COVID-19 vaccine-induced encephalitis and status epilepticus

Fan, Hua-Tung; Lin, Yen-Yu; Chiang, Wei Fan; Lin, C -Y; Chen, M -H; Wu, Kun; Chan, Jenq-Shyong; Kao, Yung‐Hsi; Shyu, Hann-Yeh; Hsiao, Po-Jen

doi:10.1093/qjmed/hcab335

Cited by 22 publications

(36 citation statements)

References 5 publications

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“…The cervical, thoracic, abdominal, and pelvic contrasted tomography and the PET scan excluded the presence of neoplasms. In the CSF, we found hyperproteinorrachia with negative cellularity, a result similar to that described in other cases of post-vaccination encephalitis [ 9 , 14 ]. However, in a case of post-vaccination NMDA-positive encephalitis with BNT162b2 (COMIRNATY), high cellularity with lymphocyte predominance was observed in the CSF [ 12 ].…”

Section: Discussionsupporting

confidence: 90%

“…On the other hand, in our case we found hyperintense lesions almost symmetrically. Concerning treatment, in most of the previous reports, methylprednisolone pulses were offered as the first treatment option, obtaining significant clinical improvement [ 6 , 9 , 11 , 12 , 14 , 15 ], as in our case.…”

Section: Discussionmentioning

confidence: 64%

“…AE post-vaccination against COVID-19 is a rare entity, and its incidence is not yet defined. In previous cases, the encephalitis symptoms’ appearance within three weeks after vaccination has been registered, defining this time as a relevant period [ 6 , 9 , 11 , 12 , 13 , 14 , 15 ] ( Table 1 ). In our case, the patient presented a subacute onset of altered content of consciousness, confusion, did not recognize family members, presented episodes of aggressiveness and difficulty walking, which is comparable to that observed in previous cases of autoimmune encephalopathy [ 6 , 9 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Post-Vaccinal Encephalitis with Early Relapse after BNT162b2 (COMIRNATY) COVID-19 Vaccine: A Case Report

et al. 2022

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We describe the case of a 72-year-old man who received the first dose of the BNT162b2 (COMIRNATY) vaccine against COVID-19 on 18 May 2021, and the second dose on 9 September 2021. One day after receiving the first dose, he cursed with malaise, headache, fever, confusion, aggressiveness, and gait alterations. We performed serum and cerebrospinal fluid (CSF) tests (finding elevated proteins in CSF) with negative results for infectious, systemic, and neoplastic causes. We performed brain nuclear magnetic resonance imaging (MRI), finding circumscribed encephalitis at the anterior frontal and bilateral temporal lobes. We were unable to perform a panel of antineuronal antibodies. The patient was readmitted due to early clinical relapse four days after receiving his second dose. We found sequelae lesions at the frontal level but with new demyelinating lesions at the left temporal level in brain MRI. We indicated methylprednisolone, and he presented a favorable improvement. We report an encephalitis case of probable autoimmune etiology after vaccination with BNT162b2, which presented early clinical relapse after receiving the second dose and presented a favorable response to methylprednisolone.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

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Post-Vaccinal Encephalitis with Early Relapse after BNT162b2 (COMIRNATY) COVID-19 Vaccine: A Case Report

et al. 2022

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“…There have been multiple reports on the rare occurrence of central nervous system (CNS) complications related to different types of COVID-19 vaccination, including ChAdOx1 nCoV-19, mRNA-1273 and BNT162b2. These included acute encephalopathy ( Roberts et al, 2021 , Grover et al, 2022 , Al-Mashdali et al, 2021 , Baldelli et al, 2021 ) or encephalitis, ( Zuhorn et al, 2021 , Torrealba-Acosta et al, 2021 , Fan et al, 2022 , Kobayashi et al, 2022 , Zlotnik et al, 2021 , Takata et al, 2021 ) which in some cases were associated with seizures including two cases of new-onset refractory status epilepticus (NORSE), ( Fan et al, 2022 , Aladdin and Shirah, 2021 ). There are also several reports of acute disseminated encephalomyelitis (ADEM) or ADEM-like presentations ( Vogrig et al, 2021 , Cao and Ren, 2021, Ozgen Kenangil et al, 2021 , Rinaldi et al, 2021, Kania et al, 2021 ) and acute necrotizing encephalopathy ( Bensaidane et al, 2022 , Siriratnam et al, 2022 ).…”

