Concurrent facial and trigeminal nerve palsies in a child following COVID-19 vaccination with the Pfizer vaccine

Abstract

We present the case of a teenaged boy who attended our Ear, Nose and Throat Emergency clinic with a left-sided lower motor neuron (LMN) facial nerve paralysis associated with sensory loss in the distribution of the ophthalmic (V1) and maxillary (V2) divisions of the trigeminal nerve. This happened 3 days following a first dose of the Pfizer-BioNTech BNT162b2 vaccine. He had a House-Brackmann grade V facial palsy, with marked inability to close the left eye. He was treated with a 10-day course of oral steroids and referred to ophthalmology for eye care. He had an MRI scan of the head, which revealed no space occupying lesions or other abnormalities. Over the 6-week period of follow-up, the patient’s V1 and V2 sensation gradually resolved, along with improvement of his LMN facial nerve palsy to House-Brackmann grade 3. Despite the potential temporal relationship, it is not possible to establish a causal relationship between the patient’s symptoms and the Pfizer-BioNTech BNT162b2 vaccine, thus further research is required.

Association of Coronavirus Disease 2019 Vaccination with Facial-Related Neurological Disorders: A Nationwide Retrospective Cohort Study

“…Multiple cases have been documented, including a 36-yearold woman who developed trigeminal neuralgia after receiving the Pfizer BioNTech vaccine [9]. Another case involved a teenage boy who experienced facial nerve paralysis and sensory loss in the trigeminal nerve distribution following the Pfizer-BioNTech vaccination [17]. A case study also described trigeminal neuropathy in a patient who had previously undergone microvascular decompression for trigeminal neuralgia [18].…”