Disclosures: David Oria, DO: No financial relationships or conflicts of interest

Case Diagnosis: Development of Guillain-Barre Syndrome (GBS) or transverse myelitis (TM) shortly following COVID-19 vaccination.

Case Description: This case series details three individuals who developed Guillain-Barre Syndrome (GBS) or transverse myelitis (TM) shortly following COVID-19 vaccination. All three of the patients received immunosuppressive therapy as part of their treatment regimen with tailored treatments for their individual deficits. Two of the patients improved with treatment while one patient retained their deficits through their hospitalization course. In this report, we will explore a series of cases in which patients developed autoimmune post-vaccination neurological sequelae including TM and GBS.

Setting: Inpatient and outpatient rehabilitation

Assessment/Results: Here, we have presented three cases of post-COVID-19 vaccination neurological sequelae including TM and GBS. The diagnosis was confirmed with MRI and/or lumbar puncture. Treatment regimens had slight variation, but at their cores utilized immunosuppressant therapies. Neurological manifestations improved in two out of the three cases with these forms of treatment.

Discussion: There have been case studies of TM following MMR and Influenza vaccinations as well. A more common, though still rare, post-vaccine adverse effect is GBS. With the administration of the COVID-19 vaccine, there have been similar reported cases. The frequency of this adverse reaction is not yet determined, and neither are any potential common risk factors.

Conclusion: Unfortunately, there has not been further support in the determination of risk factors that may make certain patients more prone to these reactions or clarification on the exact pathophysiology underlying these neurological manifestations. Despite these limitations, we can further add to the evidence for TM and GBS as potential adverse effects after COVID-19 vaccination. Additionally, we show that in most cases symptoms improved following immunosuppressive therapies. While further studies will be required to answer some of the above questions, these complications will be an important consideration for future vaccination recipients.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/post-covid-19-vaccination-transverse-myelitis-and-guillain-barre-syndrome-a-case-series/