increased exacerbated by exertion, along with cold allodynia and tinnitus. Physical examination showed hypertension, anomic aphasia, cold allodynia with left hemitremor; dysesthesias, pain and weakness in left upper limb; lower limbs hyperreflexia; and bilateral Hoffman and Marinescu. Bloodwork showed elevated ESR and CRP. SARS-CoV-2 IgM and IgG were positive. MRI showed Chiari Malformation and syringomyelia/syringobulbia. ResultsThe patient received COVID-19 treatment improving all features. Anecdotally when corticosteroids were weaned off pain returned; imposing a new corticosteroid regimen after which pain subsided returning to her daily living activities. ConclusionsThis is the first case report of an exacerbation of syringomyelia/ syringobulbia symptoms after COVID-19. We propose substance P as a key mediator for this kind of features.

Background and aimsThis quality improvement (QI) project was conducted in order to better understand how demographic factors may influence the likelihood of COVID-19 vaccination hesitation and declination in patients with neurological disorders in Hawaii. MethodsAdult patients who had visited Hawaii Pacific Neuroscience (HPN) between January 1, 2019 to January 1, 2021 were contacted through a telephone QI survey to assess COVID-19 vaccination hesitancy in relation to patient race and sex. Over 30 different sociodemographic variables and medical comorbidities were examined. Statistical analysis utilized univariate and multivariable logistic regression to determine variables associated with vaccine acceptance.