Guillain-Barré syndrome after AstraZeneca COVID-19-vaccination: A causal or casual association?

Introna, Alessandro; Caputo, Francesca; Santoro, Carlo; Guerra, Tommaso; Ucci, Maria; Mezzapesa, Domenico Maria; Trojano, María

doi:10.1016/j.clineuro.2021.106887

Cited by 71 publications

(75 citation statements)

References 8 publications

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“…9 This patient remained bedridden by the 4-week follow-up. 9 Thrombotic events in cerebral veins are another neurological complication of SARS-CoV-2 vaccinations. VST has been most frequently reported after vaccinations with the AZV.…”

Section: Re Sultsmentioning

confidence: 89%

Neurological side effects of SARS‐CoV‐2 vaccinations

Finsterer

2021

Acta Neuro Scandinavica

135

117

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Though SARS-CoV-2 vaccinations are usually sold as well tolerated, they can cause mild-to-severe side effects in some patients. 1 Since the benefit for the global population outweighs these adverse reactions, and since political and pecuniary interests create the image of a "safe and indispensable" tool against the currently dominant global burden, there is only moderate reporting and discussion about them. 2There is also an anti-vaccine movement in the world nowadays that also contributes to the biased assessment of these adverse effects.Usually, single case reports, case series, or registration studies report these side effects but systematic, transnational, multicenter, postmarketing investigations on this matter are infrequently done. This shortage of published information about type, frequency, severity, and therapeutic management of vaccination-related side effects is in contradiction to the daily experience of healthcare workers and affected probands, and may contribute to the individual or organized resistance and reservations against the vaccination from parts of the populations, the only moderate effect of vaccination campaigns, and the tendency to introduce compulsory vaccination. 3 Neurological side effects to SARS-CoV-2 vaccinations are usually mild, of short duration, self-limiting, and ambulatorily manageable.However, in some cases, these side effects are severe and require hospitalization or even admission to an intensive care unit (ICU). 4 Only, rarely these side effects can be fatal. 5 Since the virus and the adverse reactions to vaccinations show a tropism for neuronal structures and tissues this narrative review about the neurological side effects was conducted to collect and discuss published data in order to discover type, frequency, treatment, and outcome of these side effects and to eventually discover if certain patients are prone to

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Section: Re Sultsmentioning

confidence: 89%

Neurological side effects of SARS‐CoV‐2 vaccinations

Finsterer

2021

Acta Neuro Scandinavica

135

117

View full text Add to dashboard Cite

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“…Several hypotheses not yet fully proven suggest a causal link between immunization against SARS-CoV 2 and GBS, one of them mentions that considering that COVID-19 vaccines induce immunization against SARS-CoV-2 spike proteins and SARS-CoV-2 spike protein can bind to sialic acid-containing glycoprotein and gangliosides on cell surfaces, an antibody cross-reaction may be the causal link between GBS and immunization to SARS-CoV-2 ( Introna et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Guillain-Barré syndrome following SARS-CoV-2 vaccination: Is there a real association?

López-Hernández

Bazán-Rodríguez

Adib

et al. 2022

Neuroimmunology Reports

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Background Guillain-Barre Syndrome (GBS) is the most common cause of acute flaccid paralysis, with an incidence of 0.81-1.89 cases per 100,000. With the SARS-CoV-2 virus pandemic, major international vaccination campaigns continue to be carried out to minimize the total burden of the disease. This study aims to report a case series of consecutive GBS patients after SARS-CoV-2 vaccination during the massive campaign in Mexico in 2021. Methods A single-center, observational study of consecutive GBS subjects diagnosed by Asbury criteria from January 1 to August 31, 2021. Including GBS-related symptoms on or after six weeks of vaccination record, both first and second doses. Results From a total of 53 GBS patients, eight had a history of SARS-CoV-2 vaccination, 87.5% male, the median vaccination-symptom onset and symptom-to-admission time were 15 (IQR 12.75-23.25), and 3.5 (IQR 1.5-8.25), all of them had GBS Disability Scale ≥3 at admission. Acute inflammatory demyelinating polyneuropathy (AIDP) was the most common electrophysiological variant encountered in this population. All patients received treatment Intravenous Immunoglobulin (IVIG) or Plasma Exchange (PE), 62.5% recovered independent walk at three months follow up. Conclusion The annual incidence of GBS cases associated with vaccination remains lower (0.81 - 1.89 cases / 100,000 persons) than non-vaccinated patients; this should encourage health authorities to continue promoting massive vaccination as benefits outweigh the risks.

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“…In the United States, as of July 13, 2021 there were 100 preliminary reports of GBS after receiving the Janssen COVID-19 vaccine and 1 death after 12.5 million vaccine doses administered. GBS usually develops 3-22 days after the administration of COVID-19 vaccines [9][10][11][12][13][14][15] . Although MFS following COVID-19 vaccination has not been reported so far, MFS can be observed from 5 to 21 days after immunization with influenza [6][7][8] , pneumovax 8 , and DPT vaccines 5 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition to an antecedent infectious illness, vaccinemediated immunization can trigger GBS and MFS [5][6][7][8] , for example, MFS following influenza [6][7][8] , pneumovax 8 , and DPT (diphtheria, pertussis, tetanus toxoid) vaccination 5 has been reported. GBS has been listed as a very rare neurological complication of the COVID-19 vaccine [9][10][11][12][13][14][15] . However, to the best of our knowledge, there have been no case reports of isolated, unilateral ONP with anti-GQ1b antibody following vaccination.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Isolated, unilateral oculomotor palsy with anti-GQ1b antibody following COVID-19 vaccination

et al. 2021

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Neurological complications following vaccinations are extremely rare, but cannot be eliminated. Here, we report the first case of unilateral oculomotor nerve palsy (ONP) with anti-GQ1b antibody after receiving the Pfizer-BioNTech COVID-19 (BNT162b2) mRNA vaccine. A 65-year-old man developed diplopia and ptosis in the right eye 17 days after vaccination, without preceding infection. Neurological examination revealed mild blepharoptosis, limitation of adduction, and vertical gaze on the right side. Increased levels of anti-GQ1b ganglioside antibody in the serum and albuminocytologic dissociation in the cerebrospinal fluid were detected. Cranial magnetic resonance imaging showed swelling and enhancement of the right oculomotor nerve. The patient was diagnosed with right ONP accompanied with anti-GQ1b antibody, and intravenous immunoglobulin (IVIG) therapy for 5 days was administered. The limitation of adduction and vertical gaze improved, and ptosis markedly resolved after IVIG treatment. Given the temporal sequence of disease progression, laboratory findings, and a favorable response to IVIG, a causal relationship cannot be ruled out between the occurrence of ONP and COVID-19 immunization. Since immunomodulatory treatments significantly hasten the recovery and minimize the residual symptoms in anti-GQ1b antibody syndrome, clinicians should be aware of this clinical condition following COVID-19 vaccination.

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Guillain-Barré syndrome after AstraZeneca COVID-19-vaccination: A causal or casual association?

Cited by 71 publications

References 8 publications

Neurological side effects of SARS‐CoV‐2 vaccinations

Neurological side effects of SARS‐CoV‐2 vaccinations

Guillain-Barré syndrome following SARS-CoV-2 vaccination: Is there a real association?

Case Report: Isolated, unilateral oculomotor palsy with anti-GQ1b antibody following COVID-19 vaccination

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