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Acute disseminated encephalomyelitis (ADEM) after SARS- CoV-2 vaccination: A case report
Fereshteh Yazdanpanah1, Pooya Iranpour2, Sara Haseli3
1Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tabriz, Iran.
Abstract:
Acute disseminated encephalomyelitis (ADEM) is an acute demyelinating disorder of the central nervous system that is ordinarily monophasic. ADEM can develop following infection or vaccination. Here, we present a 37 y/o male patient with progressive muscle weakness in all limbs along with dysphagia following COVID-19 vaccination. Brain magnetic resonance imaging (MRI) revealed typical imaging findings which presented as multifocal T2-FLAIR signal changes in the corticospinal tract, pons, and temporal lobe with diffusion restriction. Magnetic resonance spectroscopy (MRS) further confirmed the diagnosis by the typical elevation of the Choline and Myoinositol peaks. Neurologic impairments have been reported as the potential side effects of COVID-19 vaccines. Appropriate imaging modalities together with a thorough clinical examination are essential for making a correct diagnosis.
Insights
Acute disseminated encephalomyelitis (ADEM) is a rare neurological condition that can occur after vaccination. This case highlights ADEM following COVID-19 vaccination, emphasizing the need for prompt diagnosis.
Area of Science:
- Neurology
- Immunology
Background:
- Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system.
- ADEM is typically monophasic and can be triggered by infections or vaccinations.
Observation:
- A 37-year-old male presented with progressive muscle weakness and dysphagia post-COVID-19 vaccination.
- Clinical presentation suggested a neurological complication.
Findings:
- Brain MRI revealed multifocal T2-FLAIR signal abnormalities in the corticospinal tract, pons, and temporal lobe with diffusion restriction.
- Magnetic resonance spectroscopy (MRS) showed elevated Choline and Myoinositol peaks, supporting ADEM diagnosis.
Implications:
- This case underscores the potential for neurological side effects, including ADEM, following COVID-19 vaccination.
- Accurate diagnosis relies on integrating clinical findings with advanced neuroimaging techniques like MRI and MRS.
