Abstract
BackgroundThe coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in late 2019. One of the vaccines approved against COVID-19 is the BNT162b2 mRNA COVID-19 vaccine (Pfizer/BioNTech).Case presentationWe present the case of a 71-year-old man with no history of the SARS-CoV-2 infection or any recent viral or bacterial illnesses who presented with bilateral oculomotor palsy and limb ataxia after BNT162b2 mRNA COVID-19 vaccination. The diagnosis of Miller Fisher syndrome (MFS) was established based on physical examination, brain magnetic resonance imaging (MRI), cerebrospinal fluid analysis (CSF), and positron emission tomography (PET). There was no evidence of other predisposing infectious or autoimmune factors, and the period from COVID-19 vaccination to the appearance of neurological symptoms was similar to that of other vaccines and preceding events, such as infection.ConclusionGuillain–Barré syndrome (GBS) and its variants after COVID-19 vaccination are extremely rare. Note that more research is needed to establish an association between MFS and COVID-19 vaccines. In our opinion, the benefits of COVID-19 vaccination largely outweigh its risks.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in late 2019
We study the case of the Miller Fisher syndrome (MFS) recorded after receiving the first dose of BNT162b2 mRNA COVID-19 vaccine
COVID-19 vaccination might have been responsible for the development of MFS in the patient in this case report because of the following reasons: (1) The period from vaccination to neurological symptoms coincided with the time taken for the immune response to occur, (2) neurological symptoms worsened after the second vaccination, and (3) the immunotherapy administered was effective
Summary
We report the first case of COVID-19 vaccinationassociated MFS. We want to highlight that the risk of neurological complications or any other adverse effects associated with COVID-19. Clinical characteristics of published cases of Guillain–Barré syndrome/Miller Fisher syndrome following COVID-19 vaccination. Phagia sis, asthma, AstraZeneca osteoporosis, migraine back pain, urinary AIDP, ITP n.d. pain, headache, Johnson vomiting postural instability GBS negative HTN, hyper- IVIg. GBS Guillain-Barre syndrome, MFS Miller Fisher syndrome, COVID-19 Coronavirus disease 2019, FD Facial diplegia, OP Ophthalmoplegia, RF Respiratory failure, AGAAnti-ganglioside antibodies, GM3 Anti-GM3 antibody, AIDP Acute inflammatory demyelinating polyneuropathy, BFP Bifacial weakness with paraesthesias, ITP Immune thrombocytopenia, HTN Hypertension, DM Diabetes mellitus, RA Rheumatoid arthritis, HL Hyperlipidemia, n.d. No data, MV Mechanical ventilation, PP Plasmaphersis, PSL Prednisolone vaccination is low and the benefits of the vaccination outweigh any potential risks or side effects at both individual and social levels.
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