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Ganjeh S, Aslani H, Kalantari KK, Roostayi MM. Parsonage-Turner syndrome, affecting suprascapular nerve and especially to infraspinatus muscles after COVID-19 vaccination in a professional wrestler, a case report and literature review of causes and treatments. BMC Neurol 2024; 24:187. [PMID: 38840070 PMCID: PMC11151581 DOI: 10.1186/s12883-024-03694-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Acute peripheral neuropathy, also known as Parsonage-Turner syndrome or neuralgic amyotrophy, mostly affects the upper brachial plexus trunks, which include the shoulder girdle. It is typically accompanied by abrupt, intense pain, weakness, and sensory disruption. The etiology and causes of this disease are still unknown because of its low prevalence, however viral reactions-induced inflammation is one of its frequent causes. CASE PRESENTATION Here, we introduce a professional wrestler patient who was diagnosed with PTS after vaccination and was treated, and we review some articles in this field. CONCLUSION When it comes to shoulder-girdle complaints and pain, Parsonage-Turner syndrome can be a differential diagnosis. Corticosteroids during the acute period, followed by physical therapy, appear to be an efficient way to manage pain, inflammation, muscular atrophy, and the process of recovering to full nerve regeneration.
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Affiliation(s)
- Soheila Ganjeh
- Student Research Committee, Department of Physical Therapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Aslani
- Department of Orthopedics, Knee and Sport Medicine Education and Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Drakou A, Altsitzioglou P, Roustemis AG, Vourda E, Papakonstantinou ME, Sioutis S, Koulalis D. Parsonage-Turner Syndrome and SARS-CoV-2 Infection: A Literature Review With Case Presentation. Cureus 2024; 16:e63305. [PMID: 39070412 PMCID: PMC11283305 DOI: 10.7759/cureus.63305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/30/2024] Open
Abstract
Neuralgic amyotrophy, also known as Parsonage-Turner syndrome (PTS), is characterized by severe pain and muscle wasting affecting the anterior body, including the head, shoulder, upper limb, and chest wall. Often triggered by an antecedent event, such as infection, PTS encompasses various conditions historically identified as separate entities. In 1948, Parsonage and Turner unified these conditions under the term neuralgic amyotrophy based on shared features of intense pain and muscular atrophy. Recent studies have highlighted PTS as a spectrum disorder with diverse manifestations, including pure sensory neuropathy, extensive neuropathy, spinal accessory nerve involvement, and diaphragmatic palsy. We reviewed 26 documented cases of PTS following SARS-CoV-2 infection, emphasizing the importance of considering PTS in individuals with a history of COVID-19 due to varied clinical presentations. Standardized diagnostic methods and comprehensive evaluations are crucial for accurate diagnosis and management. Future research should focus on consistent evaluation methods and employing a comprehensive differential diagnosis approach.
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Affiliation(s)
| | - Pavlos Altsitzioglou
- 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, Attikon Hospital, Athens, GRC
| | - Anastasios G Roustemis
- 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, Attikon Hospital, Athens, GRC
| | - Eleni Vourda
- Department of Allergy and Immunology, National and Kapodistrian University of Athens, Attikon Hospital, Athens, GRC
| | | | - Spyridon Sioutis
- 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, Attikon Hospital, Athens, GRC
| | - Dimitrios Koulalis
- 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, Attikon Hospital, Athens, GRC
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Lee KW, Yap SF, Amin-Nordin S, Ngeow YF. Cardiac and Neurological Complications Post COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series. Vaccines (Basel) 2024; 12:575. [PMID: 38932303 PMCID: PMC11209191 DOI: 10.3390/vaccines12060575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/28/2024] Open
Abstract
Following mass vaccinations for the control of the COVID-19 epidemic, a spectrum of cardiac and neurological disorders was reported among vaccinated individuals. This study examined the range of complications documented and factors related to their occurrence. Three electronic databases were searched for case reports and case series with descriptions of cardiac and/or neurological complications in COVID-19 vaccine recipients. A total of 698 vaccinees were included in this review, of which 259 (37.1%) had cardiac and 439 (62.9%) had neurological complications. Inflammatory conditions were the commonest among the cardiac complications; while polyneuropathy, demyelinating diseases and cerebrovascular disorders were the more common neurological complications. The mean age of those with cardiac complications (33.8 years) was much younger than those with neurological complications (49.7 years). There was no notable difference in the gender distribution between these two groups of vaccine recipients. mRNA vaccines (all brands) were associated with almost 90.0% of the cardiac complications, whereas viral vector vaccines were associated with slightly over half (52.6%) of the neurological complications. With regard to the dose, cardiac complications were more common after the second (69.1%), whereas neurological complications were more common after the first dose (63.6%). The majority of the cases had an uncomplicated clinical course. Nevertheless, 5.9% of cases with neurological complications and 2.5% of those with cardiac complications were fatal, underscoring the significance of the consistent surveillance and vigilant monitoring of vaccinated individuals to mitigate these occurrences.
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Affiliation(s)
- Kai Wei Lee
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (K.W.L.); (S.A.-N.)
| | - Sook Fan Yap
- Department of Pre-Clinical Sciences, M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang 43200, Selangor, Malaysia;
- Dr. Wu Lien-Teh Centre of Research in Communicable Diseases, Universiti Tunku Abdul Rahman, Kajang 43200, Selangor, Malaysia
| | - Syafinaz Amin-Nordin
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (K.W.L.); (S.A.-N.)
| | - Yun Fong Ngeow
- Department of Pre-Clinical Sciences, M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang 43200, Selangor, Malaysia;
- Dr. Wu Lien-Teh Centre of Research in Communicable Diseases, Universiti Tunku Abdul Rahman, Kajang 43200, Selangor, Malaysia
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Dickey Z, Sharma N. The Utility of an Epidural Steroid Injection for the Treatment of Idiopathic Brachial Neuritis. Cureus 2024; 16:e57211. [PMID: 38681293 PMCID: PMC11056218 DOI: 10.7759/cureus.57211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
Idiopathic brachial neuritis is an uncommon disorder that predominately affects the superior and middle trunks of the brachial plexus. Severe throbbing and aching shoulder pain is initially present for a period of days to weeks, followed by severe weakness and atrophy that can develop for an extended period of months to years. There are currently no known treatments for brachial neuritis, with the standard of care consisting of analgesics and corticosteroids, which typically provide minimal to no benefit in most cases. In this case, we will present a case of a patient who was diagnosed with idiopathic brachial neuritis and underwent an interlaminar epidural steroid injection (ESI) for treatment. Following treatment with the ESI, the patient had a subsequent resolution of symptoms. This case underscores the value of early recognition for the diagnosis of brachial neuritis and the utility of an ESI as a treatment option, thus preventing long-term pathological sequalae. To our knowledge, this is the first known reported case to have successfully cured brachial neuritis.
