Peripheral Nervous System Complications after COVID-19 Vaccination

While vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains crucial, neurological complications have been detected following the coronavirus disease 2019 (COVID-19) vaccination. The neurological complications of COVID-19 vaccination can be seen in both the central...

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Main Authors: Seyed Sepehr Khatami, Samaneh Ghorbani Shirkouhi, Poul Flemming Høilund-Carlsen, Mona-Elisabeth Revheim, Abass Alavi, Morten Blaabjerg, Sasan Andalib
Format: Article
Language:English
Published: IMR Press 2025-03-01
Series:Journal of Integrative Neuroscience
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Online Access:https://www.imrpress.com/journal/JIN/24/3/10.31083/JIN26632
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author Seyed Sepehr Khatami
Samaneh Ghorbani Shirkouhi
Poul Flemming Høilund-Carlsen
Mona-Elisabeth Revheim
Abass Alavi
Morten Blaabjerg
Sasan Andalib
author_facet Seyed Sepehr Khatami
Samaneh Ghorbani Shirkouhi
Poul Flemming Høilund-Carlsen
Mona-Elisabeth Revheim
Abass Alavi
Morten Blaabjerg
Sasan Andalib
author_sort Seyed Sepehr Khatami
collection DOAJ
description While vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains crucial, neurological complications have been detected following the coronavirus disease 2019 (COVID-19) vaccination. The neurological complications of COVID-19 vaccination can be seen in both the central nervous system (CNS) and the peripheral nervous system (PNS). In this study, we reviewed PNS complications after COVID-19 vaccination, their underlying mechanisms, diagnosis, and management. Inflammatory polyneuropathy, small fiber neuropathy, Parsonage-Turner syndrome (PTS), cranial mononeuropathies, and myasthenia gravis (MG) have been reported following COVID-19 vaccination. Inflammatory polyneuropathy following COVID-19 vaccination should be diagnosed early based on clinical presentation and treated with supportive care, and immunoglobulin or plasmapheresis to prevent respiratory distress if required. It is important to differentiate peripheral from central facial paralysis after COVID-19 vaccination to rule out upper motor neuron damage, including stroke. Diagnosis of small fiber neuropathy in the setting of COVID-19 vaccination should be suspected in patients with dysesthesia, dysautonomia, and lower extremity paresthesia. A skin biopsy of the proximal or distal lower limb should generally be considered for diagnosing small fiber neuropathy following COVID-19 vaccination. Even though pain at the injection site is one of the most common symptoms after COVID-19 vaccination, shoulder pain lasting more than 3 weeks should raise the suspicion of severe complications such as PTS. In addition to a proper physical examination as a reliable diagnosis tool, needle electromyography can be considered to help the diagnosis of PTS following COVID-19 vaccination. In our opinion, despite complications after COVID-19 vaccination, the benefit of vaccination immunity should not be forgotten.
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spelling doaj-art-e412bf19f695404fb15548418d6b88e92025-08-20T03:42:23ZengIMR PressJournal of Integrative Neuroscience0219-63522025-03-012432663210.31083/JIN26632S0219-6352(24)00889-1Peripheral Nervous System Complications after COVID-19 VaccinationSeyed Sepehr Khatami0Samaneh Ghorbani Shirkouhi1Poul Flemming Høilund-Carlsen2Mona-Elisabeth Revheim3Abass Alavi4Morten Blaabjerg5Sasan Andalib6Department of Neurology, University of California Irvine, Irvine, CA 92617, USAStudent Research Committee, School of Medicine, Shahroud University of Medical Sciences, 3614773943 Shahroud, IranDepartment of Nuclear Medicine, Odense University Hospital, University of Southern Denmark, 5000 Odense, DenmarkThe Intervention Center, Division of Technology and Innovation, Oslo University Hospital, 0450 Oslo, NorwayDepartment of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USAResearch Unit of Neurology, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5230 Odense, DenmarkResearch Unit of Neurology, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5230 Odense, DenmarkWhile vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains crucial, neurological complications have been detected following the coronavirus disease 2019 (COVID-19) vaccination. The neurological complications of COVID-19 vaccination can be seen in both the central nervous system (CNS) and the peripheral nervous system (PNS). In this study, we reviewed PNS complications after COVID-19 vaccination, their underlying mechanisms, diagnosis, and management. Inflammatory polyneuropathy, small fiber neuropathy, Parsonage-Turner syndrome (PTS), cranial mononeuropathies, and myasthenia gravis (MG) have been reported following COVID-19 vaccination. Inflammatory polyneuropathy following COVID-19 vaccination should be diagnosed early based on clinical presentation and treated with supportive care, and immunoglobulin or plasmapheresis to prevent respiratory distress if required. It is important to differentiate peripheral from central facial paralysis after COVID-19 vaccination to rule out upper motor neuron damage, including stroke. Diagnosis of small fiber neuropathy in the setting of COVID-19 vaccination should be suspected in patients with dysesthesia, dysautonomia, and lower extremity paresthesia. A skin biopsy of the proximal or distal lower limb should generally be considered for diagnosing small fiber neuropathy following COVID-19 vaccination. Even though pain at the injection site is one of the most common symptoms after COVID-19 vaccination, shoulder pain lasting more than 3 weeks should raise the suspicion of severe complications such as PTS. In addition to a proper physical examination as a reliable diagnosis tool, needle electromyography can be considered to help the diagnosis of PTS following COVID-19 vaccination. In our opinion, despite complications after COVID-19 vaccination, the benefit of vaccination immunity should not be forgotten.https://www.imrpress.com/journal/JIN/24/3/10.31083/JIN26632neurological complicationsperipheral nervous systemcovid-19sars-cov-2vaccinationvaccine safety
spellingShingle Seyed Sepehr Khatami
Samaneh Ghorbani Shirkouhi
Poul Flemming Høilund-Carlsen
Mona-Elisabeth Revheim
Abass Alavi
Morten Blaabjerg
Sasan Andalib
Peripheral Nervous System Complications after COVID-19 Vaccination
Journal of Integrative Neuroscience
neurological complications
peripheral nervous system
covid-19
sars-cov-2
vaccination
vaccine safety
title Peripheral Nervous System Complications after COVID-19 Vaccination
title_full Peripheral Nervous System Complications after COVID-19 Vaccination
title_fullStr Peripheral Nervous System Complications after COVID-19 Vaccination
title_full_unstemmed Peripheral Nervous System Complications after COVID-19 Vaccination
title_short Peripheral Nervous System Complications after COVID-19 Vaccination
title_sort peripheral nervous system complications after covid 19 vaccination
topic neurological complications
peripheral nervous system
covid-19
sars-cov-2
vaccination
vaccine safety
url https://www.imrpress.com/journal/JIN/24/3/10.31083/JIN26632
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