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Zuhorn F, Graf T, Klingebiel R, Schäbitz WR, Rogalewski A. Postvaccinal Encephalitis after ChAdOx1 nCov-19. Ann Neurol 2021; 90:506-511. [PMID: 34324214 PMCID: PMC8426979 DOI: 10.1002/ana.26182] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 11/11/2022]
Abstract
The global SARS-CoV-2 pandemic has contributed to more than 163 million confirmed infections and 3.3 million deaths worldwide. The severity of the pandemic has led to an unprecedented effort to develop multiple effective vaccines. Due to excellent safety and efficacy data from clinical trials, several vaccines were approved. We report a case series of postvaccinal encephalitis in temporal correlation to vaccination with ChAdOx1 nCov-19. The diagnostic criteria for possible autoimmune encephalitis were fulfilled. Our patients responded well to immunosuppressive therapy with corticosteroids. The incidence has been estimated to be approximately 8 per 10 million vaccine doses. Complication of postvaccinal encephalitis after ChAdOx1 nCoV-19 vaccination still appear to be very rare, but need to be diagnosed and treated adequately. Large pooled data from observational epidemiologic studies are necessary to verify causality. ANN NEUROL 2021.
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Affiliation(s)
- Frédéric Zuhorn
- Department of Neurology, University Hospital OWL of the University Bielefeld, Bielefeld, Germany
| | - Tilmann Graf
- Department of Neurology, University Hospital OWL of the University Bielefeld, Bielefeld, Germany
| | - Randolf Klingebiel
- Department of Neuroradiology, University Hospital OWL of the University Bielefeld, Bielefeld, Germany
| | - Wolf-Rüdiger Schäbitz
- Department of Neurology, University Hospital OWL of the University Bielefeld, Bielefeld, Germany
| | - Andreas Rogalewski
- Department of Neurology, University Hospital OWL of the University Bielefeld, Bielefeld, Germany
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Torrealba-Acosta G, Martin JC, Huttenbach Y, Garcia CR, Sohail MR, Agarwal SK, Wasko C, Bershad EM, Hirzallah MI. Acute encephalitis, myoclonus and Sweet syndrome after mRNA-1273 vaccine. BMJ Case Rep 2021; 14:14/7/e243173. [PMID: 34312136 PMCID: PMC8314742 DOI: 10.1136/bcr-2021-243173] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
A patient presented with fever, generalised rash, confusion, orofacial movements and myoclonus after receiving the first dose of mRNA-1273 vaccine from Moderna. MRI was unremarkable while cerebrospinal fluid showed leucocytosis with lymphocyte predominance and hyperproteinorrachia. The skin evidenced red, non-scaly, oedematous papules coalescing into plaques with scattered non-follicular pustules. Skin biopsy was consistent with a neutrophilic dermatosis. The patient fulfilled the criteria for Sweet syndrome. A thorough evaluation ruled out alternative infectious, autoimmune or malignant aetiologies, and all manifestations resolved with glucocorticoids. While we cannot prove causality, there was a temporal correlation between the vaccination and the clinical findings.
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Affiliation(s)
| | - Jennifer C Martin
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
| | - Yve Huttenbach
- Department of Dermatopathology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Muhammad R Sohail
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Sandeep Krishna Agarwal
- Department of Medicine, Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas, USA
| | - Carina Wasko
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
| | - Eric M Bershad
- Neurology, Baylor College of Medicine, Houston, Texas, USA
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Paredes-Ebratt ÁM, Espinosa-García ET. Síndrome de Kinsbourne: reporte de un caso. IATREIA 2017. [DOI: 10.17533/udea.iatreia.v30n1a08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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