COVID-19 Vaccination in Young People with Functional Neurological Disorder: A Case-Control Study

Natalie Lim; Nicholas Wood; Archana Prasad; Karen Waters; Davinder Singh-Grewal; Russell C Dale; Joseph Elkadi; Stephen Scher; Kasia Kozlowska

doi:10.3390/vaccines10122031

COVID-19 Vaccination in Young People with Functional Neurological Disorder: A Case-Control Study

Vaccines (Basel). 2022 Nov 28;10(12):2031. doi: 10.3390/vaccines10122031.

Authors

Natalie Lim¹, Nicholas Wood^{2

3}, Archana Prasad⁴, Karen Waters^{5

6}, Davinder Singh-Grewal^{6

7

8}, Russell C Dale^{9

10}, Joseph Elkadi¹, Stephen Scher^{11

12

13}, Kasia Kozlowska^{1

3

6

14}

Affiliations

¹ Department of Psychological Medicine, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
² National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Westmead, NSW 2145, Australia.
³ The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia.
⁴ Department of General Medicine, The Children's Hospital at Westmead Clinical School, Westmead, NSW 2145, Australia.
⁵ Sleep Medicine, The Children's Hospital at Westmead, Westmead Clinical School, Westmead, NSW 2145, Australia.
⁶ Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia.
⁷ Department of Rheumatology, Sydney Children's Hospital Network, Westmead, NSW 2145, Australia.
⁸ School of Women's and Children's Health, University of New South Wales, Randwick, NSW 2031, Australia.
⁹ Kids Neuroscience Centre, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia.
¹⁰ The Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia.
¹¹ McLean Hospital, Belmont, MA 02478, USA.
¹² Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA.
¹³ Speciality of Psychiatry, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia.
¹⁴ Brain Dynamics Centre at Westmead Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia.

Abstract

Background: The emergence of acute-onset functional neurological symptoms, the focus of this study, is one of three stress responses related to immunisation. This case-control study documents the experience of 61 young people with past or current functional neurological disorder (FND) in relation to the COVID-19 vaccination program in Australia.

Methods: Information about the young person's/parent's choice and response pertaining to COVID-19 vaccination was collected as part of routine clinical care or FND research program follow-up.

Results: 61 young people treated for FND (47 females, mean age = 16.22 years) and 46 healthy controls (34 females, mean age = 16.37 years) were included in the study. Vaccination rates were high: 58/61 (95.1%) in the FND group and 45/46 (97.8%) in the control group. In the FND group, 2 young people (2/61, 3.3%) presented with new-onset FND following COVID-19 vaccination; two young people with resolved FND reported an FND relapse (2/36, 5.56%); and two young people with unresolved FND (2/20, 10.0%) reported an FND exacerbation. In the control group no FND symptoms were reported.

Conclusions: Acute-onset FND symptoms following COVID-19 vaccination are uncommon in the general population. In young people prone to FND, COVID-19 vaccination can sometimes trigger new-onset FND, FND relapse, or FND exacerbation.

Keywords: COVID-19 vaccines; SARS-CoV-2 vaccines; adolescents; children; dissociative neurological symptom reactions (DNSRs); functional (dissociative) seizures; functional neurological (conversion) disorder (FND); immunisation stress–related responses (ISRRs); young people.

Grants and funding

This research received no external funding.