Section: Electroencephalography (Eeg)mentioning

confidence: 99%

“…There are also several reports of acute disseminated encephalomyelitis (ADEM) or ADEM-like presentations ( Vogrig et al, 2021 , Cao and Ren, 2021, Ozgen Kenangil et al, 2021 , Rinaldi et al, 2021, Kania et al, 2021 ) and acute necrotizing encephalopathy ( Bensaidane et al, 2022 , Siriratnam et al, 2022 ). In almost all of the aforementioned cases, when EEG findings were reported, they consisted of nonspecific generalized slow activity ( Zuhorn et al, 2021 , Torrealba-Acosta et al, 2021 , Fan et al, 2022 , Aladdin and Shirah, 2021 , Al-Mashdali et al, 2021 , Baldelli et al, 2021 , Vogrig et al, 2021 , Bensaidane et al, 2022 , Siriratnam et al, 2022 ) or were assessed as normal ( Sluyts et al, 2022 , Zlotnik et al, 2021 , Takata et al, 2021 , Grover et al, 2022 ). Thus, these data indicate that there is no specific EEG pattern that affirms an association of vaccination against SARS-Covid-2 with post-vaccination neurological dysfunction.…”

Section: Electroencephalography (Eeg)mentioning

confidence: 99%

The clinical neurophysiology of COVID-19-direct infection, long-term sequelae and para-immunization responses: A literature review

Haykal

Menkes

2023

Clinical Neurophysiology Practice

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Electroencephalographic findings post‐COVID‐19 vaccination: A systematic review of case reports and case series

Fazlollahi,

Zahmatyar,

Shamekh

et al. 2023

Reviews in Medical Virology

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A number of different neurological complications have been reported following vaccination against the coronavirus disease 2019 (COVID‐19). Electroencephalogram (EEG) is one of the modalities used to evaluate the neurological complications of diseases. The aim of the present study was to identify the EEG changes in participants vaccinated against COVID‐19. PubMed, Scopus, Web of Science, medRxiv, and Google Scholar were searched up to 1 September 2022, with terms related to COVID‐19 vaccines, EEG, neurological signs/symptoms, or neurological disorders. All case reports and case series were included if the participants had received at least one dose of a COVID‐19 vaccine and a post vaccination EEG report was also reported. We used the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for case reports and case series to appraise the methodological quality of the included studies. Thirty‐one studies were included, which were comprised of 24 case reports and seven case series and a total of 36 participants. Generalised slowing and non‐convulsive focal status epilepticus were the most common EEG findings post‐COVID‐19 vaccination. The most frequent symptoms were headache, fatigue, generalised weakness, and vomiting. In addition, the most common signs were encephalopathy, post‐ictal phases, and confusion. Encephalitis, acute disseminated encephalomyelitis, and post‐vaccinal encephalopathy were the most commonly diagnosed adverse events. Furthermore, most of the imaging studies appeared normal. The EEG reports mainly showed background slowing and epileptiform discharges, encephalitis, encephalopathies, and demyelinating disorders. Future studies with larger samples and more vaccine types may help to further unravel the potential neurological effects of COVID‐19 vaccinations on recipients.

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COVID-19 vaccine-induced encephalitis and status epilepticus

Cited by 22 publications

References 5 publications

Post-Vaccinal Encephalitis with Early Relapse after BNT162b2 (COMIRNATY) COVID-19 Vaccine: A Case Report

Post-Vaccinal Encephalitis with Early Relapse after BNT162b2 (COMIRNATY) COVID-19 Vaccine: A Case Report

The clinical neurophysiology of COVID-19-direct infection, long-term sequelae and para-immunization responses: A literature review

Electroencephalographic findings post‐COVID‐19 vaccination: A systematic review of case reports and case series

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