Published online Jan 16, 2023. doi: 10.12998/wjcc.v11.i2.464
Peer-review started: November 6, 2022
First decision: November 16, 2022
Revised: November 18, 2022
Accepted: January 3, 2023
Article in press: January 3, 2023
Published online: January 16, 2023
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 pes cavus 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 GJB1 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.
Core Tip: We present a case report of a young man who presented with episodic aphasia and dysphagia after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. After a complete neurological evaluation, nerve conduction study, and DNA analysis, we diagnosed the patient with Charcot-Marie-Tooth disease type 1 (CMTX1). CMTX1 can occur after SARS-CoV-2 vaccination, and thus SARS-CoV-2 vaccination should be considered a potential predisposing factor for CMTX1. There is paucity of information on the neurological consequences of SARS-CoV-2 vaccination, even though billions of vaccines have been administered worldwide. We believe that our study makes a significant contribution to the literature based on the continued urgency of the coronavirus disease 2019 pandemic.