Multiple cranial nerve palsies with small angle exotropia following COVID-19 mRNA vaccination in an adolescent: A case report

Table 1 Timeline of the case

	Time	Event	Evaluation	Management
	-18 day	COVID-19 vaccination; Second dose
ER visit, admission	0	Right facial nerve palsy	Brain MRI + CISS: Focal enhancement at Right IAC	Methylprednisolone 1 mg/kg/day
	1	Right trigeminal nerve palsy; Right glossopharyngeal nerve palsy; Small angle exotropia	Extraocular muscle examination: Small angle exotropia	Methylprednisolone 1000 mg/day for 3 days
Discharge	3			Steroid tapering
	7	Symptoms started to improve
Frist, follow-up	13
Last, follow-up	+2 mo	All symptoms had disappeared except diplopia	Extraocular muscle examination: Small angle exotropia (improved)	Prescription of prism glasses

COVID-19: Coronavirus disease 2019; ER: Emergency room; MRI: Magnetic resonance imaging; CISS: Constructive interference in the steady state; IAC: Internal acoustic canal.