key: cord-0719824-xz50js1y
authors: Katada, Eiichi; Toyoda, Takanari; Yamada, Gohei; Morishima, Akira; Matsukawa, Noriyuki
title: A case of chronic inflammatory demyelinating polyneuropathy following COVID‐19 vaccine
date: 2022-05-02
journal: Neurol Clin Neurosci
DOI: 10.1111/ncn3.12604
sha: d0a226ed4311106f94b444ccee7d08d193722710
doc_id: 719824
cord_uid: xz50js1y

We report a 44‐year‐old woman who presented with bilateral weakness of the hands and distal paresthesia of the arms on the next day of the second COVID‐19 vaccine, and gradually progressed ascending weakness of the arms and legs, and sensory ataxia beyond 2 months. She was diagnosed as a chronic inflammatory demyelinating polyneuropathy (CIDP) following COVID‐19 vaccine on the basis of clinical and electrophysiological findings. This is a first case diagnosed as a CIDP following COVID‐19 vaccine alone.

Recently, the number of case reports regarding to Guillain-Barrẻ syndrome (GBS) after Coronavirus disease 2019 (COVID-19) infection or following COVID-19 vaccine has been increasing. 1 Here, we described the first case of chronic inflammatory demyelinating polyneuropathy (CIDP) following COVID-19 vaccine alone.

Differentiating CIDP from GBS is crucial at the initial clinical presentation, because there have been different treatment and outcomes. 

The large population-based study revealed that the risk of neurological complications from SARS-CoV-2 infection was substantially higher than the risk of adverse events from vaccinations and that there was an increased risk of GBS and Bell`s palsy with ChAdOx1nCoV-19 and an increased risk of hemorrhagic stroke with BNT162b2. 4 CIDP is characterized by an insidious onset showing slow and progressive course, but may present acutely in up to 13% of patients, who rapidly progress within 4 weeks and initially may be diagnosed with GBS. 3 The first case of acute-onset CIDP in association with COVID-19 disease and its vaccination was reported. 5 To our knowledge, our case diagnosed as CIDP following COVID-19 vaccine alone is first described. This case might indicate the possible causal relationship between COVID-19 vaccination and CIDP.

However, because CIDP may develop by chance, the causal relationship between two events should be considered with caution in the same manner as GBS. 6 Katada et al.

The authors declare no conflict of interest for this article.

This case report was conducted in accordance with the Declaration of Helsinki, and the identity of the patient has been protected.

Informed consent was obtained from the patient to publish these features of her case.

Eiichi Katada https://orcid.org/0000-0002-1594-5141

Neurological complications of COVID-19: Guillain-Barre syndrome following Pfizer COVID-19 vaccine

Clinimetric evaluation of a new overall disability scale in immune mediated polyneuropathies

European academy of neurology/peripheral nerve society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force-second revision

Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection

Acute-onset chronic inflammatory demyelinating polyneuropathy after COVID-19 infection and subsequent ChAdOx1 nCoV-19 vaccination

Emerging infection, vaccination, and Guillain-Barrẻ syndrome: a review

Abbreviations: CMAP, compound muscle action potential; MCV, motor conduction velocity; SCV, sensory conduction velocity; SNAP, sensory nerve action potential.