Covid-19 vaccine (covishield) heralding Moyamoya angiopathy

Das, Shambaditya; Ray, (Prof) Dr Biman Kanti; Pandit, Dr Alak; Dutta, Dr Ajitava; Bhat, Dr Saumen; Bhattacharyya, Dr Dwaipayan; Chakraborty, Arka Prava; Agrawal, Dr Raju; Dubey, Souvik

doi:10.1016/j.nerep.2022.100100

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…The crosstalk between prothrombotic milieu and inflammatory pathway may lead to decompensation of an existing intracranial vasculopathy, although definite causal association warrants extensive research. 40 However, vaccine adverse events reporting system (VAERS) data in a recent analysis revealed no increased risk of neuroautoimmune complications from COVID-19 vaccination compared to other existing vaccines. 41 The limitations of this study include a considerably low sample size and exclusion of patients with other neurological events post -vaccination which did not require hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of Neurological Adverse Events Following COVID-19 Vaccination: An Observational Study From a Tertiary Care Centre of Eastern India

CHAKRABORTY,

RAY,

PANDIT

et al. 2023

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Background: As the world tends to recover from the crisis created by the COVID-19 pandemic, vaccines have served as one of the most valuable tools of combat and large-scale immunization has helped to tide over the catastrophe. However, several reports of post -vaccination neurological complications around the globe have surfaced up in recent literature. This study was conducted with an aim to describe the spectrum of neurological ailments requiring hospitalization following COVID-19 vaccination.Methods: An ambispective observational study was carried out from March 2021 to February 2022 at a tertiary care institute with 25 patients who satisfied the inclusion criteria of a new onset neurological illness requiring hospitalization within 4 days to 42 days of vaccination. The patients were duly followed upto months after discharge.Results: The median age of the sample was 36 years and the median latency of onset of neurological events was 14 days. Guillain-Barré syndrome was documented in 11 patients; majority were acute motor axonal neuropathy (45.45%) followed by acute inflammatory demyelinating polyradiculoneuropathy (36.36%) and acute motor sensory axonal neuropathy (18.18%). Central nervous system demyelination was reported in 9 patients; two patients had acute disseminated encephalomyelitis, 2 patients were diagnosed with myelin oligodendrocyte glycoprotein antibody-associated disease, one patient with aquaporin-4 positive neuromyelitis optica spectrum disorder , and the rest were labelled as seronegative central nervous system demyelination. Vascular events were noted in 5 patients comprising of 2 cases each of cerebral venous sinus thrombosis and intracerebral hemorrhage and a case of Moyamoya angiopathy. All patients were conservatively managed and had a complete to partial recovery suggestive of a favorable outcome after 3 months. Conclusion: The pathomechanisms of post -vaccination neurological complications is yet to be elucidatedand any causal association attributable to vaccination warrants further research. Compared to the enormity of the vaccinated population, the adverse effects are miniscule to hinder and discourage vaccination.

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Section: Discussionmentioning

confidence: 99%

Spectrum of Neurological Adverse Events Following COVID-19 Vaccination: An Observational Study From a Tertiary Care Centre of Eastern India

CHAKRABORTY,

RAY,

PANDIT

et al. 2023

Preprint

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Profile of precipitating factors and its implication in 160 Indian patients with Moyamoya angiopathy

et al. 2022

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Introduction Moyamoya angiopathy (MMA) has been known to manifest with myriad of neurological manifestations, often in association with various precipitating factors. This is the first study to systematically analyze the precipitating triggers to neurological symptoms done on the largest cohort of MMA in India. Methods A single-centered, cross-sectional observational study, recruiting 160 patients with consecutive angiographically proven MMA over a period of 5 years (2016–2021), was undertaken to evaluate the profile of immediate precipitating factors in temporal association to the neurological symptoms, along with their clinical and radiological characteristics. SPSS 25 was used for statistical analysis. Results Among the 160 patients (Adult-85, children-75), precipitating factors were seen in 41.3%, significantly higher in children (52%) than adults (31.8%) ( p value: 0.011). The commonest triggers included fever (18.8%), emotional stress (8.1%), heavy exercise and diarrhea (6.3% each). Cold bath triggered MMA symptoms in 1.3%. Fever ( p value: 0.008) and persistent crying ( p value: 0.010) triggered neurological symptoms more commonly in children than in adults. Amongst MMA patients with precipitating factors, the commonest MMA presentation included cerebral infarction type (37.9%) and TIA (31.8%). The majority of precipitating factors that preceded an ischemic event were BP-lowing ones (54.7%). Conclusion Neurological symptoms of MMA are commonly associated with several precipitating factors, including the lesser known triggers like cold bath. The frequency and profile precipitating factors varies with the age of presentation and type of MMA. It can serve as an early clue to the diagnosis of MMA and its careful avoidance can be largely beneficial in limiting the distressing transient neurological symptoms.

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Azd-1222

2023

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Covid-19 vaccine (covishield) heralding Moyamoya angiopathy

Cited by 4 publications

References 16 publications

Spectrum of Neurological Adverse Events Following COVID-19 Vaccination: An Observational Study From a Tertiary Care Centre of Eastern India

Spectrum of Neurological Adverse Events Following COVID-19 Vaccination: An Observational Study From a Tertiary Care Centre of Eastern India

Profile of precipitating factors and its implication in 160 Indian patients with Moyamoya angiopathy

Azd-1222

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