping Review for an Atypical Variant of Guillain–Barré Syndrome

Kim

Yoon

et al. 2022

Brain Sciences

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Background and Purpose: Recent population-based studies from the US and UK have identified an increase in the occurrence of Guillain–Barré syndrome (GBS) following coronavirus disease 2019 (COVID-19) vaccination. However, the localized variant of GBS might be underestimated due to its rarity and atypical features. We aimed to identify and characterize bilateral facial weakness with distal paresthesia (BFWdp) as a GBS variant following COVID-19 vaccination. Materials and Methods: Relevant studies published during the COVID-19 pandemic were searched and identified in the MEDLINE, Embase, and other databases. Results: This review found that 18 BFWdp cases presented characteristics similar to previous BFWdp cases as defined in the literature: male dominance, frequent albuminocytological dissociation, and acute inflammatory demyelinating neuropathy pattern. In contrast, facial nerve enhancement on brain MRI and antiganglioside antibody positivity were often observed in BFWdp following COVID-19 vaccination. Conclusions: The mechanism of BFWdp following COVID-19 vaccination appears to be somewhat different from that of sporadic BFWdp. Neurological syndromes with rare incidence and difficulty in diagnosis should be considered adverse events of COVID-19 vaccination.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bilateral Facial Weakness with Distal Paresthesia Following COVID-19 Vaccination: A Scoping Review for an Atypical Variant of Guillain–Barré Syndrome

Kim

Yoon

et al. 2022

Brain Sciences

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“…Another report included nine GBS patients with rare subtype known as Bilateral Facial Palsy with paresthesias (BFP) with ve vaccinated with Sputnick V and four with ChAdOx1. Of these nine patients, four tested positive with ganglioside antibody panel (2: anti-GM1, antig-GD1a, and anti-sulfatide) [40].…”

Section: Guillain-barré Syndrome (Gbs)mentioning

confidence: 99%

“…GBS has been associated with in uenza [4] and COVID-19 vaccinations [5]. GBS has been reported following Moderna [6][7][8][9][10], P zer BioNTech BNT162b2 [11][12][13][14][15][16][17][18][19], Oxford AstraZeneca ChAdOx1 day [15,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34], Johnson & Johnson/Janssen Ad26.CoV2.S [10,[35][36][37][38][39], Sinopharm [33,34], and Sputnik V [34,40] COVID-19 vaccines. Many GBS patients are expected as sporadic cases and should not be considered causal [41].…”

Section: Introductionmentioning

confidence: 99%

Pain Adverse Events, Bell’s Palsy, and Guillain-Barré Syndrome Following Vaccination

Ricke¹

2022

J Mod Biol Drug Discov

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ObjectiveSome individuals (vaccinees) experience pain related adverse events following vaccinations. The majority of these pain related vaccination reactogenicity adverse events resolve within days. Rare adverse events like Bell's palsy and Guillain-Barré syndrome (GBS) have been associated with some vaccines. Herein, multiple working hypotheses are examined in the context of available characteristics of vaccinees and onset of these pain related adverse events post vaccination. MethodsThe Vaccine Adverse Event Reporting System (VAERS) database was datamined for pain associated vaccine adverse events data by vaccine, age, gender, dose, and onset post vaccination. Results for vaccines with the highest number of pain related adverse events were compared. ResultsFor the pain related adverse events examined, the highest number of adverse events are reported within 1 day, roughly half this number the second day, and roughly a quarter this number by the third day. The day of onset for these pain related adverse events approximates a power of two decay pattern for the rst three days. This same pattern is observed for all of the vaccines with the highest number of pain related adverse events. The consistency of these day of onset frequency patterns of examined adverse events following vaccinations for multiple unrelated vaccines enables the exclusion of speci c vaccine components and excipients as speci cally causative entities. ConclusionThe observed onset occurrences of examined pain associated adverse events are consistent with likely etiology relationship with innate immune responses to vaccinations for multiple vaccines including SARS-CoV-2 COVID-19, in uenza, and additional vaccines. Innate immune responses may be contributing to the initial etiology of Bell's palsy and GBS post SARS-CoV-2 mRNA and adenoviral vaccinations.

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Lyme neuroborreliosis as a cause of sudden sensorineural hearing loss and facial palsy

Nitro

Martino

Fuccillo

et al. 2022

Clinical Case Reports

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We present a case of sudden sensorineural hearing loss and rapidly progressive facial palsy in a female patient in her 40s with no, apparently, notable past medical or surgical history. Investigations revealed a positive serology for B. burgdoferi and the MRI allowed us to identify suggestive signs of Lyme meningitis with multiple cranial nerve involvement. After diagnosis, the patient was treated with intravenous ceftriaxone with a full recovery of sensorineural deafness and facial palsy. This case report highlights the importance of collecting a complete medical history in all cases of facial palsy and sudden hearing loss while presenting an infrequent clinical presentation of early disseminated Lyme disease with neuroborreliosis.

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Bilateral facial palsy with paresthesias, variant of Guillain-Barré syndrome following COVID-19 vaccine: A case series of 9 patients

Cited by 18 publications

References 8 publications

Bilateral Facial Weakness with Distal Paresthesia Following COVID-19 Vaccination: A Scoping Review for an Atypical Variant of Guillain–Barré Syndrome

Bilateral Facial Weakness with Distal Paresthesia Following COVID-19 Vaccination: A Scoping Review for an Atypical Variant of Guillain–Barré Syndrome

Pain Adverse Events, Bell’s Palsy, and Guillain-Barré Syndrome Following Vaccination

Lyme neuroborreliosis as a cause of sudden sensorineural hearing loss and facial palsy

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