Sequential orbital apex syndrome following the COVID-19 vaccination: A case report

Q3 Neuroscience eNeurologicalSci Pub Date : 2023-03-01 DOI:10.1016/j.ensci.2023.100447

Seo-Young Choi , Jae-Hwan Choi , Eun Hye Oh , Kwang-Dong Choi

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引用次数: 1

Abstract

Background

Many kinds of vaccines have been developed worldwide to bring the coronavirus disease 2019 (COVID-19) to an end. We report a case of recurrent orbital apex syndrome following the first and third doses of SARS-CoV-2 vaccination.

Case presentation

A 71-year-old woman presented with acute painless diplopia and visual disturbance for two days. She had received the first dose of the COVID-19 vaccine two weeks before. She showed decreased visual acuity and ophthalmoplegia in the right eye. An orbital magnetic resonance image (MRI) revealed a hyperintense lesion with enhanced bulging in the right cavernous sinus. Following the steroid pulse therapy, she fully recovered. However, six months after the first attack, painful ophthalmoplegia with decreased visual acuity recurred in her left eye after the booster vaccination for COVID-19. MRI also showed a well-enhanced hyperintense lesion in the left orbital apex. Fortunately, her visual acuity and ocular motility returned to normal after the steroid therapy.

Conclusions

Immunologic reactions from COVID-19 vaccines may cause multiple cranial neuropathies. Diverse individual immunologic states should be considered before any kind of vaccine.

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COVID-19疫苗接种后序贯眼眶尖综合征1例报告

为了消灭2019冠状病毒病(COVID-19)，世界各地已经开发出多种疫苗。我们报告一例在第一次和第三次接种SARS-CoV-2疫苗后出现复发性眶尖综合征。病例表现:71岁女性，急性无痛性复视及视力障碍2天。她在两周前接种了第一剂COVID-19疫苗。她表现出视力下降和右眼麻痹。眼眶核磁共振成像显示右侧海绵窦高强度病变伴增强的肿胀。经过类固醇脉冲治疗，她完全康复了。然而，在第一次发作6个月后，在接种COVID-19加强疫苗后，左眼再次出现疼痛的眼麻痹和视力下降。MRI也显示在左眶尖处有明显增强的高强度病变。幸运的是，在类固醇治疗后，她的视力和眼球运动恢复正常。结论新型冠状病毒疫苗免疫反应可引起多发性颅脑神经病变。在接种任何一种疫苗之前，应考虑不同个体的免疫状态。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

eNeurologicalSci Neuroscience-Neurology

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

62 days

期刊介绍： eNeurologicalSci provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. eNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials). eNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism. The fields covered may include neuroanatomy, neurochemistry, neuroendocrinology, neuroepidemiology, neurogenetics, neuroimmunology, neuroophthalmology, neuropathology, neuropharmacology, neurophysiology, neuropsychology, neuroradiology, neurosurgery, neurooncology, neurotoxicology, restorative neurology, and tropical neurology.