Acute disseminated encephalomyelitis (ADEM) following recent Oxford/AstraZeneca COVID-19 vaccination
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This report describes the clinical context and autopsy findings in the first reported fatal case of acute disseminated encephalomyelitis (ADEM), developed after being vaccinated using the Oxford/AstraZeneca COVID-19 vaccine. ADEM is a rare autoimmune disease, causing demyelination in the brain and spinal cord. A wide variety of precipitating factors can trigger ADEM, and it has long been known to be a rare adverse event following some types of vaccinations. Recently, ADEM has also been associated with COVID-19 infection and (very rarely) with COVID-19 vaccination. The reports of the latter however all pertain to living patients. Our case demonstrates that ADEM should be considered in patients developing neurological symptoms post COVID-19 vaccination, although that this adverse reaction is likely to remain extremely rare. Our report further emphasizes the added value of comprehensive post mortem investigation to confirm ante mortem diagnosis and to determine vaccination safety.
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Although some case reports have suggested a possible association between COVID-19 vaccination and ADEM, there was no consistent pattern in terms of vaccine or timing following vaccination, and larger epidemiological studies have not confirmed any potential association.
“Although some case reports have suggested a possible association between COVID-19 vaccination and ADEM, there was no consistent pattern in terms of vaccine or timing following vaccination, and larger epidemiological studies have not confirmed any potential association [41 -44].”
From COVID-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals (2024) · cites this paper as [43]
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Neurological complications after covid-19 vaccination
Мухсиновна, Х. Х., Rashidova, N., & Salimjonov, J. (2023) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202312312113
Pathophysiology of Acute Disseminated Encephalomyelitis – Immune and Autoimmune Aspects
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Neurological Complications after COVID-19 Vaccination
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- Authors
- Permezel, F., Borojevic, B., Lau, S., & de Boer, H. H.
- Affiliations
- Austin Hospital (AU)
- Venue
- Forensic Science, Medicine and Pathology
- Published
- 2021-11-04
- Volume
- 18
- Issue
- 1
- Pages
- 74-79
- ISSN
- 1547-769X (ISSN-L)
- 1556-2891
- PMC
- PMC8567127
- OpenAlex
- W3208126552
- Cited by
- 62
- References
- 32
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 11 · 2023: 21 · 2022: 27
- FWCI
- 9.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Forensic Science Medicine and Pathology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Keywords
- acute disseminated encephalomyelitis, vaccine adverse events, demyelination, autoimmune disease, fatal outcome, autopsy, vaccine safety
- MeSH terms
- COVID-19, COVID-19 Vaccines, Brain, Encephalomyelitis, Acute Disseminated, Humans, Vaccination
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