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1.
Medicine (Baltimore) ; 101(6): e28758, 2022 Feb 11.
Article in English | MEDLINE | ID: covidwho-1708012

ABSTRACT

RATIONALE: Sleep disturbance is commonly noted after Guillain-Barré syndrome (GBS) and is often caused by persistent discomfort after disease survival. Intravascular laser irradiation of blood (ILIB) has been shown to be effective in pain modulation owing to the influence of nociceptive signals in the peripheral nervous system. We investigated the application of ILIB on post-Oxford -AstraZeneca vaccination GBS and evaluated its effect on sleep quality. PATIENT CONCERNS: A 48-year-old woman was subsequently diagnosed with GBS after Oxford-AstraZeneca vaccination. The patient was discharged after a 5-day course of intravenous immunoglobulin administration. However, 1 week after discharge, the previously relieved symptoms flared with accompanying sleep disturbance. DIAGNOSIS AND INTERVENTIONS: The patient was diagnosed with post-vaccination GBS, and persistent pain and sleep disturbances persisted after disease survival. ILIB was performed. OUTCOMES: We used the Pittsburgh Sleep Quality Index before and after intravascular laser irradiation. There was a marked improvement in the sleep duration, efficiency, and overall sleep quality. The initial score was 12 out of 21 and the final score was 7 out of 21. LESSONS: We found that ILIB was effective in pain modulation in post-vaccination GBS and significantly improved sleep quality.


Subject(s)
/adverse effects , Guillain-Barre Syndrome/chemically induced , Low-Level Light Therapy , Sleep Wake Disorders/therapy , COVID-19 Vaccines , Female , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/drug therapy , Humans , Immunoglobulins, Intravenous/administration & dosage , Immunoglobulins, Intravenous/therapeutic use , Middle Aged , Pain , Sleep , Sleep Wake Disorders/etiology , Vaccination/adverse effects
4.
Hum Vaccin Immunother ; 17(11): 4093-4096, 2021 Nov 02.
Article in English | MEDLINE | ID: covidwho-1621461

ABSTRACT

Guillain-Barre syndrome (GBS) is an acute immune-mediated disease of the peripheral nerves and nerve roots (polyradiculoneuropathy) that is usually elicited by various infections. We present a case of GBS after receiving the second dose of Pfizer-COVID 19 vaccine. Diagnosis was made after performing an accurate clinical examination, electromyoneurography and laboratory tests. In particular, anti-ganglioside antibodies have tested positive. During this pandemic with ongoing worldwide mass vaccination campaign, it is critically important for clinicians to rapidly recognize neurological complications or other side effects associated with COVID-19 vaccination.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , COVID-19 Vaccines , Guillain-Barre Syndrome/chemically induced , Guillain-Barre Syndrome/diagnosis , Humans , Laboratories , SARS-CoV-2
5.
Indian J Public Health ; 65(4): 422-424, 2021.
Article in English | MEDLINE | ID: covidwho-1603912

ABSTRACT

Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating disorder of the peripheral nerve. Different variants of GBS can produce a wide array of symptoms among which motor weakness, areflexia without bladder-bowel involvement are commonly encountered. ChAdOx1 nCoV-19 is a recombinant Corona Virus Vaccine and it is incorporated into India's coronavirus disease-2019 (COVID-19) vaccination program. Few rare instances of serious neurological complications have been reported following COVID-19 vaccination. Our case received 2 dose of COVID-19 vaccine. After receiving 1st dose he had rapid onset of ascending paralysis without any sensory and bladder bowel involvement. He received Intra Venous Immuno Globulin and Injection prednisolone for 5 days. Following that his lower limb weakness resolved rapidly but there was no improvement in upper limb weakness. Nerve conduction study showed demyelinating etiology and along with clinical features, it was appeared to be a case of GBS. However, more evidence is needed before establishing the causal relationship between COVID-19 vaccines and GBS.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , COVID-19 Vaccines , Guillain-Barre Syndrome/chemically induced , Humans , India , Male , SARS-CoV-2 , Vaccination
7.
BMJ Case Rep ; 14(11)2021 Nov 30.
Article in English | MEDLINE | ID: covidwho-1546480

