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• #AURAL MIGRAINE STROKE SERIES#

None received a second dose of the ChAdOx1 vaccine. There were 2553 individuals to whom first doses of the ChAdOx1 vaccine were administered.

Īs of May 9, 2021, at King Chulalongkorn Memorial Hospital, 13,194 individuals had been administered first doses of the CoronaVac vaccine, and among them, 4064 s doses were administered. This work was presented as an abstract at the World Congress of Neurology (WCN 2021) in Rome, Italy (3–7 October 2021). Here we present eight cases of this immunization-related focal neurological syndrome that underwent extensive investigation in our hospital. Interestingly, these unusual presentations and findings were consistent among the patients. After thousands of injections in our hospital, several more cases have been consulted by the neurology team for further evaluation as acute stroke was suspected. The very first case report regarding this phenomenon was published in this journal. However, after mass vaccination, cases with a distinctive, novel focal neurological syndrome have begun to emerge nationwide among those receiving CoronaVac. Both were approved by the Thai Food and Drug Administration. The COVID-19 vaccination program in Thailand started in February 2021, with the two available vaccines at that time being CoronaVac (Sinovac Biotech, China) and ChAdOx1 (AstraZeneca/Oxford, UK). Neurologic complications of COVID-19 vaccination are rare, but reported definite and possible nervous system adverse events have included cerebral venous thrombosis, Guillain-Barre syndrome, postural orthostatic tachycardia, and immunization stress-related response. We propose that pain related to vaccine injection, component of vaccine, such as aluminum, or inflammation related to vaccination might trigger migraine aura in susceptible patients. The characteristic sensory symptoms, history of migraine, female predominant, and abnormal functional brain imaging without structural changes suggest migraine aura as pathophysiology.

#AURAL MIGRAINE STROKE SERIES#

Here, we present a case series of transient focal neurological syndrome following Coronavac vaccination. None developed permanent deficits or structural brain injury. All patients showed moderately large regions of hypoperfusion and concurrent smaller regions of hyperperfusion on SPECT imaging while symptomatic. Magnetic resonance imaging of the brain during and after the attacks did not demonstrate any abnormalities suggesting ischemic stroke. Migraine headache occurred in half of the patients. All presented with lateralized sensory deficits, motor deficits, or both, of 2–14 day duration. Acute onset of focal neurological symptoms occurred within the first 24 h after vaccination in 75% and between 1-7d in 25%.

Patients were aged 24–48 years and 75% were female. We report 8 patients with focal neurological symptoms after receiving inactivated virus vaccine, CoronaVac. After the initiation of the COVID-19 vaccination program in Thailand, thousands of patients have experienced unusual focal neurological symptoms.