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Affiliation(s)
- Zachary Dickey
- Physical Medicine and Rehabilitation, Edward Via College of Osteopathic Medicine, Monroe, USA
| | - Navneet Sharma
- Physical Medicine and Rehabilitation, Green Clinic, Ruston, USA
- Rehabilitation, Ruston Regional Specialty Hospital, Ruston, USA
- Physical Medicine and Rehabilitation, Edward Via College of Osteopathic Medicine, Monroe, USA
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Botchu R, Aspland L, Ariyaratne S, Burgess J, Bhogal G, Beale D. An Unusual Case of Denervation Changes of the Intercostal Muscles Associated with Intercostal Neuralgia in a Patient with Chest Pain. Acta Med Litu 2024; 31:27-32. [PMID: 38978853 PMCID: PMC11227689 DOI: 10.15388/amed.2024.31.1.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/24/2023] [Accepted: 11/17/2023] [Indexed: 07/10/2024] Open
Abstract
Musculoskeletal aetiologies account for most patients presenting with chest pain. Intercostal neuralgia is a lesser-known cause of musculoskeletal chest pain, which can present a diagnostic challenge with nonspecific imaging findings. We report a case of a 31-year-old male who presented with severe lower thoracic and chest wall pain following a suspected viral infection, where Magnetic Resonance Imaging (MRI) revealed characteristic features of denervation oedema within the affected intercostal muscles. This pattern of imaging findings in intercostal neuralgia is sparely described in the current literature. MRI along with history and examination was crucial in diagnosing the condition and excluding other potential causes of musculoskeletal chest wall pain on this occasion. The patient's symptoms were subsequently managed conservatively. The case highlights the importance of considering intercostal neuralgia as a potential cause of chest wall pain, particularly in the setting of post viral infection and absence of preceding mechanical musculoskeletal injury and explores an uncommon yet characteristic imaging finding which may be important in diagnosing the condition.
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Affiliation(s)
- Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - Lorraine Aspland
- Centre of Musculoskeletal Medicine, Royal Orthopaedic Hospital, Birmingham, UK
| | - Sisisth Ariyaratne
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - James Burgess
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - Gurjit Bhogal
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - David Beale
- Department of Radiology, Heath Lodge Clinic, Knowle, UK
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Tayebi A, Samimisedeh P, Jafari Afshar E, Mahmoudnia S, Milan N, Ayati A, Madady A, Rastad H. Neuromuscular diseases associated with COVID-19 vaccines: a systematic review and pooled analysis of 258 patients. BMC Neurol 2023; 23:437. [PMID: 38082244 PMCID: PMC10712145 DOI: 10.1186/s12883-023-03486-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Neuromuscular diseases (NMD) emerged as one of the main side effects of the COVID-19 vaccination. We pooled and summarized the evidence on the clinical features and outcomes of NMD associated with COVID-19 vaccination. METHODS We comprehensively searched three databases, Medline, Embase, and Scopus, using the key terms covering "Neuromuscular disease" AND "COVID-19 vaccine", and pooled the individual patient data extracted from the included studies. RESULTS A total of 258 NMD cases following COVID-19 have been reported globally, of which 171 cases were Guillain-Barré syndrome (GBS), 40 Parsonage-Turner syndrome (PTS), 22 Myasthenia Gravis (MG), 19 facial nerve palsy (FNP), 5 single fiber neuropathy, and 1 Tolosa-Hunt syndrome. All (100%) SFN patients and 58% of FNP patients were female; in the remaining NMDs, patients were predominantly male, including MG (82%), GBS (63%), and PTS (62.5%). The median time from vaccine to symptom was less than 2 weeks in all groups. Symptoms mainly appeared following the first dose of vector vaccine, but there was no specific pattern for mRNA-based. CONCLUSION COVID-19 vaccines might induce some NMDs, mainly in adults. The age distribution and gender characteristics of affected patients may differ based on the NMD type. About two-thirds of the cases probably occur less than 2 weeks after vaccination.
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Affiliation(s)
- Amirhossein Tayebi
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Parham Samimisedeh
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Elmira Jafari Afshar
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeideh Mahmoudnia
- Department of Neurology, Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Nesa Milan
- Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Department of Orthopedics, Tehran university of medical sciences, Tehran, Iran
| | - Aryan Ayati
- Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Aryan Madady
- Department of Neurology, Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Hadith Rastad
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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Mooshage CM, Kele H, Bendszus M, Schwarz D. High-resolution MR neurography follow-up of SARS-CoV-2 vaccination-associated neuralgic amyotrophy. Ann Clin Transl Neurol 2023; 10:2421-2425. [PMID: 37807679 PMCID: PMC10723225 DOI: 10.1002/acn3.51916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/16/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023] Open
Abstract
Little is known about the value of high-resolution follow-up imaging in patients with neuralgic amyotrophy (NA) and the question of the best treatment algorithm remains unclear. Three patients (one female, two male) with the clinical presentation of SARS-CoV-2-vaccination-associated NA underwent initial magnetic resonance neurography (MRN) imaging and follow-up examinations. All patients showed a marked clinical improvement, independent of treatment, including an almost full recovery of motor function over the course of 8-12 months which was accurately mirrored by imaging findings on MRN. MRN imaging is a valuable tool for monitoring the further clinical course of patients suffering from vaccination-associated NA.
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Affiliation(s)
| | - Henrich Kele
- Center for Neurology and Clinical NeurophysiologyHamburgGermany
| | - Martin Bendszus
- Department of NeuroradiologyHeidelberg University HospitalHeidelbergGermany
| | - Daniel Schwarz
- Department of NeuroradiologyHeidelberg University HospitalHeidelbergGermany
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Valnet-Rabier MB, Tebacher M, Gautier S, Micallef J, Salvo F, Pariente A, Bagheri H. Pharmacovigilance signals from active surveillance of mRNA platform vaccines (tozinameran and elasomeran). Therapie 2023; 78:499-507. [PMID: 37012149 PMCID: PMC10007713 DOI: 10.1016/j.therap.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/07/2023] [Indexed: 03/13/2023]
Abstract
INTRODUCTION Two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines, tozinameran/BNT162b2 (Comirnaty®, Pfizer-BioNTech) and elasomeran/mRNA-1273 (Spikevax®, Moderna), were approved by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) at the end of 2020, less than a year after the start of the coronavirus disease 2019 (COVID-19) pandemic. In France, the health authorities have requested an intensive vaccination campaign, accompanied by a reinforced and active pharmacovigilance surveillance. This surveillance and analysis of real-life data, based on spontaneous reports received by the French Network of Regional PharmacoVigilance Centers (RFCRPV), has enabled to identify numerous pharmacovigilance signals. Some of them, such as myocarditis and heavy menstrual bleeding, have been confirmed as adverse effects of these vaccines. METHOD We propose a descriptive review of the main pharmacovigilance signals identified by the RFCRPV concerning vaccines from the mRNA platform. RESULTS Most pharmacovigilance signals were common to both mRNA vaccines: myocarditis, menstrual disorders, acquired haemophilia, Parsonage-Turner syndrome, rhizomelic pseudo-polyarthritis and hearing disorders. Other signals were more specific, such as arterial hypertension with tozinameran or delayed reaction site injection with elasomeran. CONCLUSION This non-exhaustive review illustrates the experience of RFCRPV in identifying and monitoring pharmacovigilance signals related to mRNA vaccines in France during the COVID-19 pandemics, and the crucial role of pharmacological and clinical expertise in this area. It also highlights the predominant contribution of spontaneous reporting in the generation of pharmacovigilance signals, particularly for serious and rare adverse events not detected before marketing.
