2338 Peripheral neuropathies temporally associated with COVID-19 vaccination

• Published in: BMJ neurology open Vol. 4; no. Suppl 1; p. A42
• Main Authors: Krishnan, Dhayalen, Swart, Grace, Wang, Min-Xia, Jankelowitz, Stacey, Spies, Judith
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.2022; BMJ Publishing Group LTD
• Subjects: Abstracts; Biopsy; COVID-19 vaccines; Guillain-Barre syndrome; Immunization
• ISSN: 2632-6140
• DOI: 10.1136/bmjno-2022-ANZAN.110

ObjectivesNeurological complications of vaccination are rare and usually have a good outcome. We were interested to investigate the incidence of Guillain Barre Syndrome (GBS) after COVID vaccination at our institution.MethodsWe retrospectively reviewed data of patients admitted for neuropathy from April to December 2021, corresponding to the period when immunisation against SARSCOV2 was actively undertaken in New South Wales. We also separately reviewed nerve biopsies of three patients from other institutions.ResultsThere were 13 cases of neuropathy; 10 GBS and three small fibre neuropathy. Eight were temporally linked to SARSCoV2 vaccination (6 ChAdOx-1S). Five were sporadic cases of GBS (three preceded by diarrhoea). Latency between vaccination and onset of symptoms ranged from 2 to 30 days. Facial diplegia was seen in 3 of the 7 post vaccine GBS patients and none of the sporadic cases. Patients with GBS received standard immunomodulatory therapy while most of those with small fibre neuropathy recovered spontaneously.Sural nerve biopsies from three external patients were reviewed; two GBS and one mononeuritis multiplex. There were no histopathological features specific to the SARSCoV2 vaccination with two showing typical findings of AIDP and one an active axonal neuropathy with lymphocytic infiltrates. One of the biopsy patients with GBS post vaccine died within two days of hospitalisation of unknown cause. All other patients made a complete or partial recovery over three months.ConclusionThis review highlights the peripheral nerve complications temporally associated with COVID vaccination, some unique clinical features, and confirms most make a complete recovery.