TY - JOUR T1 - Bilateral facial weakness with paraesthesia variant of Guillain-Barré syndrome following Vaxzevria COVID-19 vaccine JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 341 LP - 342 DO - 10.1136/jnnp-2021-327027 VL - 93 IS - 3 AU - Guendalina Beatrice Bonifacio AU - Dharmini Patel AU - Sarah Cook AU - Elena Purcaru AU - Michael Couzins AU - Janine Domjan AU - Suzanne Ryan AU - Ahmad Alareed AU - Orla Tuohy AU - Sean Slaght AU - Julian Furby AU - David Allen AU - Haider A Katifi AU - Lucy Kinton Y1 - 2022/03/01 UR - http://jnnp.bmj.com/content/93/3/341.abstract N2 - 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.A 66-year-old man developed interscapular back and leg pain, particularly severe at night, 1 week after his first dose of Vaxzevria. He had paraesthesia of both hands and feet and was unsteady. Ten days later, he developed bilateral facial weakness with numbness of the tongue and mouth.Examination revealed marked bilateral lower motor neuron (LMN) facial weakness. Tone, power and reflexes were normal in the limbs except absent right ankle jerk. Light touch and pinprick sensation was reduced symmetrically in both lower limbs to the knee and vibration to the ankles. His gait was ataxic.A 43-year-old man … ER -