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Affiliation(s)
| | - Martine Tebacher
- Centre de pharmacovigilance de Strasbourg, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - Sophie Gautier
- Centre de pharmacovigilance Nord pas de Calais, service de pharmacologie médicale, CHU, 59000 Lille, France
| | - Joelle Micallef
- Centre de pharmacovigilance de Marseille, service de pharmacologie clinique et pharmacovigilance, AMU, APHM, 13000 Marseille, France
| | - Francesco Salvo
- Université de Bordeaux, Inserm, BPH, U1219, Team AHeaD, 33000 Bordeaux, France; Service de pharmacologie médicale, centre de pharmacovigilance de Bordeaux, CHU de Bordeaux, 33000 Bordeaux, France
| | - Antoine Pariente
- Université de Bordeaux, Inserm, BPH, U1219, Team AHeaD, 33000 Bordeaux, France; Service de pharmacologie médicale, centre de pharmacovigilance de Bordeaux, CHU de Bordeaux, 33000 Bordeaux, France
| | - Haleh Bagheri
- Service de pharmacologie médicale, CIC1436, Centre de pharmacovigilance de Toulouse, CHU Toulouse, 31000 Toulouse, France.
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Massy N, Atzenhoffer M, Boulay C, Pecquet PE, Ledys F, Cracowski JL, Masmoudi K, Lepelley M, Gras-Champel V. [COVID-19 and adenovirus vaccines: French experience of enhanced pharmacovigilance]. Therapie 2023; 78:489-498. [PMID: 36759287 PMCID: PMC9862661 DOI: 10.1016/j.therap.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023]
Abstract
As part of the COVID-19 vaccination campaign, the National Agency for the Safety of Medicines and Health Products and all 31 regional pharmacovigilance centers were mobilized in an exceptional reinforced vaccine pharmacovigilance surveillance system. Concerning adenovirus vaccines, Vaxzévria® and Jcovden®, this national system, based on the daily analysis of notified cases of adverse events, has allowed the early identification of safety signals, some of which have been validated, others still under analysis, common to mRNA vaccines or more specific of adenovirus vaccines such as Vaccine Induced Immune Thrombocytopenia. Complementing european and international actions, this follow-up has contributed to a better definition of the safety profile of these vaccines and has led to redefine the vaccine strategy in our country. Although today these two vaccines have no longer place in the national vaccine strategy, they are still used in other countries, where the experience acquired could be useful and will contribute to fuel the reflection on future therapies involving viral vectors.
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Affiliation(s)
- Nathalie Massy
- Centre régional de pharmacovigilance, service de pharmacologie, CHU Rouen, 76031 Rouen, France
| | - Marina Atzenhoffer
- Centre régional de pharmacovigilance, service hospitalo-universitaire de pharmacologie et toxicologie, hospices civils de Lyon, 69424 Lyon, France
| | - Charlène Boulay
- Centre régional de pharmacovigilance, service de pharmacologie, CHU Rouen, 76031 Rouen, France
| | - Pauline-Eva Pecquet
- Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, 80054 Amiens, France
| | - Fanny Ledys
- Centre régional de pharmacovigilance, service hospitalo-universitaire de pharmacologie et toxicologie, hospices civils de Lyon, 69424 Lyon, France
| | - Jean-Luc Cracowski
- Centre régional de pharmacovigilance, service de pharmacologie, CHU Grenoble, 38043 Grenoble cedex 09, France
| | - Kamel Masmoudi
- Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, 80054 Amiens, France
| | - Marion Lepelley
- Centre régional de pharmacovigilance, service de pharmacologie, CHU Grenoble, 38043 Grenoble cedex 09, France
| | - Valérie Gras-Champel
- Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, 80054 Amiens, France.
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Chiang PI, Chen CM. Increased 18 F-FDG uptake in denervated muscles in a case of Parsonage-Turner syndrome. BMC Neurol 2023; 23:280. [PMID: 37495981 PMCID: PMC10369682 DOI: 10.1186/s12883-023-03328-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Parsonage-Turner Syndrome (PTS) is a rare brachial plexopathy characterized by the sudden onset of pain in the shoulder girdle followed by upper limb weakness. PTS is frequently under-recognized or misdiagnosed as other more common neurological disorders presenting in a similar fashion, such as cervical radiculopathy which may require surgical intervention. Accurate diagnosis and prompt management implicate a good prognosis. Although electrophysiological studies are considered the most important for evaluating peripheral nerve injuries, it usually takes time, up to 3 weeks after the initial insult of the nerve for electromyogram (EMG) and nerve conduction studies (NCS) to display abnormalities. In the cases of PTS, especially when initial EMG/NCS and magnetic resonance neurography (MRN) results are inconclusive, 18 F-FDG positron emission tomography and computed tomography (18 F-FDG PET-CT) may be useful in helping the early detection of muscle denervation. CASE PRESENTATION A 60-year-old right-handed Taiwanese woman presented with sudden onset of intense and sharp left shoulder girdle pain without radiating to the arm, followed by muscle weakness of her left arm in abduction and elevation 3 days after the onset of pain. A detailed neurological examination and EMG and NCS suggested the clinical diagnosis of left brachial plexopathy. MRN imaging revealed no significant abnormality. 18 F-FDG PET-CT showed increased uptake in denervated muscles (supraspinatus, deltoid, and biceps muscles). Treatment with oral prednisolone and physiotherapy significantly improved pain and muscle weakness. CONCLUSIONS We present increased 18 F-FDG uptake in denervated muscles detected by 18 F-FDG PET-CT. 18 F-FDG PET-CT may serve as an adjunct examination to evaluate PTS, which has been suggested previously but rarely reported.
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Affiliation(s)
- Ping-I Chiang
- Center for Medical Education in English, Poznan University of Medical Sciences, Poznan, 60-512, Poland
| | - Chiung-Mei Chen
- Linkou Medical Center, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Neurology, College of Medicine, Chang Gung University, Taoyuan County, 33305, Taiwan.
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Ameer MZ, Haiy AU, Bajwa MH, Abeer H, Mustafa B, Ameer F, Amjad Z, Rehman AU. Association of Parsonage-Turner syndrome with COVID-19 infection and vaccination: a systematic review. J Int Med Res 2023; 51:3000605231187939. [PMID: 37523491 PMCID: PMC10392513 DOI: 10.1177/03000605231187939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES The exact etiology of Parsonage-Turner syndrome is unknown, but it is known to be preceded by infection, vaccination, or surgical intervention. In this review, we describe associations of Parsonage-Turner syndrome with COVID-19 infection and vaccination. METHODS A systematic literature search was conducted using PubMed/MEDLINE, ScienceDirect, and Google Scholar. Microsoft Excel was used for data extraction and statistical analysis. The quality of case reports and case series was assessed using the Joanna Briggs Institute Critical Appraisal Tool. RESULTS We selected 44 case reports and 10 case series, including 68 patients (32 post-vaccination and 36 with post-COVID-19 infection Parsonage-Turner syndrome). Middle-aged males were predominantly affected in both groups. The most frequently administered vaccine was Comirnaty (Pfizer) (53%). The mean latency was 11.7 days in the post-vaccination group and 20.3 days in the post-infection group. The most affected nerves in both groups were the axillary, suprascapular, and musculocutaneous nerves; and 78.1% and 38.9% of patients showed partial amelioration of their symptoms in the post-vaccination and post-infection groups, respectively. CONCLUSION Post-vaccination Parsonage-Turner syndrome presents earlier than post-infection disease. Pain and sensorimotor deficits of the upper limb are common in both situations. Complete or partial recovery occurs in most cases.