ABSTRACT

We describe a patient who developed bilateral oculomotor nerve palsy, ataxia, facial diplegia and lower limb weakness 2 weeks post-Oxford-AstraZeneca SARS-CoV2 vaccination, consistent with Miller-Fisher syndrome (MFS) and Guillain-Barre syndrome (GBS) overlap syndrome. Although some features of the patient's presentation were typical of recently reported cases of a rare GBS variant post-Oxford-AstraZeneca vaccination, including severe facial weakness and a lack of respiratory involvement, to our knowledge this is the first reported case of MFS associated with SARS-CoV2 vaccination. While postvaccination GBS remains rare, it appears to have a favourable prognosis, and recognising this entity is therefore important for patient counselling and monitoring for potential complications.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Miller Fisher Syndrome , COVID-19 Vaccines , Guillain-Barre Syndrome/chemically induced , Guillain-Barre Syndrome/diagnosis , Humans , Miller Fisher Syndrome/chemically induced , Miller Fisher Syndrome/diagnosis , RNA, Viral , SARS-CoV-2 , Vaccination
8.
Acta Medica (Hradec Kralove) ; 64(3): 183-186, 2021.
Article in English | MEDLINE | ID: covidwho-1543015

ABSTRACT

A number of neurological complications have been reported after the administration of flu vaccine, including Guillain-Barré syndrome (GBS), especially after vaccination against swine flu. Only facial nerve neuropathy has thus far been reported after vaccination against COVID-19. More recently, there was a case of an elderly woman with GBS. In our report, we describe a case of a 42-year-old, previously almost healthy male who developed sensory symptoms 14 days after the first dose of Pfizer vaccine. One week later, the patient developed right facial nerve palsy and lower limb weakness and was no longer able to walk. Albuminocytological dissociation was detected in the cerebrospinal fluid, and there were inflammatory radicular changes in MRI scans of the lumbosacral spine. EMG indicated significant demyelinating polyradiculoneuritis and no antibodies against gangliosides were demonstrated. A 5-day course of immunoglobulins at a dose of 2 g/kg lead to a significant improvement and the patient was soon able to walk. In conclusion, we report a case of Guillan-Barré syndrome after COVID-19 vaccine in a young patient with a rapid diagnosis and prompt administration of immunoglobulins.


Subject(s)
COVID-19 Vaccines , COVID-19 , Guillain-Barre Syndrome , Aged , COVID-19 Vaccines/adverse effects , Guillain-Barre Syndrome/chemically induced , Humans , Male , SARS-CoV-2 , Vaccination/adverse effects
10.
Neurol Sci ; 43(2): 755-761, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1525541

ABSTRACT

BACKGROUND: Since the SARS-CoV-2 pandemic has started in December 2019, millions of people have been infected all over the world. Vaccination is the most efficient tool to end this pandemic, but vaccine surveillance is necessary to identify side effects. Some studies have shown that neurological complications after COVID-19 vaccination are rare and dominated by demyelinating disease. CASE PRESENTATION: We present a case of a 67-year-old man who presented 7 days following his first dose of Pfizer-BioNTech COVID-19 vaccine a rapidly progressive ascending muscle weakness. The diagnosis of Guillain-Barré syndrome (GBS) was confirmed according to the clinical features, the albumino-cytological dissociation in the cerebrospinal fluid, and the electroneuromyography findings. The workup for all known infections associated with immune-mediated GBS was negative. The patient received treatment with intravenous immunoglobulin. Neurological examination 1 month after discharge showed full recovery and he regained his baseline functional status. CONCLUSIONS: As far as we know, this is the first reported case in Tunisia. Although extremely rare, neurologists should remain vigilant for acute inflammatory demyelinating polyradiculoneuropathy after COVID-19 vaccination.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Aged , COVID-19 Vaccines , Guillain-Barre Syndrome/chemically induced , Humans , Male , SARS-CoV-2
11.
Muscle Nerve ; 65(2): 233-237, 2022 02.
Article in English | MEDLINE | ID: covidwho-1520266

