Acute disseminated encephalomyelitis after SARS-CoV-2 vaccination

Abstract

Several central and peripheral nervous system complications associated with the severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection have been recently described. An effective mass vaccination program is necessary to effectively reduce infection spread and, consequently, limit long-term sequelae, including those affecting the nervous system. Nevertheless, as more patients gain access to coronavirus disease 2019 (COVID-19) vaccines, it is important to report potential adverse events. Herein, we report a patient with previous history of post-infectious rhombencephalitis who developed an acute disseminated encephalomyelitis (ADEM) two weeks after being vaccinated for COVID-19.

Keywords: COVID-19; Encephalitis; Neurological adverse events; Neurological complications; Vaccine.

Fig. 1

Clinical evolution of the patient. Clinical features and their severity, treatment, and CSF cell count during the disease course. Abbreviations: CSF, cerebrospinal fluid; SARS-CoV-2, severe acute respiratory syndrome coronavirus.

Fig. 2

Brain magnetic resonance imaging (MRI) findings. FLAIR hyperintensity involving the frontal white matter, with the largest lesion on the left side (A: axial view, B: sagittal view) and the ipsilateral superior cerebellar peduncle (C: axial view, D: sagittal view). Abbreviations: FLAIR, Fluid attenuated inversion recovery.