suspected acute disseminated encephalomyelitis (ADEM) after ChAdOx1 nCoV-19 vaccine: A case report

https://doi.org/10.1016/j.jns.2021.119796Get rights and content

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Background and aims

Acute Disseminated Encephalomyelitis (ADEM) is an immune-mediated demyelinating disease of the Central Nervous System clinically defined by acute polyfocal neurological syndrome usually following a monophasic course. ADEM often occurs after infections, but 5-10% of cases are preceded by vaccinations. Several cases of ADEM after SARS-CoV-2 infection have been described, whereas no cases have been reported after administration of mRNA/adenovirus COVID-19 vaccines. Here, we describe a suspected

Methods

Case report

Results

A 45-year-old man developed numbness in his hands two weeks after receiving the first dose of ChAdOx1 nCoV-19. His condition worsened in a few days: numbness extended to the upper limbs, trunk and legs and he progressively experienced visual acuity deficits, dysarthria, dysphagia, clumsy right hand movements and urge incontinence. Symptoms persisted for one week but then spontaneously improved. At admission to our unit, MRI showed large T2-weighted hyperintensities in the pons (which appeared

Conclusions

The diagnostic work-up suggests a diagnosis of ADEM, a disease whose association with vaccines is well-known. This is the first description of a possible association with an adenovirus COVID-19 vaccine.

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