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Título

Bell’s palsy after CoronaVac vaccination: a case report.

RESUMO

Case report: Patient is a 66 year old woman, diagnosed with systemic arterial hypertension and type II diabetes, with blood glucose under control. She received the first dose of the CoronaVac COVID-19 vaccine on April 1st, 2021, and the second dose on April 22nd of the same year. Four days after receiving the second dose, the patient reports waking up with left side labial deviation, along with a painful sensation in her right eye. In addition, she exhibited muscle weakness on the right side of her face, causing difficulties in chewing food and swallowing liquids, which poured out of her mouth. Furthermore, the patient states hardship in articulating words. She seeked a neurological evaluation on the same day, where peripheral facial palsy House-Brackmann V was noted. No further abnormalities were found in the evaluation, and no signs of Herpes infection were noted in her ear. A brain MRI was performed, with no acute alterations being revealed. She received a prescription of 60mg of Predinisone daily during ten days, together with physiotherapy. In a few months of treatment, the patient had a complete recovery of facial sensibility and motor function.
Discussion: Peripheral facial palsy or Bell's palsy is an acute mononeuropathy that leads to paresis or paralysis of the upper and lower face. Several etiologies for Bell's Palsy have been reported, such as thermal shock, ischemia, infection and post-vaccination immune trigger reactions. However, there are still few studies on the relationship between peripheral facial paralysis and vaccination for COVID-19, especially with the CoronaVac vaccine. A Chinese study compared the risk of developing peripheral facial palsy between two different COVID-19 vaccines: Pfizer and CoronaVac. The study found an Odds Ratio of 2.385 for CoronaVac and 1.755 for Pfizer - the latter, however, was not statistically significant (CI=0.886–3.77 and p=0.11), not having a significantly higher relative risk than the control group. Therefore, the study concluded that there is an increased risk of developing Bell's Palsy with Coronavac.
Final comments: Peripheral facial paralysis can be one of the adverse events of vaccination for COVID-19. However, the risk of developing these effects is minimal and does not outweigh the benefit of getting vaccinated.

Palavras Chave

Bell’s palsy; vaccination; COVID-19.

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