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2336 Central nervous system (CNS) inflammation post covid-19 vaccination: a case series
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2336 Central nervous system (CNS) inflammation post covid-19 vaccination: a case series
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2336 Central nervous system (CNS) inflammation post covid-19 vaccination: a case series
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Journal Article
2336 Central nervous system (CNS) inflammation post covid-19 vaccination: a case series
2022
Overview
ObjectivesCases of CNS demyelination temporally associated with covid-19 vaccination have been reported in the literature. We report six cases presenting to Royal Prince Alfred Hospital, a tertiary hospital in New South Wales, between May 2021 and January 2022.MethodsWe report clinical and MRI features of six individuals with evidence of an inflammatory CNS disorder temporally associated with receiving the Pfizer (n=2) or AstraZeneca (n=4) SARS-CoV-2 vaccines.ResultsAge ranged from 30 to 68 years (mean 56), four were female. The onset of neurological symptoms was within 1 to 60 days (mean 28 days) of the first (n=4) or the second (n=2) vaccine dose. Presenting symptoms included visual loss, numbness/paraesthesia, facial/limb weakness, speech disturbance, gait instability, and sphincter disturbance. Presentations were transverse myelitis (n=2), acute disseminated encephalomyelitis- (ADEM) like (n=2), and optic neuritis (n=2). No patients had any prior history of autoimmunity. MRI showed enhancing lesions consistent with active demyelination of the optic nerves, brain and/or spinal cord all but one patient. CSF oligoclonal bands were negative where tested (n=4). The final diagnoses included aquaporin-4 positive neuromyelitis optica (n=1), myelin oligodendrocyte glycoprotein antibody disease (MOGAD) (n=1), transverse myelitis (n=1), optic neuritis (n=1), and ADEM (n=2). All patients responded to high dose intravenous methylprednisolone therapy and returned to baseline (n=1) or near baseline (n=5).ConclusionA wide variety of inflammatory CNS syndromes temporally associated with the covid-19 vaccination have been described. Large post-marketing studies are required to investigate any causal relationship.
Publisher
BMJ Publishing Group Ltd,BMJ Publishing Group LTD
Subject
