Neurologic adverse effects commonly associated with the treatment of tuberculosis include isoniazid-related peripheral neuropathy and ethambutol-related optic neuritis. Cerebellar ataxia as a complication of antitubercular drugs is a rare clinical scenario with very few reported cases and has a characteristic imaging of diagnostic significance.

Background Acute disseminated encephalomyelitis (ADEM) is an extremely rare complication of COVID-19 vaccination with very few reports worldwide. Concomitant peripheral nervous tissue involvement in ADEM is very uncommon. Case presentation We report the case of a 52 year aged lady who developed headache and focal neurological deficits after 10 days of COVID-19 vaccination. Her evaluation suggested ADEM with optic neuritis and mononeuritis multiplex. She responded to pulse methylprednisolone therapy. Conclusions COVID-19 vaccine may be associated with ADEM, optic neuritis and concurrent peripheral nervous system inflammation in rare instances.