Neurological complications of COVID-19: Guillain-Barre syndrome following Pfizer COVID-19 vaccine. Finsterer J. In December 2019, the SARS Covid-2 virus was introduced to the world. 36. Clin Neurol Neurosurg. J Clin Neuromuscul Dis. Detection and quantification of antiFGFR-3 by enzyme-linked immunosorbent assay (ELISA) has been shown inconsistent, which may also confound these results.33 Future studies are needed to clarify the significance of these antibodies, with improved and standardized antibody detection and quantification methods, so treating physicians can make decisions whether to order the antibody test and know what to do with the results. Herein, we have provided a comprehensive review of documents reporting neurological side effects of COVID-19 vaccines in international databases from 2020 to 2022 and discussed neurological disorders possibly caused by vaccination. If there is history of gastrointestinal symptoms or gluten intolerance, evaluate for celiac disease with tests for gliadin and tissue transglutaminase antibodies and small bowel biopsy. Zhou L, Siao P. Lateral femoral cutaneous neuropathy caused by prone positioning to treat COVID-19-associated acute respiratory distress syndrome. Vegezzi E, Ravaglia S, Buongarzone G, Bini P, Diamanti L, Gastaldi M, Prunetti P, Rognone E, Marchioni E. Acute myelitis and ChAdOx1 nCoV-19 vaccine: casual or causal association? doi: 10.1002/mus.27251. Venous sinus thrombosis is associated with excessive coagulation. These criteria sets are the Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) criteria, which are graded, and the Besta criteria (Table).7,8, Evaluation should include examination for SFN signs and exclude large fiber neuropathy signs, nerve conduction studies (NCS) to rule out large fiber polyneuropathy, and skin biopsy or quantitative sensory testing (QST). People with small fiber neuropathy usually experience severe sharp or burning pain, with some sensory symptoms and no significant weakness in their body. Sore throat. Eur J Neurol. Concern for autoimmunity secondary to COVID19 vaccines has been raised by the adenovirus vaccine trials, with cases of transverse myelitis reported after the Johnson & Johnson and AstraZeneca vaccines, . Neurol Sci. 2011 Aug 9;77(6):603. A recent Indian/French study is a good example. Eitner L, Maier C, Brinkmann F, Schlegtendal A, Knoke L, Enax-Krumova E, Lcke T. Front Pediatr. 2019;142(12):3728-3736. Neurology. I did experience burning pain all over body but the burning pain was mainly consistent in . Peripheral neurological complications during COVID-19: A single center experience. McGonagle D, De Marco G, Bridgewood C. Mechanisms of immunothrombosis in vaccine-induced thrombotic thrombocytopenia (VITT) compared to natural SARS-CoV-2 infection. But again, the challenge is whether . J Neurol Neurosurg Psychiatry. sharing sensitive information, make sure youre on a federal Salinas MR, Dieppa M. Transient akathisia after the SARS-Cov-2 vaccine. Accessed 13 Novr 2022. Woo CJ, Chou OHI, Cheung BMY. According to a recent report on the Sputnik vaccine, side effects are included headache, joint pain, fever, and flu-like symptoms [14]. Early outcomes of bivalirudin therapy for thrombotic thrombocytopenia and cerebral venous sinus thrombosis after Ad26. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Jain E, Pandav K, Regmi P, Michel G, Altshuler I. Facial diplegia: a rare, atypical variant of Guillain-Barr syndrome and Ad26. These include difficulty getting through normal activities . Razok A, Shams A, Almeer A, Zahid M. Post-COVID-19 vaccine Guillain-Barr syndrome; first reported case from Qatar. 39. The paper below reiterates that: Recently, vaccine distribution Boston Medical Center Cutaneous Nerve Laboratory Pain medications can be used as monotherapy or in combination to increase efficacy, such as gabapentin with nortriptyline and pregabalin or gabapentin with tramadol. Muscle Nerve. Sputnik-V reactogenicity and immunogenicity in the blood and mucosa: a prospective cohort study. Trouble eating or swallowing. 