Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy.
Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
J Neuroimmunol. 2021 Sep 15;358:577661. doi: 10.1016/j.jneuroim.2021.577661. Epub 2021 Jul 13.
We describe the first case of hyperacute reversible encephalopathy following COVID-19 vaccination. A patient presented with acute onset encephalopathy, mainly characterized by agitation and confusion, rapidly responsive to high dosage steroid therapy and complete remission within 3 days from onset. The clinical manifestation was related with systemic and CSF cytokine hyperproduction, responsive to steroid therapy. Although the occurrence of encephalopathy after vaccination may be just a casual temporal association, we speculate that the cytokine-storm could be the result of an excessive innate immune response against the vaccine, in a predisposed patient susceptible to autoimmunity.
我们描述了首例 COVID-19 疫苗接种后超急性可逆性脑病。患者表现为急性起病的脑病，主要表现为激越和意识混乱，对大剂量类固醇治疗反应迅速，自发病后 3 天内完全缓解。临床表现与全身和 CSF 细胞因子过度产生有关，对类固醇治疗有反应。尽管接种疫苗后发生脑病可能只是一种偶然的时间关联，但我们推测细胞因子风暴可能是对疫苗产生过度固有免疫反应的结果，而患者易患自身免疫。
