Table 1.
First author | Country | Age | Sex | Neurological symptoms | Type of COVID-19 vaccine | Dosage of COVID-19 vaccine | Time interval between vaccination and neurological symptoms | MRI results | CSF findings | Auto-antibodies | SARS-CoV-2 PCR | Treatment | Outcome |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Al-Quliti et al. 2022 | Saudi Arabia | 56 | Female | Gradual discomfort + generalized weakness + myalgias + difficultly in the articulation of speech + needed assistance to ambulate + anorexia + dysmetria | AstraZeneca (ChAdOx1) | 1st | 10d | MRI: the T2 and FLAIR sequences demonstrated large multifocal, bilateral, asymmetric, multiple hyperintensities in the subcortical and deep white matter involving the basal ganglia with no contrast enhancement | CSF: protein = 1.76, CSF glucose = 4.62; CSF WBC count = 1, RBC count = 7; (CSF differential cells) CSF segs = 20 %, CSF mono = 64 %, lymphocytes = 16 % | NR | Negative | Omeprazole + acetaminophen + hypertonic saline at 2 % + sodium correction over the next 24 h + MPS + physical and occupational therapy | Complete resolution of her symptoms, continued to improve and was able to mobilize freely without assistance, discharged from hospital |
Ancau et al. 2021 | Germany | 61 | Male | Fever + headache + apathy + unconscious + foaming around the mouth + generalized seizure + comatose | AstraZeneca (ChAdOx1) | 1st | 2d | MRI: bilateral confluent cortical and subcortical FLAIR hyperintense lesions with hemorrhagic involvement of the basal ganglia | CSF: normal cell counts (1 leukocyte per μl) and moderate disturbance of the blood–brain-barrier + No CSF-specific oligoclonal bands or intrathecal IgG/-A/-M−synthesis were detected | against aquaporin-4 (AQP4) or myelin oligodendroyte glycoprotein (MOG) in cell-based assays (CBA) = negative + Screening for antinuclear antibodies (ANA), antineutrophil cytoplasmic antibodies (ANCA), antiphospholipid antibodies, neuronal and paraneoplastic antibodies = all negative. | Negative | Endotracheal intubation + MPS + PE | Slight improvement, reduction in size of the brain lesions, on clinical follow-up after 14 weeks of rehabilitation, the patient presented with a vegetative state |
25 | Female | Severe cephalgia + thoracic back pain + mild weakness + ascending numbness + complete paraplegic syndrome | AstraZeneca (ChAdOx1) | 1st | 9d | Spinal MRI: a longitudinal edema throughout the thoracic spinal cord exhibiting mild contrast enhancement as well as focal central hemorrhages + Cranial MRI: bi-hemispheric white matter lesions with focal contrast enhancement | CSF: erythrocytes 5,284 cells/μl, leukocytes241 cells/μl + highly elevated CSF/serum quotient for albumin of 164.7 × 10–3 + No CSF-specific oligoclonal bands were detected | Intrathecal IgM synthesis = positive, but IgG or IgA synthesis = negative / glial-, neuronal-targeting, and paraneoplastic autoantibodies (CBA for AQP4- and MOG-, immunofluorescence assays in the serum for ANA, ANCA, anti-double stranded DNA antibodies) = negative | Negative | MPS + PE | Cephalgia improved drastically and the sensory components slightly, clinical improvement of only sensory symptoms | ||
55 | Female | Progressive nausea + dizziness + meningism + severe spastic tetraparesis + increased intracerebral pressures + comatose + anisocoria | AstraZeneca (ChAdOx1) | 1st | 9d | Brain MRI: multiple FLAIR-hyperintense and hemorrhagic lesions in the right parietal and temporal lobes, bilaterally in fronto-temporal distribution as well as in the right occipital lobe and left fronto-basal region | CSF: mixed granulocytic and lymphocytic pleocytosis (10/μl) and a normal CSF/serum quotient for albumin of 7.4 × 10–3 + No CSF-specific oligoclonal bands were detected | Intrathecal IgM, IgA and IgG synthesis = positive / Both autoimmune (AQP4-, MOG-autoantibodies as measured by CBA), and paraneoplastic antibodies (immunofluorescence assays in the serum) = negative | Negative | emergency right-sided decompressive hemicraniectomy + MPS | Significant improvement of vigilance and motor function, died (due to progressive intracerebral hemorrhage of the brain stem) | ||