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Affiliation(s)
| | - Ata Ul Haiy
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | | | - Huzaifa Abeer
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Biah Mustafa
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Fatima Ameer
- Department of Medicine, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Zunaira Amjad
- Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Aqeeb Ur Rehman
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
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Parsonage-Turner Syndrome After COVID-19 Vaccination in a Child. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202303000-00006. [PMID: 36893168 PMCID: PMC10005827 DOI: 10.5435/jaaosglobal-d-22-00156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 01/28/2023] [Indexed: 03/10/2023]
Abstract
Parsonage-Turner syndrome (PTS) is a peripheral neuropathy involving the brachial plexus very rare in childhood. To date, no cases of PTS after COVID-19 vaccination have been reported in children. We report a case of a 15-year-old boy affected by PTS after the second dose of the BNT162b2 (Comirnaty, Pfizer-BioNTech) COVID-19 vaccine.
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Öncel A, Coşkun E. Reply to the Letter to the Editor for "Rule out differentials before diagnosing SARS-CoV-2 vaccination related Parsonage-Turner syndrome". Turk J Phys Med Rehabil 2023; 69:130-131. [PMID: 37201012 PMCID: PMC10186027 DOI: 10.5606/tftrd.2023.12414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 05/20/2023] Open
Affiliation(s)
- Adil Öncel
- Department of Physical Medicine and Rehabilitation, Başakşehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Evrim Coşkun
- Department of Physical Medicine and Rehabilitation, Başakşehir Cam and Sakura City Hospital, Istanbul, Türkiye
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14
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Samim M, Dhar D, Arshad F, Anudeep D, Patel VG, Neeharika SR, Dhamija K, Ravindranath CM, Yadav R, Raja P, Netravathi M, Menon D, Holla VV, Kamble NL, Pal PK, Nalini A, Vengalil S. Co-VAN study: COVID-19 vaccine associated neurological diseases- an experience from an apex neurosciences centre and review of the literature. J Clin Neurosci 2023; 108:37-75. [PMID: 36586226 PMCID: PMC9780646 DOI: 10.1016/j.jocn.2022.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/19/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Recent studies have shown various neurological adverse events associated with COVID-19 vaccine. OBJECTIVE We aimed to retrospectively review and report the neurological diseases temporally associated with COVID-19 vaccine. METHODS We performed a retrospective chart review of admitted patients from 1st February 2021 to 30th June 2022. A total of 4672 medical records were reviewed of which 51 cases were identified to have neurological illness temporally associated with COVID-19 vaccination. RESULTS Out of 51 cases, 48 had probable association with COVID-19 vaccination while three had possible association. Neurological spectrum included CNS demyelination (n = 39, 76.5 %), Guillain-Barré-syndrome (n = 3, 5.9 %), stroke (n = 6, 11.8 %), encephalitis (n = 2, 3.9 %) and myositis (n = 1, 2.0 %). Female gender had a greater predisposition (F:M, 1.13:1). Neurological events were more commonly encountered after the first-dose (n = 37, 72.5%). The mean latency to onset of symptoms was 13.2 ± 10.7 days after the last dose of vaccination. COVIShield (ChAdOx1) was the most commonly administered vaccine (n = 43, 84.3 %). Majority of the cases with demyelination were seronegative (n = 23, 59.0 %) which was followed by anti-Myelin oligodendrocyte-glycoprotein associated demyelination (MOGAD) (n = 11, 28.2 %) and Neuromyelitis optica (NMOSD) (n = 5, 12.8 %). Out of 6 Stroke cases, 2 cases (33.3 %) had thrombocytopenia and coagulopathy. At discharge, 25/51 (49.0 %) of the cases had favourable outcome (mRS 0 to 1). Among six patients of stroke, only one of them had favourable outcome. CONCLUSION In this series, we describe the wide variety of neurological syndromes temporally associated with COVID-19 vaccination. Further studies with larger sample size and longer duration of follow-up are needed to prove or disprove causality association of these syndromes with COVID-19 vaccination.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Seena Vengalil
- Corresponding author at: Associate Professor, Department of Neurology, Faculty Block First Floor, Behind Neurocenter, National Institute of Mental Health And Neurosciences, Bangalore 560029
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15
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Meixedo S, Correia M, Machado Lima A, Carneiro I. Parsonage-Turner Syndrome Post-COVID-19 Oxford/AstraZeneca Vaccine Inoculation: A Case Report and Brief Literature Review. Cureus 2023; 15:e34710. [PMID: 36909059 PMCID: PMC9996062 DOI: 10.7759/cureus.34710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Parsonage-Turner syndrome (PTS) is a rare brachial plexus neuropathy that typically presents as a severe, sudden-onset pain followed by atrophic weakness with slow recovery, which may occur after an identifiable triggering event. Vaccination is one of several known triggers of PTS, and this syndrome has already been reported in other patients who were vaccinated against coronavirus disease. We report the case of a 75-year-old Caucasian man who received the third dose of the coronavirus disease 2019 (COVID-19) Oxford/AstraZeneca vaccine and was diagnosed with PTS. A week after inoculation, the patient, with no history of trauma, developed a sudden-onset left shoulder mechanical pain and later reported an abduction deficit. Neurological examination showed an atrophy of the proximal muscles of the left upper limb. No bulbar weakness or pathological upper motor neuron signs were seen. The MRI excluded rotator cuff pathology, including ruptures and tendinopathy. Electroneuromyography findings carried out 10 months after the onset of symptoms indicated left brachial panplexopathy, suggestive of PTS. The raised consciousness of PTS and vaccine association is crucial for prompt identification and diagnosis and, therefore, better clinical outcomes.
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Affiliation(s)
- Sofia Meixedo
- Physical Medicine and Rehabilitation, Centro Hospitalar Vila Nova de Gaia/Espinho - Centro de Reabilitação do Norte, Gaia, PRT
| | - Miguel Correia
- Physical Medicine and Rehabilitation, Centro Hospitalar Vila Nova de Gaia/Espinho - Centro de Reabilitação do Norte, Gaia, PRT
| | - Ana Machado Lima
- Physical Medicine and Rehabilitation, Centro Hospitalar Vila Nova de Gaia/Espinho - Centro de Reabilitação do Norte, Gaia, PRT
| | - Ismael Carneiro
- Physical Medicine and Rehabilitation, Centro Hospitalar Vila Nova de Gaia/Espinho - Centro de Reabilitação do Norte, Gaia, PRT
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16
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Allahyari F, Molaee H, Hosseini Nejad J. Covid-19 vaccines and neurological complications: a systematic review. Z NATURFORSCH C 2023; 78:1-8. [PMID: 36087300 DOI: 10.1515/znc-2022-0092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/09/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 mainly causes respiratory disorders with high infection and severe morbidity and mortality. Neurologists have concerns about potential neurological side effects, profits, and timing of COVID-19 vaccines. This study aimed to review systematically research for the COVID-19 vaccine and neurological complications. Data was searched in Scopus, ISI web of knowledge, Medline, PubMed, Wiley, Embase, International Clinical Trials Registry Platform and Clinical Trials, Cochrane Library, and Google Scholar. Two reviewer authors individually searched and assessed the titles and abstracts of all articles. The third reviewer resolved disagreement between them. Data were documented regarding study location, study design, type of complications, number of patients, various types of COVID-19 vaccine, and type of neurological complications. Six studies in COVID-19 vaccine and neurological complications include two studies about neurological manifestations after the mRNA vaccines, four records about side effects of vector-based vaccine were included in the study. The main neurological complication associated mRNA vaccines were body aches, paresthesia, and difficulty walking, erythema migrans lesion, fatigue, myalgia, and pain in the left lateral deltoid region. The major neurological complication related to vector-based vaccines were urinary retention difficulty, feeding and ambulating, arm soreness, mild fatigue, chills, left-sided facial droop, headaches, a generalized epileptic seizure, hemianopia, and mild aphasia, acute somnolence and right-hand hemiparesis, acute transverse myelitis, deep vein thrombosis in her left leg, a vigilance disorder and a twitching, a severe immobilizing opsoclonus myoclonus syndrome, and encephalitis. A large spectrum of severe neurological unfavorable has been reported. These complications could occur as a result of molecular stimulation and later neuronal damage. Generally, the advantages of COVID-19 vaccination are dominant on the risks of a neurological complication at both individual and population levels. Future investigations will be required to find any relationship between neurological complications and COVID-19 vaccines principally as new strains of the virus and new vaccines are technologically advanced against them.
