'Radial Nerve Motor Palsy After COVID Vaccination': 'Journal of Family Medicine and Primary Care' Case Report

Symptoms occurred three days after receiving a second mRNA booster vaccination.

A November publication in the Journal of Family Medicine and Primary Care reported a case of a patient acquiring radial nerve motor palsy after receiving a Pfizer Inc. COVID-19 mRNA vaccine.

Radial nerve palsy impacts the radial nerve, governing arm and hand movement and sensation, including elbow, wrist, and finger extension.

Symptoms may include numbness, weakness, and loss of muscle control served by the affected nerve.

In their article, titled “Radial nerve motor palsy after COVID vaccination: A case report,” the authors describe a 91-year-old woman who came to their outpatient clinic due to a “weakness in her left arm since the day before.”

After receiving a second booster vaccination three days prior, the woman “developed pain at the site of the injection, which spread out over the whole arm.”

“The pain slowly faded away followed by a weakness in the arm that reached its maximum that morning,” the authors detail. “Since then she was not able to lift up her fingers, wrist or forearm.”

The Austrian authors noted the woman had not taken any sleeping pills or benzodiazepines, nor had she consumed any alcohol and had no trauma.

The physical exam showed a noticeable bulge over the left shoulder joint with no signs of bruising or tenderness during joint movement.

Moreover, a neurological examination revealed weakness in extending the wrist and fingers, along with a reduced reflex response in the brachioradialis muscle of the left arm.

Clinically, it suggested a radial nerve issue.

The researchers also detected a hematoma—a collection of blood outside of blood vessels—underneath her deltoid muscle “that was displacing the muscles around the shoulder upwards and forward resulting in the bulge visible in the inspection.”

The hematoma applied pressure on the radial nerve, requiring surgeons to perform a puncture.

Case report author affiliations:

• Department of Neurology, Christian-Doppler University Hospital, Paracelsus Medical University, Centre for Cognitive Neuroscience, Member of EpiCARE, Salzburg, Austria

• Neuroscience Institute, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria

• Department of Public Health, Health Services Research and Health Technology Assessment, UMIT –University for Health Sciences, Medical Informatics and Technology, Austria

• Karl Landsteiner Institute of Neurorehabilitation and Space Neurology, Salzburg, Austria