Ballout et al. 2022 | USA | 81 | Male | Change in mental status + severe encephalopathy + viral-like illness + fever + fatigue + myalgia + acute inflammatory demyelinating process | Moderna | 1st | 13d | Brain MRI with gadolinium: on hospital Day 5 a diffusion restricting lesion involving the right dorsal medulla with corresponding T2 FlAIR hyperintensity, very faint left pontine, midbrain, and thalamic T2 FlAIR hyperintensity, and minimal T2 sulcal hyperintensity without apparent enhancement suggestive of a possible inflammatory or infectious process / Repeated Brain MRI with gadolinium: on hospital day 17 demonstrated multiple, non-enhancing, T2 hyperintense lesions involving bilateral frontoparietal lobes, lentiform nuclei, thalami, cerebral peduncles, pons, and right posterior medulla | 1st CSF: opening pressure = 26 cmH2O, glucose = 69 mg/dL (reference range 40–70 mg/dL), protein = 45 mg/dL (reference range 15–45 mg/dL), and WBC count = 3 cells/μL (reference range 0–5 cells/μL). / 2nd CSF: a mild lymphocytic pleocytosis with a WBC count of 11 cells/μL and protein of 52 mg/dL / A CSF autoimmune encephalitis panel + negative / 3rd CSF: pleocytosis of 69 cells/μL with 83 % lymphocytic predominance, protein of 45 mg/dL, and significantly elevated myelin basic protein (MBP) > 167.0 ng/mL (reference range 0–6.0 ng/mL). | anti-MOG antibody = negative | Negative | Vancomycin + IVIG + MPS + PE | Died (due to hemorrhagic shock of probable gastrointestinal origin) |
Francis et al. 2022 | UK | 36 median | 14 Female | Transeverse myelitis + optic neuritis + Fever + Headache + dysesthesia + Posterma + Facial nerve palsy + paraplegia | 18 AstraZeneca (ChAdOx1) and 7 Pfizer (BioNTech) | 23 at 1st and two at 2nd | 20d | Brain MRI: Involving cerebrall peduncles, internal capsule, splenium, and spinal cord. Longitudinally extensive transverse myletis and periependymal FLAIR hyperintensities. | CSF: Protein (0.63 g/L, range 0.33–2.25), lymphocyte count was 36 × 106/L, and negative oligoclonal bands (OCBs) in MOGIgG + Patients. | Twelve patients were MOGIgG + and two patients were AQP4IgG+ | NR | IVMP + PE + IVIG | Only two patients had poor recovery |
Ahmad et al. 2022 | USA | 61 | Female | General weakness and difficulty in communications | Pfizer (BioNTech) | 1st | 63d | Brain MRI: Signficant diffuse and symmetric acute leukoencephalopathy process involving the deep white matter extending downward through the brainstem into the cerebellar white matter tracts | White blood cell count of 10.1 K/uL and hemoglobin of 12.6 g/dL. Her comprehensive metabolic panel was significant for potassium of 3.2 mmol/L, bicarbonate of 11 mmol/L, chloride of 120 mmol/L. Additional tests, including procalcitonin, cortisol, glucose level, thyroid function tests, antinuclear antibody screen, and COVID RNA nasopharyngeal swab, were within normal limits. Her urinalysis was unremarkable, but her urine toxicology was positive for tetrahydrocannabinol. | Negative myelin oligodendrocyte glycoprotein (MOG) | Negative | MPS + IVIG | Significant improvement in the patient’s mentation. There was no further disease progression in brain MRI |
Cao et al. 2021 | China | 24 | Female | Somnolence + memory decline + headache + low-grade fever + muscle stiffness + extremity weakness + reduced appetite + generalized tonic–clonic seizure | Vero Cells | 1st | 2w (14d) | Brain MRI: abnormal signals in the bilateral temporal cortex / Repeat brain MRI: an increased number of lesions, which were more striking in appearance on day 10; the lesions were improved by day 15 | 1st CSF: WBC count = 51 × 106/L / 2nd CSF: WBC count = 25 × 106/L | anti-aquaporin-4, anti-myelin basic protein, anti-MOG, anti-glial fibrillary acidic protein, autoimmune encephalitis, and paraneoplastic syndrome = all negative | Negative | Ceftriaxone + acyclovir + diazepam + levetiracetam + IVIG | MMSE scores improved, discharged, on a visit 1 month after discharge, felt no discomfort, and a repeat MRI showed complete resolution of brain lesions |
