Optic neuromyelitis after vaccination against SARS-CoV-2

Area of Science:

• Neuroimmunology
• Demyelinating Diseases
• Central Nervous System Disorders

Background:

• Neuromyelitis optica (NMO) is an autoimmune astrocytopathy targeting the optic nerve and spinal cord.
• NMO involves aquaporin 4 antibodies, complement activation, and lymphocytic infiltration, leading to axonal damage.
• Post-vaccination inflammatory central nervous system events, including acute disseminated encephalomyelitis, have been reported following SARS-CoV-2 vaccination.

Observation:

• A patient presented with symptoms resembling acute disseminated encephalomyelitis the day after receiving a SARS-CoV-2 vaccine.
• Three months later, the patient developed longitudinally extensive transverse myelitis.
• The myelitis was consistent with aquaporin 4-positive neuromyelitis optica spectrum disorder.

Findings:

• The patient's neuromyelitis optica spectrum disorder was successfully treated with an interleukin-6 inhibitor.
• This case suggests a potential temporal link between SARS-CoV-2 vaccination and the onset of NMO spectrum disorder symptoms.
• No definitive causal association between SARS-CoV-2 vaccination and NMO can be established from this single case.

Implications:

• Further research is crucial to investigate any potential relationship between SARS-CoV-2 vaccination and neuromyelitis optica.
• Understanding such associations is vital for vaccine safety monitoring and patient management.
• This report contributes to the limited literature on rare neurological events post-vaccination.