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BackgroundImmunization stress-related responses presenting as stroke-like symptoms may develop following COVID-19 vaccination. This study aimed to describe the clinical characteristics of immunization stress-related responses causing stroke-like events following COVID-19 vaccination. MethodsWe conducted a retrospective study of the secondary data of reported adverse events following COVID-19 immunization that presented with neurologic manifestations. Between March 1 and July 31, 2021, we collected and analyzed the medical records of 221 patients diagnosed with stroke-like symptoms following immunization. Demographic and medical data included sex, age, vaccine type, sequence dose, time to event, laboratory data, and recovery status as defined by the modified Rankin score (i.e., defining the degree of severity/dependence, with higher scores indicating greater disability). The affected side was evaluated for associations with the injection site. ResultsIn total, 221 patients were diagnosed with immunization stress-related responses (stroke-like symptoms) following CoronaVac (Sinovac) or ChAdOx1 (AstraZeneca) vaccinations. Most patients (83.7%) were women. The median (interquartile range) age of onset was 34 (28-42) years in patients receiving CoronaVac and 46 (33.5-60) years in those receiving ChAdOx1. The median interval between vaccination and symptom onset for each vaccine type was 60 (16-960) min and 30 (8.8-750) min, respectively. Sensory symptoms were the most common symptomology. Most patients (53.8%) developed symptoms on the left side of the body; 99.5% of the patients receiving CoronaVac and 90% of those receiving ChAdOx1 recovered well (modified Rankin scores [≤]2, indicating slight or no disability). ConclusionsImmunization stress-related responses presenting as stroke-like symptoms can develop following COVID-19 vaccination. Symptoms that are more likely to occur on the injection side are transient (i.e., without permanent pathological deficits). Public education and preparedness are important for administering successful COVID-19 vaccination programs.
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Background & Objective: Co-exiting of CIDP and diabetes mellitus had been reported. Idiopathic CIDP(I-CIDP) is a treatable disease and had favorable response to immunosuppressive therapies but there is no established data for CIDP in diabetic patients (DM-CIDP). This study aims to determine clinical characteristics, phenotypes, electrophysiological tests and treatment response of CIDP in diabetic patients; and to determine the response to immunosuppressive therapy in DM-CIDP and I-CIDP. Methods: The study was a retrospective chart review of Prasat Neurological Institute patients with diagnosis of CIDP between January 1st, 2008 and December 31th, 2015. Results: Sixty four CIDP patients were identified, 12 were DM-CIDP and 52 were I-CIDP. Clinical characteristics, phenotypes, disease duration and disease severity in DM-CIPD were not different from I-CIDP. Demyelinating changes in nerve conduction studies were not different in the two entities but axonal features were more predominant in DM-CIDP. DM-CIDP also responded to immunosuppressive treatment, with modified Ranking Scale decreased after treatment as in I-CIDP. There was no difference in treatment response in DM-CIDP and I-CIDP. Conclusion: Clinical characteristics, phenotypes, disease severity and treatment response to immunosuppressive treatment in DM-CIPD were not different from I-CIDP. Demyelinating features in nerve conduction studies were not different in the two entities but axonal features were more predominant in DM-CIDP.
