Prado Mario B, Adiao Karen Joy B
Section of Adult Neurology, Department of Neurosciences, Philippine General Hospital, University of the Philippines- Manila, Manila, Philippines.
Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines- Manila, Manila, Philippines.
Neurohospitalist. 2022 Jul;12(3):508-511. doi: 10.1177/19418744221097350. Epub 2022 Apr 23.
Recently, a large study concluded that certain brands of vaccines may increase the risk of Bell's palsy and Guillain Barre Syndrome (GBS). As to whether vaccination after COVID-19 modify the risk of Bell's palsy or GBS has not yet been studied.
Here we report a 35 years old COVID-19 survivor whom in less than 2 weeks after his second dose of inactivated SARS-CoV2 vaccine, developed bilateral facial nerve paralysis. In addition, he had hyperacusis, dysgeusia and decreased lacrimation without any signs of sensory and motor deficits in the limbs. His limb nerve conduction study (NCS) was unremarkable in contrast to bilaterally abnormal facial NCS and blink reflexes. Although he had negative anti-GM1 IgG and IgM antibodies, he has marked albuminocytologic dissociation, classic of acute inflammatory demyelinating polyneuropathy.
To date, there were no similar case reports which published the occurrence of facial diplegia as sole manifestation of GBS in a post COVID-19 patient who recently completed vaccination. We believe that molecular mimicry, induced by magnified immune response from both COVID-19 and vaccination may have caused the symptom.
最近，一项大型研究得出结论，某些品牌的疫苗可能会增加贝尔氏麻痹和吉兰-巴雷综合征（GBS）的风险。至于新冠病毒感染后接种疫苗是否会改变贝尔氏麻痹或GBS的风险，尚未进行研究。
在此，我们报告一名35岁的新冠病毒感染康复者，在接种第二剂灭活严重急性呼吸综合征冠状病毒2疫苗后不到2周，出现双侧面神经麻痹。此外，他有听觉过敏、味觉障碍和泪液分泌减少，四肢无任何感觉和运动功能障碍的迹象。与双侧异常的面部神经传导研究（NCS）和瞬目反射相比，他的肢体神经传导研究结果无异常。尽管他的抗GM1 IgG和IgM抗体呈阴性，但他有明显的蛋白细胞分离现象，这是急性炎症性脱髓鞘性多发性神经病的典型表现。
迄今为止，尚无类似病例报告发表，即近期完成疫苗接种的新冠病毒感染后患者以双侧面瘫作为GBS的唯一表现。我们认为，新冠病毒感染和疫苗接种引发的放大免疫反应所诱导的分子模拟可能导致了该症状。