2021;78(4):5114. Vaccines. Of the remaining seven patients who had normal skin biopsies, six showed no clinical neuropathy signs and one exhibited signs and had abnormal AFT. Abstracts of Presentations at the Association of Clinical Scientists 143. Progression is slow, and most people affected by SFN do not develop large fiber involvement over time. 2014;49(3):329-336. WHO COVID-19 Research Database. 3 non-responding patients had improvement with IVIG injections. 2021. https://doi.org/10.1002/alr.22809. de Terreros Caro GG, Daz SG, Al MP, Gimeno MM. Kohli S, Varshney M, Mangla S, Jaiswal B, Chhabra PH. JAMA Neurol. According to reports published in the VAERS database, COVID-19 vaccines have several local and systemic neurological complications that occur in different people, from mild to severe, depending on age, sex, history of the disease, and pre-existing immunity [7]. NCI CPTC Antibody Characterization Program, Nalbandian A, Sehgal K, Gupta A, et al. 2023 BioMed Central Ltd unless otherwise stated. Article Nerve damage might be causing everything from low blood pressure to gastrointestinal distress without your knowing it. 2022;73(1):8787. Because we may see more people with painful SFN after COVID-19 and this may be immune-mediated, it would be helpful to study whether IVIG can expedite recovery, especially for those with severe neuropathy and poor response to symptomatic treatment. Guillain-Barr syndrome and COVID vaccine - in Qatar, an elderly man developed this condition following his second dose 5 . Two received the Pfizer-BioNTech vaccine, one Moderna, and one Johnson & Johnson. Influenza is well known to affect taste and smell, too, and there are other respiratory viruses that can cause similar kinds of troubles. Muscle Nerve. 2021;42(9): e1213. Provided by the Springer Nature SharedIt content-sharing initiative. Many pain medications have sedative side effects that can limit use of a therapeutic dose. 2021. https://doi.org/10.7759/cureus.16624. A small study of patients suffering from persistent symptoms long after a bout of COVID-19 found that nearly 60% had nerve damage possibly caused by a defective immune response, a finding that . Side effects and perceptions following Sinopharm COVID-19 vaccination. Nagy A, Alhatlani B. Follow-up duration ranged from 8 to 12 mo. On the other hand, women have the highest incidence of neurological complications because they induce a stronger immune response against foreign antigens, which can lead to the targeting of self-antigens and lead to autoimmune disorders [9]. The patient responded to symptomatic treatment very well with resolution of the symptom.29 These reports suggest that COVID-19 and COVID-19 vaccine reactions may represent new associated conditions for SFN. Bell's palsy and small fiber neuropathy are more commonly observed in mRNA-based vaccines [63, 64]. In connection with brain disorders, the possible mechanism is the entry of inflammatory mediators secreted by peripheral blood cells into the brain and the destruction of myelin and axonal degeneration. Autonomic dysfunction following COVID-19 infection: an early experience. There have been many reports of the Pfizer vaccine being associated with olfactory [66], visual [67], auditory [68, 69], and sometimes abducens nerve palsy. Neurol Sci. The development of our patient's presentation soon after . The drug candidate was also under development for Alzheimer's disease, myocarditis, juvenile rheumatoid arthritis, polymyositis, dermatomyositis and . 2021;12:20837. Hasan T, Khan M, Khan F, Hamza G. Case of Guillain-Barr syndrome following COVID-19 vaccine. COVID-19 vaccination can sometimes have severe side effects on nervous system, including the brain, spinal cord, cranial nerves, and peripheral nerves, and has been shown to have adverse vascular, metabolic, inflammatory, and functional effects on the brain [1]. 