Case presentation
A 62-year-old Pilipino female with a past medical history of type 2 diabetes mellitus, hypertension and hyperlipidemia presented to the emergency department with a 2-day history of right facial droop 20 days following the Ad26.COV2.S vaccination. The patient denied prior history of stroke, transient ischemic attack, Bell’s palsy or other unexplained neurological symptoms. She also denied any recent viral infection or facial trauma. At the time of presentation, she denied tingling, ear pain, hearing loss, dysgeusia, drooling, vision problems or rashes. Her physical examination was notable for near-complete paralysis of the right lower face and significant paralysis of the right upper face with incomplete eye closure, consistent with a House–Brackmann score 4 Bell’s Palsy (Figure 1). Her motor, sensory, gait and cerebellar examination were otherwise normal. Head computed tomography and brain magnetic resonance imaging were unremarkable, without infarct, demyelination or peripheral nerve enhancement. She was diagnosed with Bell’s Palsy related to Coronavirus Disease 2019 (COVID-19) vaccination.
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