Department of Neurology, Kepler University Hospital, Linz, Austria.
BMC Neurol. 2022 Nov 9;22(1):416. doi: 10.1186/s12883-022-02929-2.
SARS-CoV-2 vaccination is associated with an increased risk for Bell's palsy and some other neurological disorders assumed to be of autoimmune origin. While facial nerve palsy is frequent and usually idiopathic, hypoglossal nerve palsy is rare, and a specific cause is almost always found. We firstly report two patients who developed isolated hypoglossal nerve palsy shortly after SARS-CoV-2 vaccination.
Two otherwise healthy patients, a 49-year-old man and a 39-year-old woman, developed unilateral hypoglossal nerve palsy 10 and 7 days after the second SARS-CoV-2-vaccination (AstraZeneca and BioNTech/Pfizer), respectively. In both subjects, needle electromyography showed denervation and rarefication of motor units. CT, MRI, examination of blood and CSF as well as ENT exam were unremarkable. In both subjects symptoms gradually improved.
Due to close temporal relationship, the absence of other etiologies, and spontaneous improvement we suspect the vaccination as the cause for hypoglossal nerve palsy in both patients. This is further supported by the rarity of isolated hypoglossal nerve palsies, especially in idiopathic cases. We suggest the addition of hypoglossal nerve palsy to the list of neurological injuries potentially caused by SARS-CoV-2 vaccination.
SARS-CoV-2 疫苗接种与贝尔氏麻痹和一些其他假定为自身免疫起源的神经系统疾病的风险增加有关。虽然面神经麻痹很常见且通常为特发性，但舌下神经麻痹很少见，几乎总是能找到特定的病因。我们首次报告了两例患者，他们在接种 SARS-CoV-2 疫苗后不久发生孤立性舌下神经麻痹。
两名健康状况良好的患者，一名 49 岁男性和一名 39 岁女性，分别在接种第二剂 SARS-CoV-2 疫苗（阿斯利康和辉瑞/BioNTech）后 10 天和 7 天出现单侧舌下神经麻痹。在这两个患者中，针极肌电图显示运动单位失神经和稀疏。CT、MRI、血液和 CSF 检查以及 ENT 检查均无异常。在这两个患者中，症状逐渐改善。
由于时间上的密切关系、其他病因的缺失以及自发性改善，我们怀疑疫苗是导致这两个患者舌下神经麻痹的原因。这进一步得到了孤立性舌下神经麻痹的罕见性的支持，特别是在特发性病例中。我们建议将舌下神经麻痹添加到可能由 SARS-CoV-2 疫苗接种引起的神经系统损伤列表中。
