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Onoda K, Sashida R, Fujiwara R, Wakamiya T, Michiwaki Y, Tanaka T, Shimoji K, Suehiro E, Yamane F, Kawashima M, Matsuno A. Trigeminal neuropathy after tozinameran vaccination against COVID-19 in postmicrovascular decompression for trigeminal neuralgia: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE22101. [PMID: 36303493 PMCID: PMC9379720 DOI: 10.3171/case22101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Vaccines against coronavirus disease 2019 have a high level of efficacy and safety across all populations. However, numerous case series have been published on neurological disorders, including Bell’s palsy, Guillain-Barre syndrome, transverse myelitis, and multiple sclerosis. The authors presented a case of trigeminal neuropathy after coronavirus vaccination in a patient who had undergone microvascular decompression (MVD) for trigeminal neuralgia (TN). OBSERVATIONS A 77-year-old woman presented with acute trigeminal neuropathy after receiving a Pfizer-BioNtech vaccination (tozinameran) against severe acute respiratory syndrome coronavirus 2. The patient had undergone MVD for TN and the facial pain completely disappeared. One month later, she received the first injection of the tozinameran vaccine. Twelve hours after vaccination, she presented with numbness and pain induced by touching any place on the entire right face. No eruption was observed on her face. The serum herpes zoster virus antibodies were confirmed within the normal range. Magnetic resonance imaging revealed no abnormalities. The authors suspected a right trigeminal neuropathy after vaccination. Administration of carbamazepine and pregabalin improved TN but facial numbness persisted, especially in the mandibular division. LESSONS The coronavirus is a possible etiology of secondary trigeminal neuropathy in the case of MVD for TN.
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Affiliation(s)
- Keisuke Onoda
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Ryohei Sashida
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Ren Fujiwara
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Tomihiro Wakamiya
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Yuhei Michiwaki
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Tatsuya Tanaka
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Kazuaki Shimoji
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Eiichi Suehiro
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Fumitaka Yamane
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Masatou Kawashima
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
| | - Akira Matsuno
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan
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Kaya A, Kaya SY. A case of trigeminal neuralgia developing after a COVID-19 vaccination. J Neurovirol 2021; 28:181-182. [PMID: 34870807 PMCID: PMC8647511 DOI: 10.1007/s13365-021-01030-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/20/2021] [Accepted: 11/09/2021] [Indexed: 11/02/2022]
Abstract
In this case, we report a patient who developed acute trigeminal neuritis after using a Pfizer-BioNtech vaccination against SARS-CoV-2. The patient was completely recovered with steroid treatment.
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Affiliation(s)
- Abdurrahman Kaya
- Department of Infectious Disease, Istanbul Training and Research Hospital, Istanbul, Turkey.
| | - Sibel Yıldız Kaya
- Department of Infectious Disease, Sungurlu State Hospital, Sungurlu, Turkey
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Narasimhalu K, Lee WC, Salkade PR, De Silva DA. Trigeminal and cervical radiculitis after tozinameran vaccination against COVID-19. BMJ Case Rep 2021; 14:14/6/e242344. [PMID: 34155020 PMCID: PMC8217939 DOI: 10.1136/bcr-2021-242344] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this report, we describe a patient who developed an acute trigeminal neuritis and cervical radiculitis after receiving a Pfizer-BioNtech vaccination (tozinameran) against SARS-CoV-2.
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Affiliation(s)
- Kaavya Narasimhalu
- National Neuroscience Institute - Singapore General Hospital Campus, Singapore
| | - Wai Ching Lee
- General Medicine, Sengkang General Hospital, Singapore
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Abstract
Vaccinations are very effective measures for prevention of infections but are also associated with a long list of possible side effects. Adverse ocular effects following vaccination have been rarely reported or considered to be related to vaccinations. Conjunctivitis is a frequent sequel of various vaccinations. Oculorespiratory syndrome and serum sickness syndrome are considered to be related to influenza vaccinations. The risk of reactivation or initiation of autoimmune diseases (e. g. uveitis) cannot be excluded but has not yet been proven. Overall the benefit of vaccination outweighs the possible but very low risk of ocular side effects.
