Acute abducens nerve palsy with acute disseminated encephalomyelitis-like presentation following COVID-19 vaccination

We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated sys...

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Bibliographic Details
Published in:Indian journal of ophthalmology 2023-05, Vol.71 (5), p.2279-2281
Main Authors: Kalita, Iva, Singh, Harsh, Sharma, Swati
Format: Article
Language:English
Subjects:
Abducens nerve
Abducens nerve diseases
Abducens Nerve Diseases - complications
Abducens Nerve Diseases - etiology
abducens nerve palsy
acute disseminated encephalomyelitis
adem
Adult
Adverse and side effects
adverse event
Case Reports
Case studies
Causes of
ChAdOx1 nCoV-19
Child
Complications
COVID-19
COVID-19 - complications
covid-19 vaccination
COVID-19 Vaccines - adverse effects
Cranial nerves
demyelinating changes post-covid-19 vaccination
Demyelination
Diagnosis
Drugs
Encephalomyelitis
Encephalomyelitis, Acute Disseminated - complications
Encephalomyelitis, Acute Disseminated - etiology
Humans
Inflammation
Magnetic resonance imaging
mri findings post-covid-19 vaccine
Neuroimaging
Neurological complications
Paralysis
Vaccination - adverse effects
Vaccines
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Description
Summary:We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated systemic symptoms. Post-vaccination demyelination typically known as acute disseminated encephalomyelitis (ADEM) associated with several vaccines is more common in children. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to the post-vaccine neuroinflammatory syndrome. Cranial nerve palsies and ADEM-like presentations may represent part of the neurologic spectrum following COVID-vaccination in adults, and ophthalmologists should be aware of these sequelae. Although cases of sixth nerve palsy following COVID vaccination are already reported, associated MRI changes have not been reported from India.
ISSN:0301-4738
1998-3689
DOI:10.4103/ijo.IJO_1778_22