CNS Demyelination Syndromes Following COVID-19 Vaccination: A Case Series

"Materials and Methods: This prospective observational study was conducted at Al-Azhar University Tertiary Hospital, Al-Azhar University-Assiut branch, Egypt, from the first of June 2021 to the end of February 2022. We included all patients with no history of COVID-19 infection who presented with different neurological manifestations within two weeks after receiving the first or second dose of the COVID-19 vaccine... 

Results: The study was carried out on 18 patients who presented with different neurological disorders after the first or second dose of the COVID-19 vaccine. There were eight men (44.44%) and ten women (55.56%) with a mean age of 34.78 ± 7.13 years, ranging from 23 to 44 years. The mean duration between the onset of symptoms and the date of the last dose of the COVID-19 vaccine was 7.67 ± 3.83 days, ranging from 2–14 days. Regarding the type of vaccine, 12 patients (66.67%) received the Pfizer vaccine, and the remaining six (33.33%) received the AstraZeneca vaccine. Eight patients (44.44%) developed neurological manifestations after the first dose of the vaccine, and the remaining ten (55.56%) developed them after the second dose.

Four patients (22.22%) presented with optic neuritis, three (16.67%) with hemiparesis, three (16.67%) with paraparesis, three (16.67%) with seizures (GTC and myoclonic), two (11.11%) with ataxia, one (5.56%) with hemihypesthesia, one (5.56%) with headache, and one (5.56%) with tinnitus [Table 2]. Sixteen patients (88.89%) had brain MRI findings suggestive of a demyelinating disorder [Figures 1 and 2], and two (11.11%) had a normal brain MRI but with the spine MRI showing a picture of transverse myelitis."