Central Nervous System Demyelination Following COVID-19 mRNA-Based Vaccination: Two Case Reports and Literature Review

Lee, Shirley; Hor, Jyh Yung; Koh, Kee Leong; Chia, Yuen Kang

doi:10.1177/11795735221102747

Cited by 9 publications

(20 citation statements)

References 18 publications

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“…Overall, we have identified 17 previous case reports of patients with ADEM following SARS-CoV-2 vaccination, including vaccines based on mRNA, viral vector and inactivated virus (Kania et al 2021 ; Vogrig et al 2021 ; Shimizu et al 2021 ; Lee et al 2022 ; Poli et al 2022 ; Ahmad et al 2022 ; Maramattom et al 2022 ; Rinaldi et al 2022 ; Permezel et al 2022 ; Mumoli et al 2022 ; Nagaratnam et al 2022 ; Al-Quliti et al 2022 ; Lazaro et al 2022 ; Garg et al 2022 ; Cao and Ren 2022 ; Ozgen Kenangil et al 2021 ; Yazdanpanah et al 2022 ); however, this case report is the first described case of ADEM following exposure to the Ad26.COV2.S vaccine.…”

Section: Discussionmentioning

confidence: 99%

“…We have been able to identify 17 case reports that have described ADEM, including one case report of ADEM-like presentation, following a COVID-19 vaccination: seven cases with mRNA vaccine (from Moderna and Pfizer), (Kania et al 2021 ; Vogrig et al 2021 ; Shimizu et al 2021 ; Lee et al 2022 ; Poli et al 2022 ; Ahmad et al 2022 ; Maramattom et al 2022 ) seven cases with a viral vector vaccine (from AstraZenica and Sputnik V) (Rinaldi et al 2022 ; Permezel et al 2022 ; Mumoli et al 2022 ; Nagaratnam et al 2022 ; Al-Quliti et al 2022 ; Lazaro et al 2022 ; Garg et al 2022 ) and three cases with vaccines based on inactivated virus (from SinoVac and Sinopharm) (Cao and Ren 2022 ; Ozgen Kenangil et al 2021 ; Yazdanpanah et al 2022 ). However, this case report is the first described case of ADEM following exposure to the Ad26.COV2.S vaccine from Johnson & Johnson.…”

Section: Introductionmentioning

confidence: 99%

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Acute disseminated encephalomyelitis following the COVID-19 vaccine Ad26.COV2.S, a case report

2023

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Background The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has been leading to dramatic health, social and economic problems around the world. It was necessary to introduce worldwide vaccination program against SARS-CoV-2 virus. Vaccination of billions of people around the world leads to many questions about risk of vaccines and possible side effects. It is well known that acute disseminated encephalomyelitis (ADEM) is a rare, but possible complication of vaccines. Previously, cases of ADEM following various COVID-19 vaccines, including the vaccines from AstraZenica, Pfizer, Sputnik V, SinoVac, Moderna, Sinopharm, have been described. In this case report, we present the first documented case of ADEM following the COVID-19 vaccine Ad26.COV2.S from Johnson & Johnson. Case presentation We present the case of a 31-year-old female with gradually progression of right-sided weakness and numbness during a three-week period. Four weeks prior to symptom onset, the patient received the single-dose SARS-CoV-2 vaccine Ad26.COV2.S. Neuroimaging revealed five large juxtacortical T2 FLAIR hyperintense lesions with incomplete contrast enhancement on post-contrast T1 images located supratentorial: one in the right cerebral hemisphere and four in left cerebral hemisphere. The patient was followed up for four months. Symptom debut, clinical picture and MRI were typical for ADEM and the patient completely recovered after high dose intravenous methylprednisolone treatment. Conclusions This is, to the best of our knowledge, the first case report of ADEM following the COVID-19 vaccine Ad26.COV2.S. This case illustrates, although ADEM is a rare complication following SARS-CoV-2 vaccines, the necessity of maintaining a vaccine safety monitoring system to identify patients at high risk from developing severe complications from the vaccines.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute disseminated encephalomyelitis following the COVID-19 vaccine Ad26.COV2.S, a case report

2023

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“…There have been many case reports in the literature which concerned TN as a complication of COVID-19 infection [8,9] and a few reports on TN developing after COVID-19 vaccination [3][4][5][6] as well. Neurological complications during the course of COVID-19 infection, apart from TN [8,9], include the neuropathies facial nerve palsy [10], sixth cranial nerve palsy [11] and Guillain-Barré syndrome [12].…”

Section: Discussion Of the Final Diagnosismentioning

confidence: 99%

“…The first-line treatment of idiopathic TN usually is restricted to pharmacotherapy [13]. In patients who developed TN after a vaccine, administration of steroids significantly reduced the pain frequency and intensity and improved patients' condition [3][4][5]. Steroids were effective when administered both intravenously [3,4] and orally [4,5].…”

Section: Discussion Of the Final Diagnosismentioning

confidence: 99%

“…Since December 2020, when COVID-19 vaccines became the primary form of pandemic control, about 13 billion doses of vaccines have been administered worldwide. Having done a literature review, we came across only a few cases of TN in total that were postulated to have developed after COVID-19 vaccination [3][4][5][6]. Herein we present a case of TN, which originated shortly after the 3 rd dose Pfizer BioNTech COVID-19 vaccine, discussion on its differential diagnosis and suggested effective treatment, based on our observations.…”

Section: Introductionmentioning

confidence: 87%

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Trigeminal neuralgia occurring after the third dose of Pfizer BioNTech COVID-19 vaccine. Complication or coincidence? An illustrative case report and literature review

Chrostowski¹,

Piasecki²,

Bielewicz³

2023

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the coronavirus disease 2019 pandemic is an ongoing concern for medical care worldwide. since its emergence, multiple CoViD-19 vaccines have been designed, allowing for more effective control of the pandemic. CoViD-19 vaccines, like any other form of medical intervention, may cause adverse and unforeseen side effects, varying in frequency and severity. Determining a correlation between the occurring symptoms and the vaccination is often a challenging task, requiring multiple data sources and reported cases. so far, there have been multiple reports of trigeminal neuralgia developing after CoViD-19 vaccination. a 36-year-old woman was admitted to the emergency ward due to chronic pain attacks in the left side of her face. the pain appeared two months ago, on the day following the vaccination using the third dose of the pfizer Biontech CoViD-19 vaccine. at the neurology Department she was diagnosed with trigeminal neuralgia. Based on the lack of any obvious causes, relation to the vaccination, and other similar reports, we assumed that the trigeminal neuralgia was a complication of the vaccination. hospital treatment consisted of oxcarbazepine, dexamethasone and pregabalin. treatment was successful, with transient episodes of exacerbation. six months after the onset of the disorder the patient remains without pain. we believe that the presented case supports the possibility of trigeminal neuralgia occurring in relation to the pfizer Biontech CoViD-19 vaccine administration. additional reports may further contribute to establishing a certain link.

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Tozinameran

2022

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Central Nervous System Demyelination Following COVID-19 mRNA-Based Vaccination: Two Case Reports and Literature Review

Cited by 9 publications

References 18 publications

Acute disseminated encephalomyelitis following the COVID-19 vaccine Ad26.COV2.S, a case report

Acute disseminated encephalomyelitis following the COVID-19 vaccine Ad26.COV2.S, a case report

Trigeminal neuralgia occurring after the third dose of Pfizer BioNTech COVID-19 vaccine. Complication or coincidence? An illustrative case report and literature review

Tozinameran

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