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J Neuroimmunol . New-onset refractory status epilepticus following the ChAdOx1 nCoV-19 vaccine

tetano

Editor, Senior Moderator
J Neuroimmunol


. 2021 Jun 7;357:577629.
doi: 10.1016/j.jneuroim.2021.577629. Online ahead of print.
New-onset refractory status epilepticus following the ChAdOx1 nCoV-19 vaccine


Yasser Aladdin[SUP] 1 [/SUP], Bader Shirah[SUP] 2 [/SUP]



Affiliations

Abstract

Coronavirus is a novel human pathogen causing fulminant respiratory syndrome (COVID-19). Developing an effective and reliable vaccine was emergently pursued to control the dramatic spread of the global pandemic. The standard stages for vaccine development were unprecedentedly accelerated over a few months. We report a case of new-onset refractory status epilepticus (NORSE) after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. We attribute the occurrence of NORSE to the vaccine due to the temporal relationship and the lack of risk factors for epilepsy in the patient. This report adds to the literature a possible rare side effect of a COVID-19 vaccine and contributes to the extremely limited literature on potential neurological side effects of viral vector vaccines. Healthcare providers should be aware of the possibility of post-vaccination epilepsy. The patient had recurrent seizures that were refractory to conventional antiepileptic drug therapy with a dramatic response to immunotherapy with pulse steroids and plasmapheresis. This likely reflects an underlying autoimmune mechanism in the genesis of post-vaccination generalized seizures without fever. Further research is needed to probe and study the exact mechanism at a more molecular level.

Keywords: COVID-19; ChAdOx1 nCoV-19; Seizure; Status epilepticus; Vaccine.
 
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