This index case report describes a patient who presented with unilateral hyperkinetic choreiform movements of the left neck, arm, and leg caused by right-sided putamen and caudate calcification as the product of an underlying developmental venous anomaly (DVA). No underlying metabolic disorder or other calcium-related disorder was present. Calcification of the putamen and caudate has been described in relation to an underlying DVA which results in localized venous hypertension and other changes, and tends to spare the anterior limb of the internal capsule. This resulting unilateral choreiform movement disorder has not been described in the literature and represents the need for greater recognition of this entity in the differential for lateralizing hyperkinetic disorders.

Objective: To identify the incidence of seizures within 48 hours of COVID-19 vaccination in PWE Methods: This is a retrospective cross-sectional observational study performed at two Northern Virginia neurology clinics. PWE that had been vaccinated against COVID-19 were surveyed to report occurrence of a seizure within 48 hours of COVID-19 vaccination and the presence of additional triggers surrounding the seizure. Results: Of the 189 patients included in the analysis, 13 (7%) reported a seizure within 48 hours of vaccination. Of the 13 participants with reported seizures, 10 identified possible triggers present at the time of their seizure. Additionally, patients with intractable epilepsy were found to have a non-statistically significant (p = 0.16) increased risk of seizure (odds ratio = 2.2) within 48 hours of vaccination. Conclusion: The results show a low incidence of seizure within 48 hours of receiving a COVID-19 vaccination in this cohort of PWE. Those that reported seizures had additional provoking factors present that may have triggered the seizure. For patients with intractable epilepsy it appears they may have some increased risk of breakthrough seizures within 48 hours of vaccination. It is recommended that clinicians counsel their epilepsy patients, especially those with an intractable diagnosis, to mitigate potential seizure triggers prior to vaccine administration. Further research is recommended to observe for long term effects if present and to control for provoking seizure factors/triggers.