2021;69(9):2550. Intravenous immunoglobulin therapy in patients with painful idiopathic small fiber neuropathy. World J Clin Cases. HHS Vulnerability Disclosure, Help RHS leads to facial nerve palsy, vestibulocochlear neuropathy, and glossopharyngeal nerve neuropathy, so it causes numbness of the face, tongue, and hearing loss. Guillain-Barr syndrome after COVID-19 vaccine: should we assume a causal Link? Skin biopsy with intraepidermal nerve fiber density (IENFD) quantification is more accurate than QST and so is considered the most reliable test to confirm the diagnosis.7,10. "To date, the systems in place to monitor vaccine safety have not identified safety signals for serious neurological outcomes following COVID-19 vaccination, including small fiber neuropathy," the . Acta Neurol Belg. Eur J Med Res 28, 102 (2023). COVID vaccines and neuropathy. A Dutch study suggests a prevalence of 52.95 per 100,000 population that increases with age.1 Standardized diagnostic criteria for SFN are not fully established and skin biopsy remains the diagnostic test considered most reliable. Keywords: Small fibers, large impact: quality of life in small-fiber neuropathy. Adenovirus-based vaccines are at the forefront of causing this complication due to the transfer of the nucleic acids encoding the viral spike (S) protein. SFN diagnosis is established when IENFD is reduced in comparison to age- and sex-adjusted worldwide normative values of IENFD at the distal leg.15 A recent study suggests that IENFD at the distal leg might also be influenced by ethnic ancestry,16 with normative values potentially needing further studies and adjustment for specific populations to improve the diagnostic sensitivity. Following these events, as expected, peripheral blood cells and albumin enter the brain and disrupt the osmotic balance [10]. Of the 17 patients (aged mean 43.3 years, 68.8% women 94.1% White) who had COVID-19 between February 21, 2020, and January 19, 2021, 16 had mild COVID and 1 had severe COVID due to critical care . 23. Cephalalgia. 2017;74(7):773-779. Ramsay Hunt syndrome following COVID-19 vaccination. Headache. Antonio Crespo Burillo J, Martnez CL, Arguedas CG, Pueyo FJM. HIV and hepatitis C serology should be ordered if risk factors are present. Many Case Report articles were not considered due to the lack of a convincing link between the complication and vaccination. Article Post COVID-19 vaccine small fiber neuropathy. Clipboard, Search History, and several other advanced features are temporarily unavailable. This site needs JavaScript to work properly. 2021. All patients showed neurologic symptoms in at least 21 days following COVID-19 vaccination. At the same time, there are many reports of side effects after getting a COVID-19 vaccine. Spectrum of neurological complications following COVID-19 vaccination. Ish S, Ish P. Facial nerve palsy after COVID-19 vaccinationA rare association or a coincidence. Epub 2022 Apr 19. 2021;96(22):10524. McLean P, Trefts L. Transverse myelitis 48 hours after the administration of an mRNA COVID 19 vaccine. As of November 2022, 630.3 million people have been diagnosed with COVID-19 and 6.58 million deaths worldwide, according to WHO figures [2]. Google Scholar. Blauenfeldt RA, Kristensen SR, Ernstsen SL, Kristensen CCH, Simonsen CZ, Hvas AM. and some said they got it after the vaccine. Transverse myelitis is an inflammation of a part of the spinal cord that usually occurs after infection and is associated with impaired sensory, motor, and autonomic function (bladder and intestines) in areas below the area of inflammation in the spinal cord. Althoughvaccines are now considered the best way to achieve collective safety and control mortality, due to the critical situation, these vaccines have been issued the emergency use licenses andsome of theirpotentialsubsequence side effects have been overlooked. 