Kania et al. 2021 | Poland | 19 | Female | Severe headache + fever + back and neck pain + nausea + vomiting + urinary retention + atopic dermatitis + depression + nuchal rigidity + bilateral Babinski signs | Moderna | 1st | 2w (14d) | Brain MRI: multiple, poorly demarcated, hyperintense lesions in T2‐weighted and fluid‐attenuated inversion recovery (FLAIR) images located in both brain hemispheres, pons, the medulla oblongata, and cerebellum. Few of them were contrast‐enhanced lesions. Cervical and thoracic MRI revealed a widespread hyperintense area in T2‐weighted and FLAIR images extended from medulla oblongata to Th11 segment with overlapping few contrast‐enhancing lesions | CSF: WBC count = 294 × 106/L, lymphocytes = 91 %, monocytes = 8 %, neutrophils 1 %, protein levels = 648 mg/L, RBC count = 77/µL / Control lumbar puncture was done 12 days after the first one; CSF WBC count = 61 × 106/L and protein levels = 338 mg/L. | anti‐aquaporin‐4 and anti‐myelin oligodendrocyte glycoprotein = negative | NR | Ceftriaxone + acyclovir + MPS + PE | The clinical status improved after MPS, discharged from the hospital without any symptoms except a mild headache |
Kenangil et al. 2021 | Turkey | 46 | Female | Tonic–clonic seizure | Sinovac | 2nd | 1 month (30d) | Cranial MRI: There were scattered hyperintense lesions in the left thalamus, bilateral corona radiata, left diencephalon, and right parietal cortex on T2 and FLAIR sequences on MRI. Some of these lesions showed mild restricted diffusion on DWI | CSF: acellular with normal protein content (45 mm/dL), an IgG index of 0.64 + no oligoclonal bands | ANA (1/100) + anti-SOX1 antibody = positive / anti-double-stranded DNA and extractable nuclear antigen (ENA) panel, anti-aquaporin-4 and anti-myelin oligodendrocyte (MOG) antibodies = negative | Negative | Steroids | Controlled MRI, without any new signs, symptoms, or seizures. |
Lazaro et al. 2022 | Argentina | 26 | Female | Disorientation + inappropriate behavior + headache + gait imbalance + deferred memory + hypoprosexia + anosognosia + incoherent speech + visuospatial failures + Right upper limb weakness + gait ataxia | Sputnik | 1st | 4w (28d) | Brain MRI: nodular hyperintense lesions on T2-weighted image and fluid attenuated inversion recovery without restricted diffusion on diffusion. Marked vasogenic edema and T1-weighted image post contrast incomplete annular enhancement was observed | CSF: 3 cells, 50 g proteins/L, normal glucose + Oligoclonal bands (OCB) = positive / White blood cell count = 3–66 % mononuclear, Proteins = 50.6, Glucose = 78.3, Lactic acid = 1.74, Culture (bacterial, fungal and KOCH) = Negative, VDRL = Negative, Viral PCR (Herpes simplex I/I, Varicella Zoster, Cytomegalovirus, Epstein Barr, Enterovirus, Chagas, John Cunningham) = Negative, Mycobacterium Tuberculosis PCR = Negative, Oligoclonal Bands = Type 2 | Anti-myelin oligodendrocyte glycoprotein antibody (anti-MOG) IGG = negative | NR | MPS | The clinical course was favourable, neurological examination was normal, the MRI was repeated after three months, showing clear imaging improvement of all the lesions |
Maramattom et al. 2022 | India | 64 | Male | Ascending paresthesias in the legs + epigastric band-like sensation + leg stiffness + hand paresthesias | AstraZeneca (ChAdOx1) | 2nd | 20d | Brain and spine MRI: bilateral corticospinal tract hyperintensities, Dorsal cord hyperintensity at D8–9, Whole-body PET/CT normal (multifocal cord hyperintensities and bilateral hemispheric corticospinal tract hyperintensities) | CSF: normal | NMDA/VKGC/NMO, MOG/paraneoplastic panel = negative | NR | IVIG + IVMP + rituximab | A repeat MRI at 1 month showed stabilization of the lesions and no new contrast enhancement (mRS 1 Level 2) |
