Combined Central and Peripheral Demyelination with Anti-Neurofascin155 IgG Following COVID-19 Vaccination

Neuropsychiatric aspects of long COVID: A comprehensive review

“…87,88 Although this demyelination hypothesis has still not been proved with strong evidence, these changes have been reported in some cases such as acute disseminated encephalomyelitis following COVID-19 infection 89 or combined central and peripheral demyelination following the COVID-19 vaccination. 90 Prolonged immune response due to COVID-19 and the effects of cytokine storms are also possible mechanisms responsible for the neuropsychiatric symptoms of long COVID. 88,91 Inflammation of the cerebral blood vessels results in blood-brain barrier destruction and immune cell infiltration of the brain cells.…”

“…Some researchers have suggested that SARS‐CoV‐2 lies latent in the neurons, resulting in demyelination and neurodegeneration and inducing a greater risk of long‐term effects in some patients recovering from COVID‐19 87,88 . Although this demyelination hypothesis has still not been proved with strong evidence, these changes have been reported in some cases such as acute disseminated encephalomyelitis following COVID‐19 infection 89 or combined central and peripheral demyelination following the COVID‐19 vaccination 90 …”

Combined central and peripheral demyelination after COVID-19 vaccination

“…Cases of CCPD following SARS-CoV-2 vaccination are very rare, based on the scarce number of reports in the subject [ 4 , 5 ]. The association is supported by literature findings of CCPD development after infections or vaccines [ 1 ], strengthened in our case by the temporal relation between the first jab and first neurological complaints (3 weeks’ timeframe), and the striking neurological aggravation starting within days of the second jab.…”

“…There has been two case reports of CCPD following ChAdOx1 vaccination [ 4 , 5 ]. One of the reports, like in our case, described a patient presenting 10 days after the first inoculation as a GBS, and whose brain and spinal MRI showed a short cervical spinal cord demyelinating lesion and multiple subcortical and periventricular lesions in the brain [ 4 ].…”

“…The clinical condition also improved with corticosteroid, and on a 3-month follow-up, there was a complete neurological recovery and remission of the MRI lesions. The other report consisted of a severe neurological presentation associated with anti-neurofascin 155 IgG which improved with corticosteroids and IvIG [ 5 ].…”