Richardson-May J, Purcaru E, Campbell C, Hillier C, Parkin B
Ophthalmology, University Hospital Southampton, Southampton, United Kingdom.
Neurology, University Hospitals Dorset, Bournemouth, United Kingdom.
Neuroophthalmology. 2022 May 23;46(6):413-419. doi: 10.1080/01658107.2022.2048861. eCollection 2022.
A 71-year-old woman presented 2 weeks after vaccination with the first dose of Vaxzevria (AstraZeneca, Oxford) for COVID-19 with a left lower motor neuron facial nerve palsy, which progressed to bilateral involvement. This was accompanied by bilateral proximal leg weakness. She was diagnosed with the 'facial diplegia with paraesthesia' variant of Guillain-Barré syndrome. Seven weeks post vaccination she developed painless loss of vision in the right eye. The visual acuity in that eye was light perception only with a right relative afferent pupillary defect and right optic disc swelling. A diagnosis of optic neuritis was made and she received pulsed intravenous methylprednisolone for 3 days, followed by oral prednisolone. The optic neuritis recurred following initial cessation of steroids requiring an extended course of steroids. Despite this, she made a good visual recovery to 6/6 in the affected eye. We present this case and a review of the literature surrounding vaccination and the development of these conditions.
一名71岁女性在接种第一剂用于预防新冠病毒的阿斯利康公司的Vaxzevria疫苗2周后，出现左下面神经下运动神经元麻痹，并进展为双侧受累。同时伴有双侧近端腿部无力。她被诊断为吉兰-巴雷综合征的“伴有感觉异常的双侧面瘫”变异型。接种疫苗7周后，她右眼出现无痛性视力丧失。该眼视力仅为光感，伴有右侧相对性传入瞳孔障碍和右侧视盘肿胀。诊断为视神经炎，她接受了3天的静脉注射甲基泼尼松龙冲击治疗，随后口服泼尼松龙。在最初停用类固醇后，视神经炎复发，需要延长类固醇疗程。尽管如此，她患眼的视力仍恢复良好，达到了6/6。我们展示了该病例，并对围绕疫苗接种以及这些疾病发生发展的文献进行了综述。