46 | Male | Urinary complaints + progressive lower limb weakness + numbness + fever | AstraZeneca (ChAdOx1) | 1st | 4d | Brain and spine MRI: extensive supratentorial + infratentorial + long segment spinal cord hyperintensities + longitudinally extensive transverse myelitis (MRI brain: T2, FLAIR hyperintensities in bilateral middle cerebellar peduncle (left > right), pontine tegmentum, right paramedian medulla, and left thalamocapsular region) | CSF: 63 cells/mm3, Protein (52 mg/dl), sugar (93 mg/dl), CSF encephalitis panel: negative | Serum NMO, MOG, ANCA = negative | Negative | MPS + IVMP + PE | Improved significantly and was able to ambulate independently (Recovered, mRS 1 Level 2) | ||
42 | Female | Severe daily headache + photophobia + papilledema | AstraZeneca (ChAdOx1) | 1st | 5d | MRI: initial MRI: leptomeningeal and sulcal enhancement / 25 days later: large right temporal irregular enhancing lesion with significant perilesional edema | CSF: opening pressure 32 cm H2O, CSF parameters normal | Serum & CSF autoimmune encephalitis/NMO, MOG/viral encephalitis panel = all negative | NR | Decompression of lesion + Excisional biopsy + Oral prednisolone | Headache remitted spontaneously after the excision biopsy (mRS 1) | ||
Miyamoto et al. 2022 | Japan | 54 | Female | Fever + headache + somnolence + urinary retention + decreased level of consciousness | Pfizer (BioNTech) | 2nd | 12d | Brain MRI: lesions in the bilateral basal ganglia, midbrain, and cerebral white matter | CSF: elevated protein levels (31.2 mg/mL) + increased cell count (23/µL, 91 % mononuclear cells) + elevated myelin basic protein (809.8 pg/mL) | anti-aquaporine-4 antibody + other encephalitis-related auto-antibodies (glutamate receptors, leucine-rich glioma-inactivated protein 1, contactin-associated protein 2, and glial fibrillary acidic protein) = all negative | NR | MPS + PE + IVIG | Discharged and recovered, able to perform activities of daily living independently. |
Mumoli et al. 2021 | Italy | 45 | Male | Objective vertigo + fever + diffuse myalgia + feeling of burning on the back + backpain + (knees, thighs and perineum) numbness and hypoesthesia + urinary retention + loss of feet’s vibration sensation + gait difficulties and febrile status | AstraZeneca (ChAdOx1) | 1st | 12 h (0.5d) | Spinal cord MRI: a central non expansive short tau iversion recovery (STIR) signal lesions extended to spinal cord from D10 until conus without enhancement after administration of gadolinium | CSF: 43 cells (cut off < 25) associated with mild hyperproteinorachia (406 mg/l; cut off 305) + normal glycorrhachia and oligoclonal bands | IgG = positive / Autoimmune screening = normal / Acquaporin-4 antibodies = negative / anti-MOG = positive with a titer 1:2560 (positive ≥ 1:160) | Negative | Ceftriaxone + piperacillin/tazobactam + MPS | Brain and Spinal cord status was improved, the hyperintense streak in STIR has almost completely disappeared, and Anti MOG titer was stable. |
Nagaratnam et al. 2022 | Australia | 36 | Female | Headache + photophobia + blurred vision + bilateral visual impairment + subjective colour desaturation + painful eye movements + fatigue + painful eye movements | AstraZeneca (ChAdOx1) | 1st | 14d | Brain MRI: multiple T2/ FLAIR hyperintense lesions involving the subcortical white matter, posterior limb of bilateral internal capsules, pons and left middle cerebellar peduncle. The largest lesion was in the right frontal centrum semiovale measuring 17 × 17 mm with multiple internal punctate foci of gadolinium contrast enhancement + There was no callosal involvement. Notably, there was no definite abnormal signal or enhancement of optic nerves / Spine MRI: evidence of demyelinating disease | CSF: a normal protein of 0.4 g/L (0.19 – 0.56 g/L), glucose of 4.8 mmol/L (2.8 – 4.5 mmol/L) with pleocytosis (white cell count 59 × 106/L) (<5 × 106/L) + CSF IgG was 0.06 g/L (<0.03 g/L) with serum IgG of 12.4 g/L (7.0 – 16 g/L) + oligoclonal IgG bands were present / Serum and CSF aquaporin 4 antibodies = negative | Serum myelin oligodendrocyte glycoprotein antibody (MOG) = negative | NR | MPS | Improvement in vision and discharged, repeat MRI Brain showed further improvement, visual evoked potentials showed improvement, no new symptoms to suggest a clinical relapse, consistent with a monophasic illness. |
