Post COVID-19 vaccination neuromyelitis optica spectrum disorder: Case report & MRI findings

Abstract

There are rising concerns among the medical community and the public regarding the side effects of different vaccines developed throughout the world and their short and long-term effects, particularly COVID19 vaccines. Most notably, post-vaccination demyelinating diseases such as acute disseminated encephalomyelitis, transverse myelitis, and multiple sclerosis relapses have been reported. We present a case of a 32-year-old male who presented with a 2 weeks history of acute confusional state and imbalance 1 week after receiving the second dose of COVID19 vaccination. MRI findings showed typical distribution of neuromyelitis optica spectrum disorder and the patient was positive for AQP4 IgG. The pathogenesis behind developing neuromyelitis optica and vaccines is still unknown. Few case reports have been reported of post-vaccination neuromyelitis optica spectrum disorder but to our knowledge, this would be the first case published of neuromyelitis optica following exposure to COVID19 vaccine.

Keywords: Covid-19; NMOSD; Neuromyelitis optica spectrum disorder; Novel Corona Virus; SARS-CoV-2; Vaccination.

Fig. 1

MRI of the brain. Serial axial images (A-D) & sagittal (E) of the brain in FLAIR sequence showed patchy, hyperintense signal along the ependymal surface of the lateral, third and fourth ventricles, thalamus, corpus callosum and optic chiasma.