Clinical and Radiological Follow-Up of a Pfizer-BioNTech COVID-19 Vaccine-Induced Hemichorea-Hemiballismus

Tremor Other Hyperkinet Mov (N Y). 2022 May 18:12:16. doi: 10.5334/tohm.688. eCollection 2022.

Abstract

Background: Hemichorea-hemiballismus is a rare hyperkinetic movement disorder.

Case report: A 90-year-old male developed left hemichorea-hemiballismus after his second dose of the Pfizer-BioNTech COVID-19 vaccine. A wide range of investigations including magnetic resonance imaging did not reveal an alternative cause. [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) showed increases in right putamen fixation compared to the left side. The patient showed significant improvement after five days of intravenous corticosteroids, with a normal FDG-PET.

Discussion: This hemichorea-hemiballismus case shows dynamic restoration of putamen metabolism mirroring clinical evolution after administration of corticosteroids, suggesting an autoimmune COVID-19 vaccine-induced reaction.

Keywords: COVID-19; FDG-TEP; Hemichorea; hemiballismus; vaccine.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • BNT162 Vaccine
  • COVID-19 Vaccines / adverse effects
  • COVID-19*
  • Chorea* / etiology
  • Dyskinesias* / diagnostic imaging
  • Dyskinesias* / etiology
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Humans
  • Male

Substances

  • COVID-19 Vaccines
  • Fluorodeoxyglucose F18
  • BNT162 Vaccine