Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Acta Neurol Taiwan. 2023 Sep 30;32(3):118-121.
Globally, mass COVID-19 vaccine administration has revealed various adverse effects of the vaccine, such as various neurological symptoms, which are currently identified as a result of an excessive immune response.
A 70-year-old woman presented with progressive unilateral oculomotor nerve palsy and decreased visual acuity 12 days after receiving the Moderna COVID-19 vaccine. In adults, such palsy is typically caused by microvascular disease (ischemia) or compressive tumors. Given the temporal relationship between vaccination and symptoms and the exclusion of other possible causative factors, the patient's oculomotor nerve palsy and optic nerve involvement was considered to be related to the vaccination. Cranial nerve palsy following COVID-19 vaccination was diagnosed, and after pulse steroid and plasma exchange, the patient showed steady recovery.
Our patient with cranial nerve palsy following COVID-19 vaccination responded well to plasma exchange after limited improved toward steroid. This case highlights the importance of early identification and treatment of the immunological effects of COVID-19 vaccines on cranial nerves.
在全球范围内，大规模的 COVID-19 疫苗接种暴露出疫苗的各种不良反应，如各种神经系统症状，目前这些症状被认为是过度免疫反应的结果。
一名 70 岁女性在接种 Moderna COVID-19 疫苗 12 天后出现进行性单侧动眼神经麻痹和视力下降。在成年人中，这种麻痹通常由微血管疾病（缺血）或压迫性肿瘤引起。鉴于疫苗接种和症状之间的时间关系以及排除其他可能的致病因素，患者的动眼神经麻痹和视神经受累被认为与疫苗接种有关。诊断为 COVID-19 疫苗接种后颅神经麻痹，在给予脉冲类固醇和血浆置换后，患者病情稳定恢复。
我们的 COVID-19 疫苗接种后出现颅神经麻痹的患者在类固醇治疗略有改善后，对血浆置换反应良好。本病例强调了早期识别和治疗 COVID-19 疫苗对颅神经的免疫作用的重要性。
