Bell's palsy following the second dose BNT162b2 (Pfizer-BioNTech) SARS-CoV2 vaccine: A case report

Abstract

Introduction: Bell's palsy occurs when inflammation at the facial nerve impairs peripheral function. Even though no definitive link has been established, Bell’s palsy has been described as a potential side effect of SARS-CoV2mRNA vaccines. We present the case of a 74-year-old female patient with no relevant medical history, who developed Bell's palsy 10 days after receiving the second dose of the BNT162b2vaccine. Case report: A 74-year-old woman presented to her local hospital with symptoms such as sore throat, left maxilla and neck pain and fever that lasted a week. The patient received the second dose of Pfizer vaccine 10 days ago. According to the patient, a few days after the vaccine she noticed a painful lymph node in the armpit, swollen left side of the face, pain on the left side of the neck, which prevented from drinking fluids. Objective assessment: the mucous membrane of the mouth was reddened, swollen, with white plaques. Symptoms were similar to stomatitis. Patient was treated with Amoxicillin2 g/d. After a few days the woman's condition worsened: left side facial droop, absence of forehead wrinkles, lip-buccal sulcus and nasolabial fold, head dizziness, hearing loss on the left side, asymmetrical facial muscles. Complete blood count, basic metabolic panels and a computed tomography were without pathological changes. The neurology, ENT departments confirmed the diagnosis of acute unilateral Bell’s palsy, the facial and the trigeminal nerves damage, vestibular syndrome. The patient was treated with prednisone at 60mg/day for 7 days, which was subsequently tapered according to the scheme. Conclusions: Our patient’s general condition improved though incoordination and deafness in the left ear maintained. While we are unable to prove that Bell’s palsy was an adverse reaction to the Pfizer BNT162b2 mRNA vaccine in our patient, an increasing body of evidence obligesus to reflect on the close relationship between both events.