Journal Article

A case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mRNA-COVID-19 vaccination

Shalabi, Fatma, Karussis, Dimitrios, Lossos, Alexander

2022

Overview

Background We report a rare case of ipsilateral multiple cranial neuropathy and ipsilateral lymphadenopathy following mRNA-COVID-19 vaccination. Case Presentation A 41-year-old male visited our emergency room complaining of dysphagia and hoarseness that started a week after receiving COVID19 mRNA vaccination (in his right arm). During his hospitalization, he also complained of right side hearing loss and diplopia. Neurological examination depicted a right IV nerve palsy, ipsilateral facial paresthesia and peripheral facial paresis. Otorinolaryngological examination revealed right vocal cord paralysis. A brain magnetic resonance imaging showed enhancement of the right VII and VIII cranial nerves in the auditory canal. The lumbar puncture revealed increased protein concentration and lymphocytic pleocytosis in the cerebrospinal fluid (CSF). Additionally, a neck computed tomography (CT) scan showed a swollen right supraclavicular lymph node. We hypothesize that the ipsilateral cranial neuropathies of IV, VI, VII, VIII and X, associated with cervical lymphadenopathy, was possible caused by a post-vaccination immune-mediated reaction. The patient was treated with a 5-day course of intravenous methylprednisolone (1000 mg/day), and a gradual improvement was observed. Conclusions Similarly, to other vaccines, it is possibly that also mRNA vaccines may act as triggers of non-specific autoimmune neurological syndromes.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Analysis / Antibodies / Antigens / Care and treatment / Case Report / Cerebrospinal fluid / Clavicle / Computed tomography / Coronaviruses / COVID-19 / COVID-19 vaccines / Cranial nerve diseases / Cranial nerves / Cranial Neuropathy / Diagnosis / Dosage and administration / Dysphagia / Ear canal / Emergency medical care / Emergency medical services / Guillain-Barre syndrome / Hearing loss / Immune system / Intravenous administration / Lymph nodes / Lymphadenopathy / Lymphatic system / Lymphocytes / Magnetic resonance imaging / Medicine / Medicine & Public Health / Messenger RNA / Messenger RNA vaccine / Methylprednisolone / mRNA / mRNA vaccines / Neurochemistry / Neuroimaging / Neurology / Neurosurgery / Paralysis / Paresis / Paresthesia / Peripheral neuropathy / Pleocytosis / Prevention / Proteins / Risk factors / Severe acute respiratory syndrome coronavirus 2 / Skull / Vaccines