Acute disseminated encephalomyelitis following coronavirus disease vaccination

A 76-year-old man presented to our hospital with bilateral progressive amaurosis and consciousness disorder 4 weeks after he had received the Sinovac coronavirus disease (COVID-19) vaccine. He had no notable medical history, mildly elevated levels of cerebrospinal fluid protein, and a normal blood cell count. Brain magnetic resonance imaging findings revealed multiple white-matter lesions bilaterally (Figure 1A-D). The suspected diagnosis was acute disseminated encephalomyelitis. This disease usually develops following viral infection or vaccination and is characterized by monophasic acute inflammation and demyelination of the white matter, typically 1-2 weeks after exposure. Few reports have described the occurrence of acute disseminated encephalomyelitis following COVID-19 vaccination ^{1 , 2} .

FIGURE 1: Fluid-attenuated inversion recovery magnetic resonance imaging (MRI) findings in the (A) axial and (B) sagittal views showing multiple hyperintense white matter lesions and basal nuclei bilaterally (arrows). (C) Contrast-enhanced T1-weighted MRI findings showing an incomplete arc of contrast enhancement (arrows). (D) MRI diffusion-weighted imaging showing hyperintense lesions (arrows).