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Case Reports
. 2022 May 18:12:16.
doi: 10.5334/tohm.688. eCollection 2022.

Clinical and Radiological Follow-Up of a Pfizer-BioNTech COVID-19 Vaccine-Induced Hemichorea-Hemiballismus

Cédric Batot  1 , Maryane Chea  1 , Sinead Zeidan  1 , Marie Mongin  1 , Gabriel Pop  2 , Julie Mazoyer  1 , Bertrand Degos  1   3
Affiliations
Case Reports

Clinical and Radiological Follow-Up of a Pfizer-BioNTech COVID-19 Vaccine-Induced Hemichorea-Hemiballismus

Cédric Batot et al. Tremor Other Hyperkinet Mov (N Y). .

Abstract

Background: Hemichorea-hemiballismus is a rare hyperkinetic movement disorder.

Case report: A 90-year-old male developed left hemichorea-hemiballismus after his second dose of the Pfizer-BioNTech COVID-19 vaccine. A wide range of investigations including magnetic resonance imaging did not reveal an alternative cause. [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) showed increases in right putamen fixation compared to the left side. The patient showed significant improvement after five days of intravenous corticosteroids, with a normal FDG-PET.

Discussion: This hemichorea-hemiballismus case shows dynamic restoration of putamen metabolism mirroring clinical evolution after administration of corticosteroids, suggesting an autoimmune COVID-19 vaccine-induced reaction.

Keywords: COVID-19; FDG-TEP; Hemichorea; hemiballismus; vaccine.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

The patient’s MRI does not show any significant abnormality
Figure 1
Brain magnetic resonance imaging (MRI) of the patient. A: T1-weighted axial image, and B: fluid attenuated inversion recovery (FLAIR) axial image, showing normal findings in the basal ganglia and Fazekas 1 leucopathy.
Hypermetabolism of the right putamen on FDG-PET, normalized after treatment with corticosteroids
Figure 2
[18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) of the patient. A: FDG-PET before corticosteroid treatment, showing increased metabolism of the right putamen as compared to the left side (standardized uptake value (SUV) of 10.19 on the right side versus 8.77 SUV on the left, i.e. a difference of 16.2%); B: FDG-PET after corticosteroid treatment, showing resolution of the right putamen increased metabolism (12.96 SUV on the right side versus 12.17 on the left side, i.e. a difference of 6.5%).
See this image and copyright information in PMC

Comment in

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