Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10126, Turin, Italy.
Neurology 2 Unit, A.O.U. Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, 10124, Turin, Italy.
Neurol Sci. 2022 Sep;43(9):5165-5168. doi: 10.1007/s10072-022-06182-w. Epub 2022 Jun 6.
Several neurological complications have been reported following SARS-Cov-2 vaccination, without a clear causal relationship ever being verified, including some cases of worsening of Parkinson's disease (PD) symptoms and new onset of movement disorders in non-parkinsonian patients.
We describe two new cases of PD patients treated with device-aided therapy who developed worsening of parkinsonian symptoms after receiving the third vaccine dose (booster). We also conducted a short review of the cases reported in literature of PD symptoms worsening and new onset of movement disorders in non-parkinsonian patients after SARS-Cov-2 vaccination.
The first patient, a 46-year-old man implanted with bilateral Subthalamic Deep Brain Stimulation, experienced temporary motor and non-motor symptoms worsening after mRNA-1273 booster, improved after stimulation settings modification. The second patient, a 55-year-old man implanted with percutaneous endoscopic transgastric jejunostomy (PEG-J) for levodopa-carbidopa intestinal gel (LCIG) infusion experienced severe temporary worsening of dyskinesia and managed through temporary LCIG dose reduction. Other seven cases of vaccine-related movement disorder are currently reported in literature, four describing PD symptoms worsening and three the onset of new movement disorders in otherwise healthy people.
Both our patients and the cases described so far completely recovered after few days with parkinsonian therapy modification, symptomatic treatment, or even spontaneously, underlining the transient and benign nature of side effects from vaccine. Patients should be reassured about these complications, manageable through a prompt evaluation by the reference neurologist.
SARS-CoV-2 疫苗接种后出现了多种神经系统并发症，但从未明确证实存在因果关系，包括一些帕金森病（PD）患者症状恶化和非帕金森病患者新发运动障碍的病例。
我们描述了两例接受辅助设备治疗的 PD 患者在接种第三剂疫苗（加强针）后出现帕金森症状恶化的新病例。我们还对文献中报告的 PD 症状恶化和非帕金森病患者接种 SARS-CoV-2 疫苗后新发运动障碍的病例进行了简短回顾。
第一位患者是一名 46 岁男性，接受了双侧丘脑底核深部脑刺激治疗，在接受 mRNA-1273 加强针后出现了短暂的运动和非运动症状恶化，经刺激参数调整后改善。第二位患者是一名 55 岁男性，因左旋多巴-卡比多巴肠凝胶（LCIG）输注而行经皮内镜经胃空肠造口术（PEG-J），出现严重的暂时性运动障碍恶化，通过暂时减少 LCIG 剂量得到控制。目前文献中还报告了另外七例与疫苗相关的运动障碍病例，其中四例描述了 PD 症状恶化，三例描述了原本健康的人出现新发运动障碍。
我们的两位患者和迄今为止描述的病例在几天内通过改变帕金森病治疗、对症治疗甚至自发恢复后完全康复，这突显了疫苗副作用的短暂和良性性质。应该让患者对这些并发症放心，通过参考神经科医生的及时评估即可进行管理。
