Paediatric Ophthalmology and Strabismus Services, Sitapur Eye Hospital, Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India.
Vitreo-Retina and Uvea Services, Sitapur Eye Hospital, Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India.
Indian J Ophthalmol. 2023 May;71(5):2279-2281. doi: 10.4103/ijo.IJO_1778_22.
We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated systemic symptoms. Post-vaccination demyelination typically known as acute disseminated encephalomyelitis (ADEM) associated with several vaccines is more common in children. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to the post-vaccine neuroinflammatory syndrome. Cranial nerve palsies and ADEM-like presentations may represent part of the neurologic spectrum following COVID-vaccination in adults, and ophthalmologists should be aware of these sequelae. Although cases of sixth nerve palsy following COVID vaccination are already reported, associated MRI changes have not been reported from India.
我们报告了两例成年患者，他们在接种 Covishield 疫苗第一针后立即（数周内）出现展神经麻痹。复视发作后进行的脑部磁共振成像（MRI）显示脱髓鞘改变。患者伴有全身症状。接种疫苗后发生的脱髓鞘改变，通常称为急性播散性脑脊髓炎（ADEM），与多种疫苗相关，在儿童中更为常见。尽管神经麻痹的机制尚不清楚，但怀疑与疫苗接种后神经炎症综合征有关。颅神经麻痹和 ADEM 样表现可能是 COVID 疫苗接种后成人神经系统表现的一部分，眼科医生应了解这些后遗症。虽然已经有报道称 COVID 疫苗接种后出现第六对脑神经麻痹，但印度尚未报道相关 MRI 改变。
