Acute Transient Encephalopathy after Moderna COVID-19 Vaccine
Case Reports in Neurology
; 14(2):231-236, 2022.
Article
in English
| ProQuest Central | ID: covidwho-2302761
ABSTRACT
Although mRNA vaccine responses following previous coronavirus disease 2019 (COVID-19) infection have not been assessed in trials, it has been shown that serological evidence of previous COVID-19 generates strong humoral and cellular responses to one dose of mRNA vaccine. We describe a patient with prior COVID-19 infection who developed acute transient encephalopathy with elevated inflammatory markers within 24 h of her first injection of Moderna COVID-19 vaccine. A 69-year-old cognitively normal woman presented with intermittent inattention, disorientation, left/right confusion, weakness, gait instability, and decreased speech. Head CT, brain MRI and MRA, complete blood count, liver enzymes, hepatitis B serology, ammonia, thyroid function, vitamin B12, and pulse oximetry were normal. Electroencephalography performed 48 h after symptom onset showed diffuse triphasic waves, diffuse theta and delta slowing, and no posterior dominant rhythm. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG was positive and inflammatory markers were elevated. On day 5 post-vaccine, she returned to her baseline, without neurological sequelae. The reported patient likely developed a transient inflammatory encephalopathy associated with an abnormal immunologic reaction to one dose of COVID-19 vaccine, in the setting of remote COVID-19 infection (1 year prior), SARS-CoV-2 IgG-positivity, and multiple comorbidities. Physicians should be alert to possible postvaccination reactogenicity in individuals with SARS-CoV-2 IgG-positivity, including risk of neuro-inflammation.
Medical Sciences--Psychiatry And Neurology; COVID-19 vaccine; Vaccine adverse events; Encephalopathy; SARS-CoV-2; Hemodialysis; Infections; Patients; Emergency medical care; COVID-19 vaccines; Stroke; mRNA vaccines; Encephalitis; Blood tests; Severe acute respiratory syndrome coronavirus 2; Diagnostic tests; Cytokines; Meningitis; Inflammation; Metabolism; Conflicts of interest; Electroencephalography; Ethics; Coronaviruses; Serology; Hospitalization
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Collection:
Databases of international organizations
Database:
ProQuest Central
Topics:
Vaccines
Language:
English
Journal:
Case Reports in Neurology
Year:
2022
Document Type:
Article
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