ABSTRACT
We report a 71-year-old woman who presented with paresthesia, progressive weakness, difficulty walking, diarrhea, and bladder dysfunction one week after she received the BNT162b2 COVID-19 vaccine. Her neurological signs and symptoms gradually worsened up to 27 days after onset, after which her weakness slowly improved without immunotherapy. Analysis of serial cerebrospinal fluid specimens showed gradually increasing protein levels. Results of a nerve conduction study suggested functional axonal disturbance. The clinical findings together with the monophasic clinical course were consistent with Guillain-Barré syndrome. Her previous history was negative for symptomatic infection. Serological and bacterial tests, including the presence of anti-glycolipid antibodies, were negative for prior infection. Few cases have been reported on the development of Guillain-Barré syndrome after the BNT162b2 vaccine. Our patient's syndrome was characterized by atypical proximal weakness of the dominant lower limb. (Received January 28, 2022; Accepted April 4, 2022; Published August 1, 2022).
Subject(s)
COVID-19 , Guillain-Barre Syndrome , Aged , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/etiology , Humans , RNA, Messenger , Vaccines, Synthetic , mRNA VaccinesABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease (COVID-19) were reported to originate from Wuhan, China, in December 2019, spreading rapidly worldwide. With the emergence of this pandemic, an increasing number of cases of Guillain-Barré syndrome (GBS) have been reported following this infection. Most patients had a demyelinating subtype of GBS. The time interval between infectious and neuropathic symptoms, absence of cerebrospinal fluid pleocytosis, and negative polymerase chain reaction test result support a postinfectious mechanism. Skeletal muscle injury presents as muscle pain and elevated serum creatine kinase level in patients with COVID-19. Some patients developed several myopathic manifestations, including new-onset inflammatory myopathy. Muscle injury is caused by direct SARS-CoV-2 infection or through parainfectious mechanisms such as type I interferonopathy.
Subject(s)
COVID-19 , Guillain-Barre Syndrome , COVID-19/complications , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/etiology , Humans , Myalgia/complications , Pandemics , SARS-CoV-2ABSTRACT
Severe acute respiratory syndrome-correlated new coronavirus (SARS-Cov-2) continues to spread rapidly around the world. Reports regarding the neuropathy and myopathy associated with SARS-Cov-2 increase everyday. SARS-Cov-2 infection may result in peripheral neuropathy and myopathy, although direct infection of the peripheral nerve and muscle by SARS-Cov-2 is exceedingly rare. When initiating clinical treatment for COVID-19, it is crutial to distinguish the peripheral neuropathy or myopathy caused directly or indirectly by SARS-Cov-2 from those caused by other conditions. In this review, we aimed to report the peripheral nerve and muscle disorders associated with SARS-Cov-2 and their possible underlying pathophysiological mechanisms.