Neuralgic amyotrophy following COVID-19 mRNA vaccination

Koh, Jasmine Shimin; Goh, Yihui; Tan, Benjamin Yong‐Qiang; Hui, Andrew; Hoe, Rebecca Hui Min; Makmur, Andrew; Kei, Pin Lin; Vijayan, Joy; Ng, Kim Tien; Quek, Amy May Lin; Thirugnanm, Umapathi

doi:10.1093/qjmed/hcab216

Cited by 19 publications

(23 citation statements)

References 4 publications

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“…Very few case reports/series have been published in the literature describing PTS as a sequelae of COVID-19 infection or vaccination (Table 2 ) [ 2 , 3 , 7 , 8 , 9 , 10 , 11 , 12 , 18 , 19 , 20 ]. In 5 of these articles, patients had contracted COVID-19, after which they developed shoulder and/or arm pain followed subsequently by arm/hand paresthesia and weakness [ 2 , 7 , 9 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…In 5 of these articles, patients had contracted COVID-19, after which they developed shoulder and/or arm pain followed subsequently by arm/hand paresthesia and weakness [ 2 , 7 , 9 , 11 , 12 ]. Five case reports/series featured similar presenting symptoms after receiving the COVID-19 vaccine [ 3 , 10 , 18 , 19 , 20 ]. One case report described pure sensory PTS after COVID-19 infection [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The limitations of the present work include its retrospective nature and lack of a conclusive diagnostic test for PTS. Few studies have reported the time between vaccine administration and symptom onset [ 3 , 10 , 18 , 19 , 20 , 21 ]. In Tsairis et al [ 21 ] study of 14 post-immunization patients, the interval between the innoculation and symptoms ranged between 3 and 21 days.…”

Section: Discussionmentioning

confidence: 99%

“…In Tsairis et al [ 21 ] study of 14 post-immunization patients, the interval between the innoculation and symptoms ranged between 3 and 21 days. In the patients who developed PTS post-COVID-19 vaccine depicted in Table 2 [ 3 , 10 , 18 , 19 , 20 ], the time duration between the vaccine and onset of symptoms ranged between 13 h and 25 days. The time interval between the vaccine and symptom onset in Patient #5 of our study was 8 weeks which represents an outlier.…”

Section: Discussionmentioning

confidence: 99%

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Parsonage-Turner Syndrome Following COVID-19 Vaccination: Clinical and Electromyographic Findings in 6 Patients

Shields

Iyer²,

Burger

et al. 2022

Case Rep Neurol

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Parsonage-Turner syndrome (PTS) following COVID-19 infection or vaccination is rare. The pathophysiology may involve an immune-mediated inflammatory reaction against brachial plexus nerve fibers in a genetically predisposed individual. We describe the clinical and electromyographic features of 6 patients presenting with the clinical picture of PTS following COVID-19 vaccination. All patients were referred for electromyographic studies to evaluate the acute onset of pain in the shoulder girdle/upper limb accompanied by muscle weakness in the distribution of one or more branches of the brachial plexus. Each patient had received the COVID-19 vaccine within a few weeks prior to the onset of symptoms. Patients underwent detailed neurological examinations followed by nerve conduction and EMG studies. The patients developed symptoms after a mean duration of 17 days (5 days–8 weeks) after receiving the COVID-19 vaccine. The initial symptom was pain in the shoulder girdle/upper limb, followed within days by muscle weakness. Physical examinations and EMG studies showed upper trunk brachial plexopathy in 2 patients, lower trunk plexopathy in 1 patient, posterior cord brachial plexopathy in 1 patient, and anterior/posterior interosseous nerve involvement in 2 patients. All patients either improved or attained complete resolution of the arm pain at follow-up. Three (50%) patients did not have any improvement in the arm/hand weakness, while 3 (50%) patients had some recovery in strength. PTS may occur after the COVID-19 vaccine and should be suspected in patients with symptoms and signs suggestive of acute brachial plexopathy. Studies of a larger series may provide insight into predisposing factors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Parsonage-Turner Syndrome Following COVID-19 Vaccination: Clinical and Electromyographic Findings in 6 Patients