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Affiliation(s)
- T Ness
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät der Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - H Hengel
- Institut für Virologie; Department für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Freiburg, Freiburg, Deutschland
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Ness T, Boehringer D, Heinzelmann S. Intermediate uveitis: pattern of etiology, complications, treatment and outcome in a tertiary academic center. Orphanet J Rare Dis 2017; 12:81. [PMID: 28449695 PMCID: PMC5408401 DOI: 10.1186/s13023-017-0638-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 04/19/2017] [Indexed: 12/29/2022] Open
Abstract
Background Patients with intermediate uveitis (IU) represent a heterogenous group characterized by a wide spectrum of etiologies and regional differences. Aim of the study was to analyze the characteristics of patients with IU examined in an academic center in Germany. Methods We conducted a retrospective analysis of the clinical records of all patients with intermediate uveitis referred to the Eye Center, University of Freiburg from 2007 to 2014. Diagnosis followed the Standardization in Uveitis Nomenclature (SUN) criteria. Data analysis included: etiology of IU, demographics, complications, treatment and visual acuity. Results We identified 159 patients with intermediate uveitis during that period. Mean age at diagnosis was 35 years. Most are female (64%), and the mean duration of IU was 6.1 years (range 1 month – 35 years). Etiology of IU was idiopathic in 59%. Multiple sclerosis (MS) (20%) and sarcoidosis (10%) were frequent systemic causes of IU. Other etiologies including infectious diseases (tuberculosis, borreliosis) or immune-mediated conditions (eg, after vaccination) were present in 11%. The pattern of complications included macular edema (CME) (36%), cataract (24%), secondary glaucoma (7%), and epiretinal membrane formation (19%). Periphlebitis and optic neuritis were more frequent in conjunction with MS. Treatment comprised local and systemic steroids, immunosuppressive agents, biologics, and surgery. Best corrected visual acuity was better than 20/25 in 60% of the eyes after more than 10 years of follow-up. Conclusions In our German academic center, most IU cases were idiopathic or associated with MS or sarcoidosis. In contrast to other countries, infectious cases were rare. Patients’ overall visual prognosis is favorable even when the duration of IU has been long and and despite numerous complications.
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Affiliation(s)
- Thomas Ness
- Eye Center, Medical Center, University of Freiburg, Faculty of Medicine, Killianstr. 5, 79106, Freiburg, Germany.
| | - Daniel Boehringer
- Eye Center, Medical Center, University of Freiburg, Faculty of Medicine, Killianstr. 5, 79106, Freiburg, Germany
| | - Sonja Heinzelmann
- Eye Center, Medical Center, University of Freiburg, Faculty of Medicine, Killianstr. 5, 79106, Freiburg, Germany
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Hidalgo H, Kallweit U, Mathis J, Bassetti CL. Post Tick-Borne Encephalitis Virus Vaccination Narcolepsy with Cataplexy. Sleep 2016; 39:1811-1814. [PMID: 27397572 DOI: 10.5665/sleep.6160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/27/2016] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Narcolepsy with cataplexy (NC) is a chronic neurological disorder thought to result from an altered immune response based on a genetic predisposition coupled with environmental factors. Pandemrix vaccination has been reported to increase the risk of narcolepsy. We aimed at identifying other vaccines associated with the onset of narcolepsy. METHODS Case series and retrospective database study. RESULTS We identified four cases of NC following a tick-borne encephalitis (TBE) vaccination with FSME Immun. Additional four cases could be detected in the database of the Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines in Germany. CONCLUSIONS Our findings implicate TBE vaccination as a potential additional environmental factor for the development of NC and add additional evidence for an immunological mechanism in the pathogenesis of the disease.
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Affiliation(s)
- Hildegard Hidalgo
- Neurocenter Rhine-Lahn, Clinic Katzenelnbogen, Katzenelnbogen, Germany
| | - Ulf Kallweit
- Neurocenter Rhine-Lahn, Clinic Katzenelnbogen, Katzenelnbogen, Germany.,Department of Neurology, Bern University Hospital, and University of Bern, Switzerland
| | - Johannes Mathis
- Department of Neurology, Bern University Hospital, and University of Bern, Switzerland
| | - Claudio L Bassetti
- Department of Neurology, Bern University Hospital, and University of Bern, Switzerland
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Abstract
Vaccines to protect against tick-borne encephalitis (TBE) are produced by two manufacturers and are widely used in European and Asian countries, where TBE virus is endemic. General trends in vaccine development during recent decades and extensive postmarketing experience resulted in several modifications to their formulations and practical implications for use. Modifications were made to the production process, such as the change of the virus master bank from mouse brain to primary cells; to the excipients, especially the stabilizers and preservative; and to include formulations for children. Additionally, a rapid vaccination schedule has been developed for persons who require a fast onset of protection. Recent data from clinical studies and postmarketing surveillance indicate that both vaccines are safe, efficacious and interchangeable. Further (major) changes to formulation or alternative targets for vaccine development are not anticipated in the next 5 years. Recent serologic studies indicate that the persistence of protective immunity was longer than expected. Thus, recommendations for prolongation of TBE booster intervals have been made in several European countries, and a harmonization for booster recommendations is predicted within the European Union. Based on epidemiologic trends, the use of TBE vaccines will continue to increase in all age groups, including children.
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Affiliation(s)
- Olaf Zent
- Chiron Vaccines, Clinical Research and Medical Affairs, Chiron Behring GmbH & Co KG, Emil-von-Behring Str. 76, 35041 Marburg, Germany.
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