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Affiliation(s)
- Fakhri Allahyari
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hamideh Molaee
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Javad Hosseini Nejad
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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17
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Is the Pandemic Wearing Us Out? A Cross-Sectional Study of the Prevalence of Fatigue in Adult Twins without Previous SARS-CoV-2 Infection. J Clin Med 2022; 11:jcm11237067. [PMID: 36498639 PMCID: PMC9738217 DOI: 10.3390/jcm11237067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022] Open
Abstract
During the pandemic, mental health was not only impaired in people after a SARS-CoV-2 infection, but also in people without previous infection. This is the first study on twins without prior SARS-CoV-2 infection to estimate the influence of genetic components and shared as well as individual environments on pandemic-associated fatigue. The study sample included 55 monozygotic and 45 dizygotic twin pairs. A total of 34.5% reported an increase in fatigue since the pandemic. A significant correlation was shown between the responses within monozygotic (χ2[1] = 11.14, p = 0.001) and dizygotic pairs (χ2[1] = 18.72, p < 0.001). In all pandemic-associated fatigue dimensions, individual environment (ranging from e2 = 0.64 to e2 = 0.84) and heritability (ranging from h2 = 0.32 to h2 = 1.04) seem to have the highest impact. The number of comorbidities significantly correlated with physical fatigue (Spearman’s ρ = 0.232, p < 0.001) and psychological impairment due to pandemic measures with the total fatigue score (Spearman’s ρ = 0.243, p < 0.001). However, calculated ANCOVAs with these significant correlations as covariates showed no significant influence on the mean values of the respective fatigue dimensions. Susceptibility to pandemic-associated fatigue may be genetically and environmentally determined, while intensity is also influenced by individual components. The prevalence of fatigue is high even in individuals without prior SARS-CoV-2 infection. Future mental health prevention and intervention programs should be implemented to alleviate the impact of the pandemic on the global population.
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18
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Moya D, Gómez D, Altamirano N, Alfano F, Pereira Corvalán JM, Dobkin F, Menon PH, Patinharayil G. Shoulder injury related to vaccine administration following SARS-CoV-2 inoculation: Case series and review of literature. J Orthop 2022; 35:79-84. [PMID: 36406160 PMCID: PMC9652104 DOI: 10.1016/j.jor.2022.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Shoulder Injuries Related to Vaccine Administration (SIRVA), describes those cases of shoulder severe post-inoculation complications, including pain and prolonged disability. Most of the reported cases have been secondary to influenza vaccination. This study retrospectively describes a series of 18 patients following SARS-CoV-2 inoculation and compares the findings with those previously reported for other vaccines. Materials and methods Inclusion criteria was onset of symptoms within 48 h after injection, symptoms duration of at least seven days, and restricted range of motion in absence of symptoms prior to vaccination. Average age was 59.4 years old (38-76), and 72.2% were women. Results In many cases (58%) the initial diagnosis was not clear, which lead to incorrect treatment. The most common pathological finding was subacromial-subdeltoid bursitis (66.6%). All patients who received depot corticosteroids followed by a gentle rehabilitation program showed strong clinical improvement but did not completely resolve the symptoms at 7.2 months average final follow-up. Surgical intervention was necessary in one of the patients due to the persistence of symptoms despite conservative treatment. Conclusions Shoulder injury related to vaccine administration is rare, but when present, its torpid evolution makes it difficult to treat. We have found in our case series a similar pattern to that already described for other vaccines. A high index of suspicion helps to pick up the condition promptly and early treatment can bring satisfactory outcome.
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Affiliation(s)
- Daniel Moya
- Hospital Británico de Buenos Aires, Orthopaedic Department Buenos Aires, Argentina,Corresponding author. Gabriela Mistral 2641, 8 A. C1419GFK, CABA, Argentina
| | - Diego Gómez
- Hospital Británico de Buenos Aires, Orthopaedic Department Buenos Aires, Argentina
| | - Nicolás Altamirano
- Hospital Británico de Buenos Aires, Orthopaedic Department Buenos Aires, Argentina
| | - Federico Alfano
- Hospital Español de Buenos Aires, Orthopaedic Department Buenos Aires, Argentina
| | | | - Fernando Dobkin
- Sanatorio Parque, Orthopaedic Department, Rosario, Santa Fe, Argentina
| | - Prem Haridas Menon
- Department of Orthopedics and Traumatology, Medical College, Trivandrum, Kerala University of Health Sciences, Kerala, India
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19
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Zaottini F, Picasso R, Pistoia F, Sanguinetti S, Pansecchi M, Tovt L, Viglino U, Cabona C, Garnero M, Benedetti L, Martinoli C. High-resolution ultrasound of peripheral neuropathies in rheumatological patients: An overview of clinical applications and imaging findings. Front Med (Lausanne) 2022; 9:984379. [PMID: 36388946 PMCID: PMC9661426 DOI: 10.3389/fmed.2022.984379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Peripheral neuropathies are surprisingly common and can be associated with a number of conditions, including rheumatological diseases. Whether the co-existence of peripheral neuropathies with rheumatological disorders is coincidental or related to a common pathogenic mechanism, these disabling conditions can affect the outcome of rheumatological patients and should be targeted with specific treatment. The clinical presentation of peripheral neuropathy can be multifaceted and difficult to recognize in polysymptomatic patients. However, physicians adopting state-of-art diagnostic strategies, including nerve imaging, may improve the detection rate and management of neuropathies. In particular, a diagnostic approach relying exclusively on clinical history and nerve conduction studies may not be sufficient to disclose the etiology of the nerve damage and its anatomical location and thus requires integration with morphological studies. High-Resolution Ultrasound (HRUS) is increasingly adopted to support the diagnosis and follow-up of both joint disorders in rheumatology and peripheral neuropathies of different etiologies. In this review, the different types of nerve disorders associated with the most common syndromes of rheumatological interest are discussed, focusing on the distinctive sonographic features.
