Zhang Qiang, Wang Yang, Bai Run-Tao, Lian Bao-Rong, Zhang Yu, Cao Li-Ming
Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen 518000, Guangdong Province, China.
Shantou University Medical College, Shantou University, Shantou 515063, Guangdong Province, China.
World J Clin Cases. 2023 Jan 16;11(2):464-471. doi: 10.12998/wjcc.v11.i2.464.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations have been administered worldwide, with occasional reports of associated neurological complications. Specifically, the impact of vaccinations on individuals with X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is unclear. Patients with CMTX1 can have stroke-like episodes with posterior reversible encephalopathy syndrome on magnetic resonance imaging (MRI), although this is rare.
A 39-year-old man was admitted with episodic aphasia and dysphagia for 2 d. He received SARS-CoV-2 vaccination 39 d before admission. Physical examination showed and reduced tendon reflexes. Brain MRI showed bilateral, symmetrical, restricted diffusion with T2 hyperintensities in the cerebral hemispheres. Nerve conduction studies revealed peripheral nerve damage. He was diagnosed with Charcot-Marie-Tooth disease, and a hemizygous mutation in the gene on the X chromosome, known to be pathogenic for CMTX1, was identified. Initially, we suspected transient ischemic attack or demyelinating leukoencephalopathy. We initiated treatment with antithrombotic therapy and immunotherapy. At 1.5 mo after discharge, brain MRI showed complete resolution of lesions, with no recurrence.
SARS-CoV-2 vaccination could be a predisposing factor for CMTX1 and trigger a sudden presentation.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗已在全球范围内接种，偶尔有相关神经并发症的报道。具体而言，疫苗接种对X连锁1型夏科-马里-图斯病（CMTX1）患者的影响尚不清楚。CMTX1患者在磁共振成像（MRI）上可能出现类似中风的发作，并伴有后部可逆性脑病综合征，尽管这种情况很少见。
一名39岁男性因发作性失语和吞咽困难入院2天。他在入院前39天接种了SARS-CoV-2疫苗。体格检查显示腱反射减弱。脑部MRI显示双侧、对称、扩散受限，大脑半球T2高信号。神经传导研究显示周围神经损伤。他被诊断为夏科-马里-图斯病，并在X染色体上的基因中发现了一个半合子突变，已知该突变对CMTX1具有致病性。最初，我们怀疑是短暂性脑缺血发作或脱髓鞘性白质脑病。我们开始进行抗血栓治疗和免疫治疗。出院后1.5个月，脑部MRI显示病变完全消退，无复发。
SARS-CoV-2疫苗接种可能是CMTX1的诱发因素，并引发突然发作。