ABSTRACT

INTRODUCTION/AIMS: We aimed to determine whether specific severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccines may be associated with acute-onset polyradiculoneuropathy and if they may result in particular clinical presentations. METHODS: We retrospectively reviewed records of all persons presenting with acute-onset polyradiculoneuropathy from January 1, 2021, to June 30, 2021, admitted to two Neuroscience centers, of the West and North Midlands, United Kingdom. We compared subjects with previous SARS-CoV2 vaccine exposure with a local cohort of persons with acute-onset polyradiculoneuropathy admitted between 2005 and 2019 and compared admission numbers for the studied time frame with that of the previous 3 years. RESULTS: Of 24 persons with acute-onset polyradiculoneuropathy, 16 (66.7%) presented within 4 weeks after first SARS-CoV2 vaccine. Fourteen had received the AstraZeneca vaccine and one each, the Pfizer and Moderna vaccines. The final diagnosis was Guillain-Barré syndrome (GBS) in 12 and acute-onset chronic inflammatory demyelinating polyneuropathy in 4. Among AstraZeneca vaccine recipients, facial weakness in nine persons (64.3%), bulbar weakness in seven (50%), and the bifacial weakness and distal paresthesias GBS variant in three (21.4%), were more common than in historical controls (P = .01; P = .004, and P = .002, respectively). A 2.6-fold (95% confidence interval: 1.98-3.51) increase in admissions for acute-onset polyradiculoneuropathy was noted during the studied time frame, compared to the same period in the previous 3 years. DISCUSSION: Despite a low risk, smaller than that of SARS-CoV2 infection and its complications, exposure to the first dose of AstraZeneca SARS-CoV2 vaccine may be a risk factor for acute-onset polyradiculoneuropathy, characterized by more common cranial nerve involvement.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19 , Guillain-Barre Syndrome , Polyradiculoneuropathy , COVID-19/prevention & control , Guillain-Barre Syndrome/chemically induced , Guillain-Barre Syndrome/epidemiology , Humans , Polyradiculoneuropathy/chemically induced , Polyradiculoneuropathy/epidemiology , Retrospective Studies , United Kingdom
13.
J Neuroimmunol ; 360: 577719, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1492308

ABSTRACT

The emergence of the coronavirus 2019 (COVID-19) pandemic has presented an unprecedented global challenge. Vaccines against COVID have been developed to date. Covid-19 has been linked with the development of Guillain-Barre Syndrome (GBS), a rare immune-mediated demyelinating neuropathy. We report three cases of Guillain-Barre Syndrome and one case of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), presenting to a Tasmanian hospital, and review 15 other reported cases and discuss likely immunopathology. Nearly all reported cases of post-COVID-19 vacciation inflammatory demyelinating polyneuropathy are linked to AstraZeneca vaccination and a variant with bifacial weakness is the most reported form of GBS globally.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Guillain-Barre Syndrome/chemically induced , Guillain-Barre Syndrome/diagnosis , Aged , COVID-19/epidemiology , Female , Guillain-Barre Syndrome/epidemiology , Humans , Male , Middle Aged , Tasmania/epidemiology
14.
BMJ Case Rep ; 14(10)2021 Oct 14.
Article in English | MEDLINE | ID: covidwho-1470501

ABSTRACT

In March 2020, the WHO declared COVID-19 to be a global pandemic and since December 2020, millions of vaccines have been administered. To date, cases of Guillain-Barré syndrome (GBS) following a COVID vaccine (Pfizer, Johnson & Johnson, Janssen, AstraZeneca) have been reported. A 61-year-old woman developed bilateral asymmetrical lower motor neuron (LMN) facial weakness followed by limb symptoms, 10 days after receiving the first dose of AstraZeneca COVID vaccine. The second patient was a 56-year-old man who, 9 days after receiving first dose of AstraZeneca COVID vaccine, developed bilateral asymmetrical LMN facial weakness with limb symptoms. Intravenous immunoglobulin was administered with rapid recovery. These cases of GBS following the AstraZeneca COVID vaccine add to cohort of patients reported. We flag up to raise awareness of this condition post-COVID-19 vaccine and highlight the prominent bifacial involvement. Early diagnosis and prompt treatment with intravenous immunoglobulin led to rapid recovery.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , COVID-19 Vaccines , Female , Guillain-Barre Syndrome/chemically induced , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/drug therapy , Humans , Male , Middle Aged , SARS-CoV-2 , Vaccination/adverse effects
15.
Clin Microbiol Infect ; 28(1): 130-134, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1439954

ABSTRACT

OBJECTIVE: The Pfizer BNT162b2 vaccine showed a reassuring safety profile in clinical trials, but real-world data are scarce. Bell's palsy, herpes zoster, Guillain-Barré syndrome (GBS) and other neurological complaints in proximity to vaccination have received special public attention. We compared their rates among vaccinated and unvaccinated individuals. METHODS: Individuals ≥16 years vaccinated with at least one dose of BNT162b2 were eligible for this historical cohort study in a health maintenance organization insuring 1.2 million citizens. Each vaccinee was matched to a non-vaccinated control by sex, age, population sector (general Jewish, Arab, ultra-orthodox Jewish) and comorbidities. Diagnosis of Covid-19 before or after vaccination was an exclusion criterion. The outcome was a diagnosis of Bell's palsy, GBS, herpes zoster or symptoms of numbness or tingling, coded in the visit diagnosis field using ICD-9 codes. Diagnoses of Bell's palsy and GBS were verified by individual file review. RESULTS: Of 406 148 individuals vaccinated during the study period, 394 609 (97.2%) were eligible (11 539 excluded). A total of 233 159 (59.1%) were matched with unvaccinated controls. Mean follow was 43 ± 15.14 days. In vaccinated and unvaccinated individuals there were 23 versus 24 cases of Bell's palsy (RR 0.96, CI 0.54-1.70), one versus zero cases of GBS, 151 versus 141 cases of herpes zoster (RR 1.07, CI 0.85-1.35) and 605 versus 497 cases of numbness or tingling (RR 1.22, CI 1.08-1.37), respectively. DISCUSSION: No association was found between vaccination, Bell's palsy, herpes zoster or GBS. Symptoms of numbness or tingling were more common among vaccinees. This study adds reassuring data regarding the safety of the BNT162b2 vaccine.