2010;15(1):57-62. Living with cranial neuropathy 2017;30(5):490-499. Hoffman EM, Watson JC, St Sauver J, Staff NP, Klein CJ. Although it's a bit of a controversial take in here. Neurology. COVID-19 vaccination also affects the cranial and peripheral nerves and causes side effects such as Bell's palsy (facial nerve palsy7 cranial nerve), abducens nerve palsy (lateral rectus ocular muscle nerve palsy6 cranial nerve), impaired vision, olfactory, hearing, GuillainBarre syndrome (GBS), small fiber neuropathy, ParsonageTurner syndrome, and also herpes zoster. Dagostino V, Caranci F, Negro A, Piscitelli V, Tuccillo B, Fasano F, Sirabella G, Marano I, Granata V, Grassi R. A rare case of cerebral venous thrombosis and disseminated intravascular coagulation temporally associated to the COVID-19 vaccine administration. A review of neurological side effects of COVID-19 vaccination, https://doi.org/10.1186/s40001-023-00992-0, https://doi.org/10.1007/s10072-021-05662-9, https://doi.org/10.1038/s41598-022-17514-3, https://doi.org/10.1007/s13760-021-01775-2, https://doi.org/10.9734/ijmpcr/2021/v14i130124, https://doi.org/10.1007/s12024-021-00440-7, https://doi.org/10.1016/j.nrleng.2021.05.002, https://doi.org/10.6061/clinics/2021/e3286, https://doi.org/10.1080/14992027.2021.1931969, https://doi.org/10.1136/postgradmedj-2021-141022, https://doi.org/10.1007/s00415-021-10780-7, https://doi.org/10.1016/j.nrleng.2021.04.002, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. Baldelli L, Amore G, Montini A, Panzera I, Rossi S, Cortelli P, Guarino M, Rinaldi R, DAngelo R. Hyperacute reversible encephalopathy related to cytokine storm following COVID-19 vaccine. Amyotrophic neuralgia secondary to Vaxzevria (AstraZeneca) COVID-19 vaccine. 2021;93(12):658894. Epub 2022 Apr 16. As a person ages, the pain attacks can affect other regions. Alshararni A. Post SARS-CoV-2 vaccination Guillain-Barre syndrome in 19 patients. Both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the vaccines against it elicit antibodies to the spike protein . Ercoli T, Lutzoni L, Orofino G, Muroni A, Defazio G. Functional neurological disorder after COVID-19 vaccination. Novak P. Post COVID-19 syndrome associated with orthostatic cerebral hypoperfusion syndrome, small fiber neuropathy and benefit of immunotherapy: a case report. Federal government websites often end in .gov or .mil. Successful treatment of thrombotic thrombocytopenia with cerebral sinus venous thrombosis following Ad26. Finsterer J, Scorza FA, Scorza CA. GBS is also a peripheral nerves and nerve roots injury that presents with severe motor weakness and paralysis of the legs or four limbs and is more common in the elderly after vaccination with adenovirus-based vaccines [ 65 ]. Here, we review the recent advances in the diagnosis and management of SFN. Pagenkopf C, Sdmeyer M. A case of longitudinally extensive transverse myelitis following vaccination against Covid-19. Clinical . Authors Waqar Waheed 1 , Magalie E Carey 1 , Sarah R Tandan 1 , Rup Tandan 1 Affiliation 1 Department of Neurological . Geerts M, de Greef BTA, Sopacua M, et al. Would you like email updates of new search results? Cureus. 2021;13: 100217. Monitoring blood sugar . Two patients had rare neuropathies affecting motor nerves to muscle, and 10 were diagnosed with small-fiber neuropathy, a recognized cause of chronic pain and fatigue. Acute disseminated encephalomyelitis (ADEM) following recent Oxford/AstraZeneca COVID-19 vaccination. . Acta Neurol Scand. A new study suggests that some patients with long COVID have lasting nerve damage that appears to be caused by infection-triggered immune dysfunction, which is potentially treatable. I'm inclined to believe them. In vaccines containing inactive or protein viruses, virus particles and proteins, as antigens, trigger the immune system [4]. Sodium channelopathy is not exceedingly rare in pure SFN, with a recent screening study detecting potential pathogenic variants of voltage-gated sodium channel genes, including SCN9A, SCN10A, and SCN11A, in 132/1139 (11.6%) patients with pure SFN.24 Genetic screening for Fabry disease in people with SFN is not cost-effective and should be done only if other clinical features are present.25 Familial amyloidosis associated with transthyretin (TTR) gene mutations usually affects both large and small nerve fibers, and should be suspected if renal, cardiac, or hepatic abnormalities and bilateral carpal tunnel syndrome are present.26, BOX. 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