Abstract
Introduction: A 67-year-old female with no significant past medical history presented to the critical care department with symptoms of encephalopathy.
Case Presentation: The patient’s Main Concerns and the Important Clinical Findings: The patient had a history of COVID -19 vaccination (recombinant ChAdOX1 nCoV-19) 14 days prior to the symptoms. She underwent an MRI of the brain and cervical spine and a lumbar puncture.
The Primary Diagnoses, Interventions, and Outcomes: The patient was examined and sent for an MRI of the brain and cervical spine, followed by extensive blood and CSF investigations to rule out any infective, paraneoplastic, connective tissue disorder, or inflammatory disorder. The patient was given steroids, and a good response was reported. The primary diagnosis was made as vaccine-induced ADEM.
Conclusion: The clinical exam, location, sparse contrast enhancement, and CSF findings were all consistent with an acute demyelinating event, and the history of vaccination, together with the clinical situation, was found to be favourable for the development of acute disseminated encephalomyelitis.
Keywords: COVID-19, vaccine, ADEM, encephalopathy, SARS-CoV 2, virus.
[http://dx.doi.org/10.1016/j.vaccine.2021.03.016] [PMID: 33846042]
[http://dx.doi.org/10.1016/j.vaccine.2021.03.073] [PMID: 33846043]
[http://dx.doi.org/10.1056/NEJMoa2104882] [PMID: 33835768]
[http://dx.doi.org/10.1056/NEJMoa2104840] [PMID: 33835769]
[http://dx.doi.org/10.1007/s13760-021-01608-2] [PMID: 33527327]
[http://dx.doi.org/10.1016/j.clineuro.2021.106839] [PMID: 34325334]
[http://dx.doi.org/10.1007/s13760-021-01699-x] [PMID: 34018145]
[http://dx.doi.org/10.1186/s12883-021-02517-w] [PMID: 34903200]
[http://dx.doi.org/10.1016/j.amsu.2021.102803] [PMID: 34512961]
[http://dx.doi.org/10.1093/qjmed/hcab335] [PMID: 34978572]
[http://dx.doi.org/10.3389/fimmu.2021.813487] [PMID: 35069602]
[http://dx.doi.org/10.1016/j.radcr.2021.04.015] [PMID: 33868525]
[http://dx.doi.org/10.1016/j.vaccine.2007.04.060] [PMID: 17570566]
[http://dx.doi.org/10.1016/j.vaccine.2010.02.053] [PMID: 20197145]
[http://dx.doi.org/10.2739/kurumemedj.54.95] [PMID: 18475044]
[http://dx.doi.org/10.1016/j.clinimag.2021.01.023] [PMID: 33548891]
[http://dx.doi.org/10.1016/j.nic.2012.12.005] [PMID: 23608688]
[http://dx.doi.org/10.1212/01.wnl.0000338630.20412.45] [PMID: 19038851]