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

Abstract 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 COVID1...

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Main Authors: Fatma Shalabi, Alexander Lossos, Dimitrios Karussis
Format: Article
Language:English
Published: BMC 2022-09-01
Series:BMC Neurology
Subjects:
Online Access:https://doi.org/10.1186/s12883-022-02900-1
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author Fatma Shalabi
Alexander Lossos
Dimitrios Karussis
author_facet Fatma Shalabi
Alexander Lossos
Dimitrios Karussis
author_sort Fatma Shalabi
collection DOAJ
description Abstract 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.
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spelling doaj.art-89f7d54da5bc4b288bb8afa9f114f21e2022-12-22T04:29:00ZengBMCBMC Neurology1471-23772022-09-012211410.1186/s12883-022-02900-1A case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mRNA-COVID-19 vaccinationFatma Shalabi0Alexander Lossos1Dimitrios Karussis2Department of Neurology, Hadassah Medical Organization and Faculty of Medicine, Hebrew UniversityDepartment of Neurology, Hadassah Medical Organization and Faculty of Medicine, Hebrew UniversityDepartment of Neurology, Hadassah Medical Organization and Faculty of Medicine, Hebrew UniversityAbstract 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.https://doi.org/10.1186/s12883-022-02900-1Case reportMessenger RNA vaccineCOVID-19Cranial NeuropathyLymphadenopathy
spellingShingle Fatma Shalabi
Alexander Lossos
Dimitrios Karussis
A case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mRNA-COVID-19 vaccination
BMC Neurology
Case report
Messenger RNA vaccine
COVID-19
Cranial Neuropathy
Lymphadenopathy
title A case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mRNA-COVID-19 vaccination
title_full A case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mRNA-COVID-19 vaccination
title_fullStr A case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mRNA-COVID-19 vaccination
title_full_unstemmed A case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mRNA-COVID-19 vaccination
title_short A case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mRNA-COVID-19 vaccination
title_sort case report of unilateral cervical lymphadenopathy and multiple cranial neuropathies following mrna covid 19 vaccination
topic Case report
Messenger RNA vaccine
COVID-19
Cranial Neuropathy
Lymphadenopathy
url https://doi.org/10.1186/s12883-022-02900-1
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