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Affiliation(s)
- Federico Zaottini
- San Martino Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
| | - Riccardo Picasso
- San Martino Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
- *Correspondence: Riccardo Picasso,
| | - Federico Pistoia
- Dipartimento di Medicina Sperimentale, Scuola di Scienze Mediche e Farmaceutiche, Università di Genova, Genoa, Italy
| | - Sara Sanguinetti
- Dipartimento di Medicina Sperimentale, Scuola di Scienze Mediche e Farmaceutiche, Università di Genova, Genoa, Italy
| | - Michelle Pansecchi
- Dipartimento di Scienze della Salute, Scuola di Scienze Mediche e Farmaceutiche, Università di Genova, Genoa, Italy
| | - Luca Tovt
- Dipartimento di Scienze della Salute, Scuola di Scienze Mediche e Farmaceutiche, Università di Genova, Genoa, Italy
| | - Umberto Viglino
- Dipartimento di Scienze della Salute, Scuola di Scienze Mediche e Farmaceutiche, Università di Genova, Genoa, Italy
| | - Corrado Cabona
- San Martino Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
- Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Science, School of Medical and Pharmaceutical Sciences, University of Genoa, Genoa, Italy
| | - Martina Garnero
- San Martino Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
- Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Science, School of Medical and Pharmaceutical Sciences, University of Genoa, Genoa, Italy
| | - Luana Benedetti
- San Martino Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
- Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Science, School of Medical and Pharmaceutical Sciences, University of Genoa, Genoa, Italy
| | - Carlo Martinoli
- San Martino Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
- Dipartimento di Scienze della Salute, Scuola di Scienze Mediche e Farmaceutiche, Università di Genova, Genoa, Italy
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20
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Mejri I, Ben Hmida L, Bedoui I, Znegui T, Kacem M, Moatemri Z, Derbali H, Jammeli S, Fekih Mrissa N. Parsonage-Turner syndrome of the brachial plexus secondary to COVID-19 vaccine: A case report. Clin Case Rep 2022; 10:e6483. [PMID: 36276907 PMCID: PMC9582668 DOI: 10.1002/ccr3.6483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/08/2022] Open
Abstract
Parsonage-Turner syndrome (PTS) is a peripheral inflammatory neuropathy of unknown etiology. We present a rare case of a 50-year-old male patient with PTS post-COVID-19 BNT162b2 mRNA vaccine. Symptoms occurred 15 days after the second dose. He was treated with corticosteroids, analgesics, and physical rehabilitation with a partial recovery.
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Affiliation(s)
- Islam Mejri
- Pneumology DepartmentMilitary Hospital of TunisTunisTunisia,Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Lenda Ben Hmida
- Pneumology DepartmentMilitary Hospital of TunisTunisTunisia,Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Ines Bedoui
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia,Neurology DepartmentMilitary Hospital of TunisTunisTunisia
| | - Tasnim Znegui
- Pneumology DepartmentMilitary Hospital of TunisTunisTunisia,Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Maroua Kacem
- Pneumology DepartmentMilitary Hospital of TunisTunisTunisia,Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Zied Moatemri
- Pneumology DepartmentMilitary Hospital of TunisTunisTunisia,Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Hajer Derbali
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia,Neurology DepartmentMilitary Hospital of TunisTunisTunisia
| | - Samia Jammeli
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia,Department of RheumatologyRabta HospitalTunisTunisia
| | - Nejiba Fekih Mrissa
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia,Molecular Biology Unit (UR17DN06), Laboratory of HematologyMilitary Hospital of TunisTunisTunisia
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21
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Parsonage-Turner syndrome after SARS-CoV-2 vaccination: A case report. Turk J Phys Med Rehabil 2022; 68:418-421. [DOI: 10.5606/tftrd.2022.10456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
Parsonage-Turner syndrome is a neurological disease characterized by pain, muscle weakness, sensory deficits, and reflex abnormalities. Although its exact etiology is unknown, it can be observed after infection, surgery, trauma, and vaccination. This syndrome, which can occur after various vaccines, has been reported in a few cases worldwide after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. In this case report, Parsonage-Turner syndrome developed after the SARS-CoV-2 BioNTech vaccination in a 56-year-old male patient. To the best of our knowledge, this is the first case reported in Türkiye.
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22
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Safety of COVID-19 Vaccines: Spotlight on Neurological Complications. Life (Basel) 2022; 12:life12091338. [PMID: 36143376 PMCID: PMC9502976 DOI: 10.3390/life12091338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/21/2022] Open
Abstract
The COVID-19 pandemic has led to unprecedented demand on the global healthcare system. Remarkably, at the end of 2021, COVID-19 vaccines received approvals for human use in several countries worldwide. Since then, a solid base for response in the fight against the virus has been placed. COVID-19 vaccines have been shown to be safe and effective drugs. Nevertheless, all kinds of vaccines may be associated with the possible appearance of neurological complications, and COVID-19 vaccines are not free from neurological side effects. Neurological complications of COVID-19 vaccination are usually mild, short-duration, and self-limiting. However, severe and unexpected post-vaccination complications are rare but possible events. They include the Guillain-Barré syndrome, facial palsy, other neuropathies, encephalitis, meningitis, myelitis, autoimmune disorders, and cerebrovascular events. The fear of severe or fatal neurological complications fed the “vaccine hesitancy” phenomenon, posing a vital communication challenge between the scientific community and public opinion. This review aims to collect and discuss the frequency, management, and outcome of reported neurological complications of COVID-19 vaccines after eighteen months of the World Health Organization’s approval of COVID-19 vaccination, providing an overview of safety and concerns related to the most potent weapon against the SARS-CoV-2.
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23
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Jacob S, Kapadia R, Soule T, Luo H, Schellenberg KL, Douville RN, Pfeffer G. Neuromuscular Complications of SARS-CoV-2 and Other Viral Infections. Front Neurol 2022; 13:914411. [PMID: 35812094 PMCID: PMC9263266 DOI: 10.3389/fneur.2022.914411] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022] Open
Abstract
In this article we review complications to the peripheral nervous system that occur as a consequence of viral infections, with a special focus on complications of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). We discuss neuromuscular complications in three broad categories; the direct consequences of viral infection, autoimmune neuromuscular disorders provoked by viral infections, and chronic neurodegenerative conditions which have been associated with viral infections. We also include discussion of neuromuscular disorders that are treated by immunomodulatory therapies, and how this affects patient susceptibility in the current context of the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is associated with direct consequences to the peripheral nervous system via presumed direct viral injury (dysgeusia/anosmia, myalgias/rhabdomyolysis, and potentially mononeuritis multiplex) and autoimmunity (Guillain Barré syndrome and variants). It has important implications for people receiving immunomodulatory therapies who may be at greater risk of severe outcomes from COVID-19. Thus far, chronic post-COVID syndromes (a.k.a: long COVID) also include possible involvement of the neuromuscular system. Whether we may observe neuromuscular degenerative conditions in the longer term will be an important question to monitor in future studies.
