Acute disseminated encephalomyelitis with bilateral optic neuritis following ChAdOx1 COVID-19 vaccination.

Autor: Nagaratnam SA; Department of Neurology, Gosford Hospital, Gosford, NSW, Australia. sai@nagaratnam.net., Ferdi AC; The University of Sydney, Save Sight Institute, Sydney, NSW, Australia., Leaney J; Sydney Eye Surgeons, Sydney, NSW, Australia., Lee RLK; Department of Radiology, Gosford Hospital, Gosford, NSW, Australia., Hwang YT; Brain and Mind Centre, The University of Sydney and Gosford Hospital, Gosford, NSW, Australia., Heard R; The University of Sydney, Sydney, NSW, Australia.
Jazyk: angličtina
Zdroj: BMC neurology [BMC Neurol] 2022 Feb 12; Vol. 22 (1), pp. 54. Date of Electronic Publication: 2022 Feb 12.
DOI: 10.1186/s12883-022-02575-8
Abstrakt: Background: Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated inflammatory demyelinating disease of the central nervous system. We report a case of ADEM presenting with bilateral optic neuritis temporally associated with the ChAdOx1 vaccine against SARS-COVID19 virus.
Case Presentation: A 36-year-old female presented with bilateral optic neuritis following her first dose of the ChAdOx1 vaccine. Initial MRI Brain showed evidence of demyelination within the subcortical white matter, with no radiological involvement of the optic nerves. Visual evoked potentials were consistent with bilateral optic neuritis which was confirmed radiologically on follow up MRI. She was treated with intravenous steroids with improvement both in symptoms and radiological appearance. A pseudo-relapse occurred which was treated with a further course of intravenous steroids followed by an oral taper. The clinical, radiological and serological results were most consistent with diagnosis of ADEM.
Conclusions: ADEM is an exceedingly rare complication of ChAdOx1 vaccine despite millions of doses. While it is imperative clinicians remain aware of neurological complications of vaccines, the importance of vaccination to control a pandemic should not be undermined.
(© 2022. The Author(s).)
Databáze: MEDLINE
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