Bilateral facial weakness with paraesthesia variant of Guillain-Barre syndrome following Vaxzevria COVID-19 vaccine

Guillain-Barré syndrome (GBS) is a heterogeneous disorder causing muscle weakness, sensory change, dysautonomia and often involving cranial neuropathies. An immune response to recent infection or to triggers such as vaccines, is thought to be responsible. Immunological cross-reaction with the peripheral nerve causes subsequent demyelinating or axonal damage.

GBS is a continuous spectrum of disease rather than discrete phenotypes. Recognised GBS variants in order of frequency are: (1) classical; (2) Miller Fisher syndrome; (3) pharyngeal-cervical-brachial; (4) bifacial weakness with paraesthesia of limbs (BFP); and (5) paraparetic.1

At the time of publication, no reports of BFP variant GBS post COVID-19 vaccination have been described.

We report five remarkably similar cases of BFP post-Vaxzevria. All of them presented to Wessex hospitals: Queen Alexandra Hospital, Portsmouth; Southampton General Hospital; Poole Hospital; and St Mary’s Hospital, Isle of Wight, within a 3-month period.

Case 1

A 66-year-old man developed interscapular back and leg pain, particularly severe at…

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