Neurological Adverse Reactions to SARS-CoV-2 Vaccines

Abstract

SARS-CoV-2 vaccines are not free of side effects and most commonly affect the central or peripheral nervous system (CNS, PNS). This narrative review aims to summarise recent advances in the nature, frequency, management, and outcome of neurological side effects from SARS-CoV-2 vaccines. CNS disorders triggered by SARS-CoV-2 vaccines include headache, cerebro-vascular disorders (venous sinus thrombosis [VST], ischemic stroke, intracerebral hemorrhage, subarachnoid bleeding, reversible, cerebral vasoconstriction syndrome, vasculitis, pituitary apoplexy, Susac syndrome), inflammatory diseases (encephalitis, meningitis, demyelinating disorders, transverse myelitis), epilepsy, and a number of other rarely reported CNS conditions. PNS disorders related to SARS-CoV-2 vaccines include neuropathy of cranial nerves, mono-/polyradiculitis (Guillain-Barre syndrome [GBS]), Parsonage-Turner syndrome (plexitis), small fiber neuropathy, myasthenia, myositis/dermatomyositis, rhabdomyolysis, and a number of other conditions. The most common neurological side effects are facial palsy, intracerebral hemorrhage, VST, and GBS. The underlying pathophysiology is poorly understood, but several speculations have been generated to explain the development of CNS/PNS disease after SARS-CoV-2 vaccination. In conclusion, neurological side effects develop with any type of SARS-CoV-2 vaccine and are diverse, can be serious and even fatal, and should be taken seriously to initiate early treatment and improve outcome and avoid fatalities. KEY WORDS: Side effects; COVID-19 vaccination; Neurological; Brain; Nerves."venous sinus thrombosis", "multiple sclerosis", "acute disseminated encephalomyelitis", "seizure", "Guillain Barre syndrome", "Parsonage Turner syndrome", "myositis", and "myasthenia". In addition, reference lists were searched for additional articles that matched the search criteria. Neurological COVID Vaccination Complications 223Table 1. Most common marketed anti-SARS-CoV-2 vaccines Company Generic name Brand name Ⓡ Technology Number of dosages Biontech Pfizer BNT162b2 Comirnaty m-RNA Two/booster Moderna m-RNA1273 Spikevax m-RNA Two/booster Astra Zeneca ChAdOx1-S nCoV-19 Vaxzevira Viral vector Two/booster Curevac CVnCoV Zorecimeran m-RNA Two Novavax NVX-Cov2373 Novaxovid Protein subunit Two Johnson & Johnson Ad26.COV.2S Jcovden Viral vector One Sinovac CoronaVac CoronaVac Viral vector Two/booster Valneva VLA2001 COVID-19 vaccine Viral vector Two/booster Sinopharm COVID 2019 vaccine BIBP Viral vector Two/booster Gam-Covid-Vac Sputnik-V Gam-Covid-Vac Viral vector Two Bharat Biotech BBV152 Covaxin Viral vector Two/booster CanSino Biologics Ad5-nCoV Convidecia Viral vector Single Sinopharm BBIBP32-CorV Covilo Viral vector Two booster Sanofi Pasteur VidPrevtyn beta VidPrevtyn beta Protein subunit OneOriginal articles and reviews published between 1966 and December 2022 were included. Abstracts, proceedings, and editorials were excluded from data analysis. The review does not claim to be complete, since the number of words and references was...

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