Post-vaccine SARS-CoV-2 neurological complications are rare. However, due to the SARS-CoV-2 pandemic, massive vaccination has been carried out worldwide, which is why we have seen a greater report of post-vaccination neurological adverse effects.
We present 4 cases, which after receiving the SARS-CoV-2 vaccine presented 4 different neurological pathologies at the Hospital Comarcal de Vinaroz during the year 2021.
A relationship between vaccination and the onset of neurological symptoms is observed. Three patients presented clinical manifestations in relation to the BNT162b2 vaccine. The first patient after administration of the first dose of the BNT162b2 vaccine presented diplopia and palpebral ptosis, a condition compatible with ocular Myasthenia gravis. The second patient had symptoms of acute sensory motor axonal polyneuropathy after the third dose. The third patient, who after the third dose of BNT162b2 presented lethargic encephalopathy. The fourth patient presented symptoms compatible with aseptic meningitis after AZD1222 and mRNA-1273 vaccination.
Due to the worldwide mass vaccination campaign, reports of accidentally related or causally linked neurological complications are emerging. These are very varied; they could be related to immunological and/or toxic mechanisms. Physicians must be aware of these possible adverse effects and rule out other causes. Studies should be carried out that allow us to clarify the pathological mechanisms in relation to post-vaccination complic ations.
polyneuropathy
Complicaciones neurológicas post-vacuna COVID. Neurological complications post-COVID vaccine.
Paraproteinemic Neuropathies: A Review for Neurologists Neuropatías. Paraproteinémicas: Revisión de tema para Neurólogos
As part of the workup of polyneuropathy, neurologists often encounter patients with paraproteinemias, also called monoclonal gammopathies. Given the relatively rising prevalence of both polyneuropathy and paraproteinemias in our aging population, this coexistence is frequently due to chance. Still, certain types of paraproteinemias have a well-defined causal role in the development of polyneuropathy, and therefore has implications in their subsequent work-up and management. Once a monoclonal gammopathy has been deemed as “benign” or of undetermined significance, looking at the heavy chain subtype is paramount in deciding whether it is related to a polyneuropathy. Conversely, polyneuropathies associated with monoclonal gammopathies tend to have a distinct clinical, serological, and/or electrodiagnostic phenotype that helps in establishing an association. Recognizing this association will determine approp riate workup and management.
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Síndrome de Guillain Barré imitando Muerte Encefálica.
Guillain Barré Syndrome is a neurological disease frequently admitted to the Intensive Care Unit, especially if there is associated hemodynamic or ventilatory compromise. Brain death is the irreversible cessation of all functions of Central Nervous System, and rarely, Guillain Barré Syndrome can mimick it, with subsequent recovery in the next few days or weeks. We report a case admitted to the Intensive Care Unit, with this type of evolution.
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Síndrome de POEMS, reporte de un caso con doble patrón monoclonal.
POEMS síndrome is an uncommon multisystemic paraneoplastic disorder characterized by the presence of a predominantly motor polyneuropathy associated with other manifestations like organomegaly, endocrinopathy, monoclonal gammopathy and skin changes. We report a case of a 36 years old female with diagnostic criteria for this disorder, and a particular double monoclonal pattern IgG and IgA type., demonstrated by immunofixation.
