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Inicio Enfermedades Infecciosas y Microbiología Clínica (English Edition) Ramsay Hunt syndrome and mRNA SARS-COV-2 vaccination
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Vol. 40. Issue 1.
Pages 48 (January 2022)
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Vol. 40. Issue 1.
Pages 48 (January 2022)
Letter to the Editor
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Ramsay Hunt syndrome and mRNA SARS-COV-2 vaccination
Síndrome de Ramsay Hunt y vacunación de ARNm contra el SARS-COV-2
Rujittika Mungmunpuntipantipa,
Corresponding author

Corresponding author.
, Viroj Wiwanitkitb
a Private Academic Consultant, Bangkok, Thailand
b Dr DY Patil University, Pune, India
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Dear Editor:

We would like to share ideas on “Ramsay Hunt syndrome following mRNA SARS-COV-2 vaccine.1” Rodríguez-Martín et al. noted that “The onset of ocular symptoms starting within one week following vaccination suggests an inflammatory or autoimmune … Ophthalmologists should consider the option of autoimmune … as uveitis, following COVID-19 vaccination.1” In general, adverse reaction to new COVID-19 is sporadically reported. The facial palsy is also possible. For Ramsay Hunt syndrome, there are many possible causes. In the present case, BNT162b2 vaccine is used. For mRNA COVID-19 vaccine, the important consideration is on induction of autoimmunity. Association between autoimmunity and Ramsay Hunt syndrome is reported.2 Nevertheless, if the autoimmunity is the cause of post COVID-19 vaccination Ramsay Hunt syndrome, an abnormal autoimmunity should be detected. The other possible cause of facial palsy after COVID-19 vaccination is the vaccine induced hyperviscosity. After receiving COVID-19 vaccine, a recipient might develop excessive immune response and result in excessive blood viscosity.3 Hyperviscosity is reported as cause of facial palsy in the literature and might be another cause of reported syndrome in the case report.4

M. Rodríguez-Martín, P. Corriols-Noval, E. López-Simón, C. Morales-Angulo.
Ramsay Hunt syndrome following mRNA SARS-COV-2 vaccine.
Enferm Infecc Microbiol Clin, (2021),
J. Zimmermann, S. Jesse, J. Kassubek, E. Pinkhardt, A.C. Ludolph.
Differential diagnosis of peripheral facial nerve palsy: a retrospective clinical. MRI and CSF-based study.
J Neurol, 266 (2019), pp. 2488-2494
B. Joob, V. Wiwanitkit.
Expected viscosity after COVID-19 vaccination hyperviscosity and previous COVID-19.
Clin Appl Thromb Hemost, 27 (2021),
S. Kumar, S. Das, J.L. Goyal, D. Chauhan, V. Sangit.
Bilateral orbital tumor formation and isolated facial palsy in Waldenstrom's macroglobulinemia.
Int Ophthalmol, 26 (2005), pp. 235-237
Copyright © 2021. Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica
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