COVID-19 mRNA vaccination leading to CNS inflammation: a case series

We report clinical and MRI features of seven individuals who received the Moderna (n  = 3) or Pfizer (n  = 4) SARS-CoV-2 mRNA vaccines. Within one to 21  days of either the first (n  = 2) or second (n  = 5) vaccine dose, these patients developed neurologic symptoms and MRI findings consistent with active CNS demyelination of the optic nerve, brain, and/or spinal cord. Symptoms included visual loss, dysmetria, gait instability, paresthesias, sphincter disturbance, and limb weakness. Age ranged from 24 to 64 (mean 39.1) years; five were woman (71.4%). The final diagnosis was exacerbation of known stable MS (n  = 4, two were receiving disease-modifying therapy at the time of vaccination), new onset MS (n  = 2), or new onset neuromyelitis optica (n  = 1). All responded to corticosteroid (n  = 7) or plasma exchange (n  = 1) therapy, with five returning to baseline and two approaching baseline. Large prospective studies are required to further investigate any possible relationship between COVID-19 vaccines and acute CNS demyelination.
Source: Journal of Neurology - Category: Neurology Source Type: research

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