Shields

Iyer²,

Burger

et al. 2022

Case Rep Neurol

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“…Syndrome after COVID-19 vaccines are emerging, interestingly after both mRNA [267][268][269][270][271] and adenovirus-based vaccines. 270,[272][273][274] As expected, most patients presented with paralysis preceded by pain, although with some exceptions 271 (well known to the pre-COVID literature).…”

Section: Several Reports Of Neuralgic Amyotrophy or Parsonage-turnermentioning

confidence: 99%

COVID‐19 and the peripheral nervous system. A 2‐year review from the pandemic to the vaccine era

Taga

Lauria

2022

J Peripheral Nervous Sys

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Increasing literature has linked COVID‐19 to peripheral nervous system (PNS) diseases. In addition, as we move from the pandemic to the vaccination era, literature interest is shifting towards the potential association between COVID‐19 vaccines and PNS manifestations. We reviewed published literature on COVID‐19, COVID‐19 vaccines and PNS manifestations between 1 January 2020 and 1 December 2021. For Guillain‐Barré syndrome (GBS), isolated cranial neuropathy (ICN) and myositis associated with COVID‐19, the demographic, clinical, laboratory, electrophysiological and imaging features were included in a narrative synthesis. We identified 169 studies on COVID‐19‐associated complications, including 63 papers (92 patients) on GBS, 29 papers (37 patients) on ICN and 11 papers (18 patients) on myositis. Additional clinical phenotypes included chronic inflammatory demyelinating polyneuropathy, vasculitic neuropathies, neuralgic amyotrophy, critical care‐related complications, and myasthenia gravis. PNS complications secondary to COVID‐19 vaccines have been reported during randomized clinical trials, in real‐world case reports, and during large‐scale surveillance programs. These mainly include cases of GBS, Bell's palsy, and cases of neuralgic amyotrophy. Based on our extensive review of the literature, any conclusion about a pathophysiological correlation between COVID‐19 and PNS disorders remains premature, and solely supported by their temporal association, while epidemiological and pathological data are insufficient. The occurrence of PNS complications after COVID‐19 vaccines seems limited to a possible higher risk of facial nerve palsy and GBS, to a degree that widespread access to the ongoing vaccination campaign should not be discouraged, while awaiting for more definitive data from large‐scale surveillance studies.

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High‐resolution MR neurography follow‐up of SARS‐CoV‐2 vaccination‐associated neuralgic amyotrophy

Mooshage,

Kele,

Bendszus

et al. 2023

Ann Clin Transl Neurol

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Little is known about the value of high‐resolution follow‐up imaging in patients with neuralgic amyotrophy (NA) and the question of the best treatment algorithm remains unclear. Three patients (one female, two male) with the clinical presentation of SARS‐CoV‐2‐vaccination‐associated NA underwent initial magnetic resonance neurography (MRN) imaging and follow‐up examinations. All patients showed a marked clinical improvement, independent of treatment, including an almost full recovery of motor function over the course of 8–12 months which was accurately mirrored by imaging findings on MRN. MRN imaging is a valuable tool for monitoring the further clinical course of patients suffering from vaccination‐associated NA.

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Neuralgic amyotrophy following COVID-19 mRNA vaccination

Cited by 19 publications

References 4 publications

Parsonage-Turner Syndrome Following COVID-19 Vaccination: Clinical and Electromyographic Findings in 6 Patients

Parsonage-Turner Syndrome Following COVID-19 Vaccination: Clinical and Electromyographic Findings in 6 Patients

COVID‐19 and the peripheral nervous system. A 2‐year review from the pandemic to the vaccine era

High‐resolution MR neurography follow‐up of SARS‐CoV‐2 vaccination‐associated neuralgic amyotrophy

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