Cubital Tunnel Syndrome Temporally after COVID-19 Vaccination

Abstract

Coronavirus disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium. To counter it, specific vaccines have been launched in record time under emergency use authorization or conditional marketing authorization and have been subjected to additional monitoring. The European Medicines Agency recommend reporting any suspected adverse reactions during this additional monitoring phase. For the first time in the available medical literature, we report a left cubital tunnel syndrome in a 28-year-old right-handed healthy male after seven days from the first dose of Spikevax® (formerly Moderna COVID-19 Vaccine). Histochemistry for Alcian Blue performed on the tissue harvested from the cubital site reveals myxoid degeneration of the small nerve collaterals, a clear sign of nerve injury. It still remains unclear why the syndrome occurs in a localized and not generalized form to all osteofibrous tunnels. Today, modified messenger ribonucleic acid vaccines as Spikevax® represent an avantgarde technological platform with a lot of potential, but one which needs careful monitoring in order to identify in advance those patients who may experience adverse events after their administration.

Hand conditions as sequelae of infection with COVID-19: a literature review

“…This review had found one case of cubital tunnel syndrome occurring 1 week following vaccination that was treated with a decompression (Roncati et al., 2022). Histological samples from the decompression had shown a myxoid degeneration of nerve branches, suggestive of an intrinsic nerve injury.…”

Ultramicronized Palmitoylethanolamide and Luteolin: Drug Candidates in Post-COVID-19 Critical Illness Neuropathy and Positioning-Related Peripheral Nerve Injury of the Upper Extremity

“…He suffered from post-COVID-19 CIP burdened with left-sided CTS-like positioning-related PNI, the most disabling sign of the disease; the absence of mechanical compression on the medial nerve made pharmacological therapy particularly indicated, as well as the absence of demyelination typical of Guillain-Barré syndrome but not of CIP. 5 Previously, our research group had described two cases of concomitant CTS and cubital tunnel syndrome in the nondominant limbs of middle-aged men affected by serious COVID-19, 45 and one case of cubital tunnel syndrome in the nondominant arm after 7 days from the first homolateral dose of COVID-19 vaccine (Spikevax) in a 28-year-old healthy male 46 ; therefore, the association post-COVID-19 CTS and CIP is not surprising, given the postinfectious neuroinflammatory state and the long-term prone/supine mechanical pressure. Our patient was treated with ultramicronized PEA 400 mg plus ultramicronized luteolin 40 mg (Glìalia), two tablets a day 12 hours apart for 6 months.…”

J Clin Exp Dent

“…In the analyzed literature, cases of complications have been found in the peripheral nervous system, especially Guillen Barre Syndrome, subacute axonal sensorimotor polyneuropathy, brachial plexopathy, chronic inflammatory demyelinating polyneuropathy (CIDP) ( 18 , 21 ).…”