Netravathi et al. 2022 | India | 54 | Female | Progressive quadriparesis + altered sensorium + drowsiness | AstraZeneca (ChAdOx1) | 1st | 14d | Brain MRI: T2/FLAIR hyperintensities in the corpus callosum, bl periventricular and subcortical white matter, infratentorial region with patchy contrast enhancement | CSF: 8 cells- lymphocytic predominant, Protein:77 mg/dl, Glucos:98 mg/dl | ANA, ANCA, CRP -negative Serum NMO-MOG = negative | NR | MPS + PE + Prednisolone | Significant improvement |
35 | Female | Progressive paraparesis + altered sensorium + conscious + confused + paraparesis | AstraZeneca (ChAdOx1) | 1st | 9d | MRI: T2/FLAIR hyperintensities in mid brain, pons, left MCP, bl posterior internal capsule, thalamus, bl centrum semiovale and LETM from cervical cord to conus | CSF: 58 cells -lymphocytes P: 47.4 mg/dl, G: 106 mg/dl | ANA profile, ANCA, VDRL, RA factor = negative / serum MOG = positive / VEP, BERA, SSEP = normal | NR | MPS + Prednisolone | Significant improvement | ||
20 | Female | Paraesthesias + paraparesis + altered sensorium | Covaxin (BBV152) | 1st | 1d | MRI: few juxtacortical and short segment cervical T2/FLAIR hyperintensity at C5 level with subtle enhancement | CSF: 8 cells + lymphocytic predominant, P:24.9 mg/dl, G:61 mg/dl | ANA profile, ANCA,VDRL, RA factor, CRP = negative / Serum and CSF NMO-MOG = negative / CSF OCB = Positive / VEP, BERA, SSEP = normal | NR | MPS + PE + Prednisolone | Significant improvement | ||
33 | Female | Fever + vomiting + altered sensorium + persistent paraesthesias | AstraZeneca (ChAdOx1) | 1st | 14d | Brian MRI: T2/FLAIR hyperintensity in Bl fronto parietal region, no enhancement | CSF: 105 cells + lymphocytic predominant, P: 28.12 mg/dl, G: 70.4 mg/dl | Serum MOG = Strongly positive | NR | Acyclovir + MPS + Prednisolone | Significant improvement | ||
60 | Male | Tingling paraesthesias + motor weakness + behavioural and memory disturbances | AstraZeneca (ChAdOx1) | 2nd | 14d | Brain MRI: multiple focal lesions in right pons, midbrain, medial temporal lobes, splenium of corpus callosum, high parietal lobe with tumefaction and peripheral enhancement | CSF: 9 cells – 90 % lymphocytes, P:68.3 mg/dl, G:132 mg/dl, OCBs-negative | ANA,ANCA,B12,Homocysteine,VDRL = negative / ACE = normal / Serum NMO and MOG = negative / VEP = normal | NR | MPS + Prednisolone | Significant improvement | ||
45 | Male | Fever + urinary retention + difficulty in walking | AstraZeneca (ChAdOx1) | 1st | 10d | Brain and spine MRI: hyperintensities in brainstem, cervicodorsal cord and supratentorial regions with central cord swelling | CSF: 44 cells – 44 % lymphocytes, P:90.9 mg/dl, G:68 mg/dl + rabies CSF PCR = Negative | VEP-l-141,R-129,BERA = normal / N20 = normal / P37–40(mildly prolonged), ANA-U1RNP-1+,C-ANCA-, Serum MOG = strongly positive / S.NMO = Negative | NR | MPS + PE + cycles tab WYSOLONE + MG tab | Significant improvement | ||
52 | Female | Progressive slurring of speech + muscle weakness + swallowing difficulty | AstraZeneca (ChAdOx1) | 1st | 35d | Brain MRI: tumefactive demyelination in left frontal hemisphere with insular involvement along with left more than right midbrain involvement | CSF: 2 CELLS,P-40.5 mg/dl,G-56 mg/dl ESR-18 | ANA, ANCA = Negative / VDRL = Negative / S.NMO and MOG = Negative | NR | Rituximab + cycles Tab Wysolone + PE | Remained critically ill, requiring invasive ventilation, and died (after a prolonged intensive care unit stay and superimposed infection) | ||
Permezel et al. 2021 | Australia | 63 | Male | Vertigo + abdominal pain + fatigue + ketoacidosis + silent myocardial infarction + declining cognition + emerging disorientation + impaired attention | AstraZeneca (ChAdOx1) | 1st | 12d | Brain and cervical spine MRI: numerous bilateral foci (>20) of high T2 and FLAIR signal in the cerebral white matter, with both periventricular and juxtacortical involvement | NR | NR | NR | Empiric antibiotics + antivirals + corticosteroids + PE | MRI brain was repeated on day 19 and demonstrated no changes, and died on day 20 of admission. |
