Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Apr 22;14(4):e242956.
doi: 10.1136/bcr-2021-242956.

Guillain-Barre syndrome following the first dose of the chimpanzee adenovirus-vectored COVID-19 vaccine, ChAdOx1

Shreena Umit Patel  1 , Ruhaid Khurram  2 , Anjali Lakhani  3 , Bernadine Quirk  2
Affiliations
Case Reports

Guillain-Barre syndrome following the first dose of the chimpanzee adenovirus-vectored COVID-19 vaccine, ChAdOx1

Shreena Umit Patel et al. BMJ Case Rep. .

Abstract

Prevention strategies for COVID-19 transmission are at the forefront of healthcare paradigms worldwide, the main emphasis of which is vaccination. We present an interesting case of a 37-year-old man who, 3 weeks following his first dose of the chimpanzee adenovirus-vectored COVID-19 vaccine, ChAdOx1, presented to hospital with a rapidly progressive ascending muscle weakness and back pain in the absence of any other triggers. He also had a negative COVID-19 swab during admission. A diagnosis of Guillain-Barre syndrome was confirmed by correlating the clinical features with cerebrospinal fluid analysis, nerve conduction studies and MRI of the brain and whole spine. The patient received treatment with 5 days of intravenous immunoglobulin and did not require any respiratory support. He was also regularly reviewed by a multidisciplinary team consisting of neurologists, speech and language therapists, and physiotherapists and is on the course to a recovery.

Keywords: COVID-19; healthcare improvement and patient safety; neurology; radiology; vaccination/immunisation.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Chest radiograph on admission illustrating a normal cardiomediastinal outline as well as clear lungs and pleural recesses. No radiographic features of COVID-19 are demonstrated.
Figure 2
Figure 2
(A) T2-weighted and (B) postcontrast T1-weighted axial images of the brain. (A) Normal appearance of the brain parenchyma, ventricles and subarachnoid spaces on the T2-weighted image. (B) Postcontrast T1-weighted image demonstrates no abnormal parenchymal, pachymeningeal or leptomeningeal enhancement.
Figure 3
Figure 3
Axial T2-weighted image of the lumbosacral spine demonstrating bilateral, symmetrically thickened S1 nerves (green arrows).
Figure 4
Figure 4
Postcontrast sagittal T1-weighted image showing enhancement of the cauda equina nerves, most pronounced at the ventral aspect (yellow arrow). In addition, there is evidence of pial enhancement at the conus medullaris (blue arrow). These imaging features are consistent with an underlying autoimmune aetiology.
See this image and copyright information in PMC

References

    1. Li Q, Guan X, Wu P, et al. . Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020;382:1199–207. 10.1056/NEJMoa2001316 - DOI - PMC - PubMed
    1. World Health Organisation [Internet] . WHO coronavirus disease (COVID-19) Dashboard, 2020. Available: https://covid19.who.int/
    1. NHS England and NHS Improvement coronavirus [Internet] . Vaccination information from other organisations. Available: https://www.england.nhs.uk/coronavirus/covid-19-vaccination-programme/ke...
    1. GOV.UK [Internet] . Information for UK recipients on COVID-19 vaccine Moderna, 2021. Available: https://www.gov.uk/government/publications/regulatory-approval-of-covid-...
    1. Donofrio PD. Guillain-Barré syndrome. Continuum 2017;23:1295–309. 10.1212/CON.0000000000000513 - DOI - PubMed

Publication types