Subject(s)
/adverse effects , Bell Palsy , COVID-19 , Guillain-Barre Syndrome , Herpes Zoster , Hypesthesia , Bell Palsy/chemically induced , COVID-19/prevention & control , Cohort Studies , Guillain-Barre Syndrome/chemically induced , Herpes Zoster/chemically induced , Humans , Hypesthesia/chemically induced
16.
Ideggyogy Sz ; 74(7-08): 286-288, 2021 Jul 30.
Article in English | MEDLINE | ID: covidwho-1399690

ABSTRACT

Introduction - Coronavirus disease 2019 (COVID-19) is a respiratory infection that has rapidly become a global pandemic and vaccines against SARS-CoV-2 have been developed with great success. In this article, we would like to present a patient who developed Guillain-Barré syndrome (GBS), which is a serious complication after receiving the inactive SARS-CoV-2 vaccine (CoronaVac). Case report - A 76-year-old male patient presented to the emergency department with nine days of progressive limb weakness. Two weeks prior to admission, he received the second dose of CoronaVac vaccine. Motor examination revealed decreased extremity strength with 3/5 in the lower extremities versus 4/5 in the upper extremities. Deep tendon reflexes were absent in all four extremities. Nerve conduction studies showed predominantly reduced amplitude in both motor and sensory nerves, consistent with AMSAN (acute motor and sensory axonal neuropathy). Conclusion - Clinicians should be aware of the neuro-logical complications or other side effects associated with COVID-19 vaccination so that early treatment can be an option.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Aged , COVID-19 Vaccines , Guillain-Barre Syndrome/chemically induced , Humans , Male , SARS-CoV-2 , Vaccination/adverse effects
18.
J Neuroimmunol ; 359: 577691, 2021 10 15.
Article in English | MEDLINE | ID: covidwho-1347721

ABSTRACT

Massive vaccination against COVID-19 has become a global priority. Simultaneously, concerns regarding the safety of vaccines are growing. We describe two patients who developed sensory Guillain-Barre syndrome (GBS) shortly after the first dose of the ChAdOx1 vaccine. We also summarize 12 published cases of GBS after ChAdOx1 vaccination, highlighting their unique clinical and paraclinical features. We propose a possible association between the risk of GBS and the ChAdOx1 vaccine and recommend surveillance for GBS following vaccination. Population-based studies are needed to determine causality and whether specific subpopulations are susceptible.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Guillain-Barre Syndrome/chemically induced , Guillain-Barre Syndrome/diagnostic imaging , Adult , Female , Humans , Male , Middle Aged
19.
Ann Neurol ; 90(2): 315-318, 2021 08.
Article in English | MEDLINE | ID: covidwho-1330296

ABSTRACT

Although SARS-CoV-2 vaccines are very safe, we report 4 cases of the bifacial weakness with paresthesias variant of Guillain-Barré syndrome (GBS) occurring within 3 weeks of vaccination with the Oxford-AstraZeneca SARS-CoV-2 vaccine. This rare neurological syndrome has previously been reported in association with SARS-CoV-2 infection itself. Our cases were given either intravenous immunoglobulin, oral steroids, or no treatment. We suggest vigilance for cases of bifacial weakness with paresthesias variant GBS following vaccination for SARS-CoV-2 and that postvaccination surveillance programs ensure robust data capture of this outcome, to assess for causality. ANN NEUROL 2021;90:315-318.


Subject(s)
COVID-19 Vaccines/adverse effects , Guillain-Barre Syndrome/chemically induced , Guillain-Barre Syndrome/diagnosis , COVID-19 Vaccines/administration & dosage , Glucocorticoids/administration & dosage , Guillain-Barre Syndrome/drug therapy , Humans , Immunoglobulins, Intravenous/administration & dosage , Male , Middle Aged , Prednisolone/administration & dosage , Vaccination/adverse effects , Young Adult
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