Acute Central Nervous System Demyelination Following COVID-19 Vaccination

Objective To describe features of central nervous system (CNS) demyelinating events following vaccination against coronavirus disease 19 (COVID-19). Background Several reports suggest a potential association between COVID-19 vaccines and acute CNS inflammation. Design/Methods A case series was performed at the BARLO MS Centre in Toronto, Ontario, Canada. Clinicians reported patients who experienced an event within 60 days after receiving least one from March 2021 to January 2022. Clinical characteristics were evaluated. Results Twenty identified (median age 39 years (range 25-82); 13 (65.0%) female). Two had pre-existing multiple sclerosis (MS). Individuals received Pfizer (n = 14), Moderna 5) or Astrazeneca 1) vaccines. Within 1-53 12) first 8) second vaccine dose, developed transverse myelitis (TM) 15), optic neuritis 4) brain demyelination 4). Diagnoses last follow up 114 39-255)) relapsing remitting 8), post-vaccine TM 5), clinically isolated syndrome 3), myelin oligodendrocyte glycoprotein antibody 2), relapse neuromyelitis optica spectrum disorder 1). Thirteen pulse corticosteroids, these, 4 plasma exchange. Seven did not receive treatment. 20.0% returned baseline 4), 75.0% partially recovered 15) 5.0% worsened At up, 11 on modifying therapy 9 not. Nine subsequent vaccine. Of symptom recrudescence without radiologic evidence new attack. Conclusions our knowledge, this is largest date describing COVID-19. The rate eligible general population high during time cases we could determine whether number higher than expected. Repeat associated with recurrent adverse small observational series.