Oculomotor Nerve Palsy After Influenza Vaccine in Inflammatory Bowel Disease

Influenza and pneumococcal vaccines are recommended in inflammatory bowel disease patients. Several neurologic complications have been reported after influenza vaccines, such as Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, and acute disseminated encephalomyelitis; however, rarely, oculomotor palsy will occur. We report the case of a 23-year-old male with a past medical history of ulcerative colitis on sulfasalazine who presented to the hospital with a complaint of blurry vision five days after an influenza vaccine. Most of the possible causes of oculomotor nerve palsy, such as stroke, intracranial space-occupying lesions, aneurysms, and infections, were ruled out by history, physical exam, blood work, and imaging studies, thus leading to the influenza vaccine as the most likely cause.