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Affiliation(s)
- Sarah Jacob
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ronak Kapadia
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tyler Soule
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Honglin Luo
- Centre for Heart and Lung Innovation, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kerri L. Schellenberg
- Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Renée N. Douville
- Division of Neurodegenerative Disorders, Department of Biology, Albrechtsen St. Boniface Research Centre, University of Winnipeg, Winnipeg, MB, Canada
| | - Gerald Pfeffer
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Medical Genetics, Alberta Child Health Research Institute, University of Calgary, Calgary, AB, Canada
- *Correspondence: Gerald Pfeffer
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24
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Amjad MA, Hamid Z, Patel Y, Husain M, Saddique A, Liaqat A, Ochieng P. COVID-19 Vaccine-Induced Parsonage-Turner Syndrome: A Case Report and Literature Review. Cureus 2022; 14:e25493. [PMID: 35783889 PMCID: PMC9242527 DOI: 10.7759/cureus.25493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 11/05/2022] Open
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25
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Associations and Disease–Disease Interactions of COVID-19 with Congenital and Genetic Disorders: A Comprehensive Review. Viruses 2022; 14:v14050910. [PMID: 35632654 PMCID: PMC9146233 DOI: 10.3390/v14050910] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 02/06/2023] Open
Abstract
Since December 2019, the COVID-19 pandemic, which originated in Wuhan, China, has resulted in over six million deaths worldwide. Millions of people who survived this SARS-CoV-2 infection show a number of post-COVID complications. Although, the comorbid conditions and post-COVID complexities are to some extent well reviewed and known, the impact of COVID-19 on pre-existing congenital anomalies and genetic diseases are only documented in isolated case reports and case series, so far. In the present review, we analyzed the PubMed indexed literature published between December 2019 and January 2022 to understand this relationship from various points of view, such as susceptibility, severity and heritability. Based on our knowledge, this is the first comprehensive review on COVID-19 and its associations with various congenital anomalies and genetic diseases. According to reported studies, some congenital disorders present high-risk for developing severe COVID-19 since these disorders already include some comorbidities related to the structure and function of the respiratory and cardiovascular systems, leading to severe pneumonia. Other congenital disorders rather cause psychological burdens to patients and are not considered high-risk for the development of severe COVID-19 infection.
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26
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Chua MMJ, Hayes MT, Cosgrove R. Parsonage-Turner syndrome following COVID-19 vaccination and review of the literature. Surg Neurol Int 2022; 13:152. [PMID: 35509574 PMCID: PMC9062946 DOI: 10.25259/sni_4_2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/01/2022] [Indexed: 12/22/2022] Open
Abstract
Background Parsonage-Turner syndrome (PTS) is a rare brachial plexopathy characterized by self-limiting shoulder girdle and upper arm pain followed by the upper extremity weakness and sensory changes. While the etiology is not well-understood, the most common cause of PTS is thought to be postviral. There are at least nine reports, to the best of our knowledge, of PTS associated with COVID-19 infection and nine reports associated with COVID-19 vaccination. Case Description Here, we present a case of PTS after COVID-19 vaccination in a 64-year-old male and a review of the current literature. Conclusion PTS can occur post-COVID-19 vaccination and should be on the differential diagnosis when patient continues to experience shoulder pain and develops weakness or sensory changes in the extremity.
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Affiliation(s)
- Melissa Ming Jie Chua
- Departments of Neurosurgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Michael T. Hayes
- Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Rees Cosgrove
- Departments of Neurosurgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States
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27
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Min YG, Kim JE, Hwang JY, Shin JY, Sung JJ, Hong YH. Parsonage-Turner syndrome following COVID-19 vaccination. J Neurol Neurosurg Psychiatry 2022; 93:jnnp-2021-328182. [PMID: 35387865 PMCID: PMC9606495 DOI: 10.1136/jnnp-2021-328182] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/23/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Young Gi Min
- Neurology, Seoul National University Hospital, Seoul, South Korea
- Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Jee-Eun Kim
- Neurology, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Ji Young Hwang
- Radiology, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Je-Young Shin
- Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Jung-Joon Sung
- Neurology, Seoul National University Hospital, Seoul, South Korea
- Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Yoon-Ho Hong
- Neurology, Neuroscience Research Institute, Medical Research Council, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
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28
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Elasomeran/tozinameran. REACTIONS WEEKLY 2022. [PMCID: PMC9023661 DOI: 10.1007/s40278-022-13737-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Ghanta RB, Karistinos A, Atassi OH. Parsonage-Turner Syndrome After COVID-19 Vaccination: A Case Report. JBJS Case Connect 2022; 12:01709767-202206000-00038. [PMID: 37440679 DOI: 10.2106/jbjs.cc.21.00550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
CASE One week after receiving a COVID-19 vaccine in his left deltoid, a 34-year-old man developed severe right periscapular pain that lasted 2 weeks and was followed by profound right shoulder girdle atrophy and weakness. Both the pain and motor deficits resolved over the subsequent 4 months. CONCLUSION Parsonage-Turner syndrome (PTS) is an idiopathic brachial plexopathy that can develop in the setting of recent vaccination and lead to significant shoulder pain and weakness. Given the worldwide increase in newly vaccinated patients, orthopaedic surgeons should take detailed histories to identify potential triggers (recent vaccination or illness) that point toward PTS rather than musculoskeletal pathology.
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Affiliation(s)
- Ramesh B Ghanta
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX
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30
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Aliasin MM, Yazdanpanah N, Rezaei N. Neurological and neuropsychological adverse effects of SARS-CoV-2 vaccines - where do we stand? Rev Neurosci 2022; 33:721-743. [PMID: 35334195 DOI: 10.1515/revneuro-2022-0006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/14/2022] [Indexed: 12/30/2022]
Abstract
The devastating characteristic of COVID-19 pandemic calls for immediate and effective solutions to tackle it. Vaccines seem to be the only promising and effective way to fight against the novel coronavirus - even against new mutated variants. Because of the rapid development and distribution of numerous COVID-19 vaccines in different platforms, meticulous evaluation of vaccines' safety is more critical than ever - especially given the fact that most of the candidates have not completed the clinical phase. Therefore, to optimize the vaccines' safety and efficacy, it is highly important to carefully report and scientifically discuss the serious adverse effects following vaccination. In this respect, we discuss different neurological and neuropsychological adverse effects of COVID-19 vaccines including demyelinating diseases, Bell's palsy (BP), cerebrovascular complications, seizures, functional neurological disorders (FNDs), and some other rare adverse events, and hypothetical mechanisms which can lead to the reported side effects. Given the fact that the incidence of such events are rare and most of them are treatable, the current review aims to shed light on how much the relationship between COVID-19 vaccines and these complications can be reliable and provide an insight for future studies with much more meticulous methodologies to discuss the possible correlational or causal relationship between these complications and COVID-19 vaccines and elucidate whether or not the neurological side effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines can count as a considerable threat to public health.