Rinaldi et al. 2021 | Italy | 45 | Male | Numbness + reduced visual acuity + dysarthria + dysphagia + clumsy right hand movements + urge incontinence | AstraZeneca (ChAdOx1) | 1st | 12d | Brian MRI: large, poorly marginated T2-weighted hyperintensities in the pons (which appeared swollen), right cerebellar peduncle, right thalamus, and multiple spinal cord segments (at the cervical, dorsal, and conus medullaris level). All lesions, except the thalamic one and a single dorsal spinal area, showed blurred gadolinium enhancement on T1-weighted images | CSF: mild lymphocytosis (44 leucocytes, 98 % mononuclear cells), normal proteins, no evidence of tumor cells on CSF cytology / CSF immunoelectrophoresis: the presence of three oligoclonal bands, with normal Link’s Index / Extensive panel for onco-neural antibodies on serum and CSF = negative | Anti-aquaporin-4 (AQP4), anti-myelin oligodendrocyte glycoprotein (MOG) antibodies, anti-nuclear, anti-extractable nuclear antigens, anti-neutrophil cytoplasmic, and anti-cardiolipin antibodies = all Negative | NR | MPS + prednisone | Clinically improved in a few days, and MRI significantly improved |
Shimizu et al. 2021 | Japan | 88 | Female | Impaired consciousness + gaze-evoked nystagmus | Pfizer (BioNTech) | 2nd | 29d | Brian MRI: signal abnormalities in the bilateral middle cerebellar peduncles | CSF: bacterial and fungal cultures, a CSF oligoclonal band screen, and a test for autoantibodies against myelin basic protein = all negative | antinuclear-, autoimmune vasculitis-, onconeural-, and anti-ganglioside antibodies = all negative | NR | MPS | Impaired consciousness and gaze-evoked nystagmus were found to improve, further MRI brain scans revealed the signal abnormalities had decreased (Complete clinical recovery) |
Simone et al. 2021 | Italy | 51 | Female | Acute urinary retention + bilateral hypoesthesia | NR | NR | 2w (14d) | MRI: enhancing T2 hyperintense lesions in the spinal cord with longitudinal extension, in the midbrain and in the optic nerves bilaterally | CSF: lymphocyte pleocytosis (50 cells/μL), negative oligoclonal bands | anti-MOG-IgG antibody = positive | Negative | MPS | Clinical improvement |
Vogrig et al. 2021 | Italy | 56 | Female | Unsteadiness of gait + clumsiness of left arm + malaise + chills + diplopia + mild ataxia + left-ward deviation of gait + urinary retention | Pfizer (BioNTech) | 1st | 2w (14d) | Brain MRI: an area of hyperintensity on fluid attenuated inversion recovery (FLAIR) sequences involving the left cerebellar peduncle, with modest mass effect on the fourth ventricle, which was not present on the previous MRI examination. No contrast enhancement was observed and the lesion did not exhibit diffusion restriction. In addition, new supratentorial areas of hyperintensity on FLAIR sequences were observed, the largest in the left centrum semiovale (unremarkable) | CSF: pleocytosis (80 cells/mm3), protein and glucose levels = normal | MOG, AQP4, GM1, GM2, GM3, GM4, GD1a, GD1b, GD2, GD3, GT1a, GT1b, GQ1b = all negative | Negative | Prednisone | Spontaneously recovered and underwent regular follow-up |
Yazdanpanah et al. 2022 | Iran | 37 | Male | Muscle weakness + dysphagia + drooling + nausea + vomiting + bilateral facial nerve paralysis | Sinopharm | 1st | 1 month (30d) | Brain MRI: typical imaging findings which presented as multifocal T2-FLAIR signal changes in the corticospinal tract, pons, and temporal lobe with diffusion restriction. | CSF: 2 WBCs, 32 RBCs, 56 mg/dL protein, and glucose of 97 mg/dL + IgG oligoclonal bands = negative | NR | Negative | PE + IVIG + antibiotic therapy + Heparin + Pantoprazole + Clindamycin + Paracetamol + MPS | Showed progressive recovery of motor function, and discharged (with an excellent general condition) |
PE: Plasma exchane, MPS: Methylprednisolone, IVIG: Intravenous immuneglobulin, IVMP: IV methylprednisolone, NR: Not reported.