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Affiliation(s)
- Mohammad Mahdi Aliasin
- School of Medicine, Tehran University of Medical Sciences, 14176 13151 Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, 14177 55331 Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), 14197 33151 Tehran, Iran
| | - Niloufar Yazdanpanah
- School of Medicine, Tehran University of Medical Sciences, 14176 13151 Tehran, Iran.,Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, 14197 33151 Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), 14197 33151 Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, 14197 33151 Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), 14197 33151 Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, 14176 13151 Tehran, Iran
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31
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Taga A, Lauria G. COVID-19 and the Peripheral Nervous System. A 2-year review from the pandemic to the vaccine era. J Peripher Nerv Syst 2022; 27:4-30. [PMID: 35137496 PMCID: PMC9115278 DOI: 10.1111/jns.12482] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 01/31/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
Increasing literature has linked COVID‐19 to peripheral nervous system (PNS) diseases. In addition, as we move from the pandemic to the vaccination era, literature interest is shifting towards the potential association between COVID‐19 vaccines and PNS manifestations. We reviewed published literature on COVID‐19, COVID‐19 vaccines and PNS manifestations between 1 January 2020 and 1 December 2021. For Guillain‐Barré syndrome (GBS), isolated cranial neuropathy (ICN) and myositis associated with COVID‐19, the demographic, clinical, laboratory, electrophysiological and imaging features were included in a narrative synthesis. We identified 169 studies on COVID‐19‐associated complications, including 63 papers (92 patients) on GBS, 29 papers (37 patients) on ICN and 11 papers (18 patients) on myositis. Additional clinical phenotypes included chronic inflammatory demyelinating polyneuropathy, vasculitic neuropathies, neuralgic amyotrophy, critical care‐related complications, and myasthenia gravis. PNS complications secondary to COVID‐19 vaccines have been reported during randomized clinical trials, in real‐world case reports, and during large‐scale surveillance programs. These mainly include cases of GBS, Bell's palsy, and cases of neuralgic amyotrophy. Based on our extensive review of the literature, any conclusion about a pathophysiological correlation between COVID‐19 and PNS disorders remains premature, and solely supported by their temporal association, while epidemiological and pathological data are insufficient. The occurrence of PNS complications after COVID‐19 vaccines seems limited to a possible higher risk of facial nerve palsy and GBS, to a degree that widespread access to the ongoing vaccination campaign should not be discouraged, while awaiting for more definitive data from large‐scale surveillance studies.
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Affiliation(s)
- Arens Taga
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Giuseppe Lauria
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan.,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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32
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Rochoy M, Billy E, Clarot F, Dumortier V, Gautier S, Barus R. Cluster headache after COVID-19 vaccination with Comirnaty: A signal in pharmacovigilance database. Therapie 2022; 77:753-754. [PMID: 35599191 PMCID: PMC9119780 DOI: 10.1016/j.therap.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/16/2022] [Accepted: 03/29/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Michaël Rochoy
- University of Lille, CHU de Lille, OULR 2964-METRICS, CERIM, departement de médecine générale, 59000 Lille, France,Collectif Du Côté de la Science, France,University of Lille, centre régional de pharmacovigilance, service de pharmacologie médicale, CHU de Lille, 59000 Lille, France,Corresponding author. 20, rue André-Pantigny, 62230 Outreau, France
| | | | | | - Victor Dumortier
- University of Lille, centre régional de pharmacovigilance, service de pharmacologie médicale, CHU de Lille, 59000 Lille, France
| | - Sophie Gautier
- University of Lille, centre régional de pharmacovigilance, service de pharmacologie médicale, CHU de Lille, 59000 Lille, France
| | - Romain Barus
- University of Lille, centre régional de pharmacovigilance, service de pharmacologie médicale, CHU de Lille, 59000 Lille, France
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33
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Sharma R, Dua B, Goyal S, Tiwari T. Parsonage-Turner Syndrome Following COVID-19 Vaccine. Ann Indian Acad Neurol 2022; 25:973-975. [PMID: 36561007 PMCID: PMC9764886 DOI: 10.4103/aian.aian_354_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Rajaram Sharma
- Department of Radiodiagnosis, Pacific Institute of Medical Sciences (PIMS), Umarda, Udaipur, Rajasthan, India,Address for correspondence: Dr. Rajaram Sharma, Pacific Institute of Medical Sciences (PIMS), Umarda, Udaipur-313 001, Rajasthan, India. E-mail:
| | - Bhumika Dua
- Department of Radiodiagnosis, Pacific Institute of Medical Sciences (PIMS), Umarda, Udaipur, Rajasthan, India
| | - Saurabh Goyal
- Department of Radiodiagnosis, Pacific Institute of Medical Sciences (PIMS), Umarda, Udaipur, Rajasthan, India
| | - Tapendra Tiwari
- Department of Radiodiagnosis, Pacific Institute of Medical Sciences (PIMS), Umarda, Udaipur, Rajasthan, India
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34
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Sharma A, Gupta A. A Rare Case of Brachial Plexus Neuropraxia After COVID-19 Vaccination. Cureus 2022; 14:e21244. [PMID: 35186534 PMCID: PMC8844251 DOI: 10.7759/cureus.21244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/28/2022] Open
Abstract
The brachial plexus injury is a rare complication after vaccination like that of the Influenza virus. Though a well-known and reported complication, there is still a dearth of literature mentioning its pathophysiology, the trend of involvement, symptoms, and treatment. This has also been reported after the coronavirus disease 2019 (COVID-19) vaccination. To the best of our knowledge, to date, only four cases have been reported so far. Every case needs to be reported to better understand the complication and formulate a line of management for better outcomes. We report a case of brachial plexus involvement after Covishield vaccination with complete recovery after treatment.
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Affiliation(s)
- Aditya Sharma
- Orthopedics and Trauma, Max Super Speciality Hospital, Ghaziabad, IND
| | - Anuj Gupta
- Spine Surgery, Max Super Speciality Hospital, Ghaziabad, IND
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35
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Sriwastava S, Shrestha AK, Khalid SH, Colantonio MA, Nwafor D, Srivastava S. Spectrum of Neuroimaging Findings in Post-COVID-19 Vaccination: A Case Series and Review of Literature. Neurol Int 2021; 13:622-639. [PMID: 34842783 PMCID: PMC8628885 DOI: 10.3390/neurolint13040061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in Wuhan, China in December 2019. Symptoms range from mild flu-like symptoms to more severe presentations, including pneumonia, acute respiratory distress syndrome (ARDS), and even death. In response to the COVID-19 pandemic, the Emergency Use Authorization (EUA) approved the use of several vaccines. Because vaccines have been fast-tracked for emergency use, the short and long-term safety profile has been an area of concern. The aim of this paper is to extensively review published literature regarding post-COVID-19 vaccination neurological complications and characterize neuroimaging findings from three case presentations for early diagnosis and treatment. Methods: The analysis includes data from PubMed and Google Scholar. Articles included were retrieved from database inception beginning December 2020 with no language restrictions. Terms used include "SARS-CoV-2", "post Covid vaccination", "neurological complications", "Guillain-barre Syndrome", "Transverse-myelitis", "Cerebral Venous Sinus thrombosis", and "Cerebral hemorrhage". Results: The literature review yielded several neurological complications post vaccination, including cerebral sinus venous thrombosis, transverse myelitis, Guillain-Barré Syndrome and optic neuritis, to name a few. Patient case presentation findings were consistent with documented results in published literature. Conclusions: We present a case series with a thorough literature review documenting adverse neurological affects following COVID-19 vaccination. Our case presentations and literature review highlight the importance of neuroimaging when diagnosing post-COVID-19 vaccination adverse effects. MRI imaging study is an important tool to be considered in patients presenting with post-COVID-19 vaccination-related unexplained neurological symptoms for accurate diagnosis.
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Affiliation(s)
- Shitiz Sriwastava
- Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA;
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (M.A.C.); (D.N.)
- West Virginia Clinical and Translational Science Institute, Morgantown, WV 26506, USA
- Department of Neurology, Wayne State University, Detroit, MI 48201, USA;
- Correspondence:
| | | | - Syed Hassan Khalid
- Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA;
| | - Mark A. Colantonio
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (M.A.C.); (D.N.)
| | - Divine Nwafor
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (M.A.C.); (D.N.)
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