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Letter to editor response: Why myoclonus is linked to COVID19 infection, Not to anti-COVID 19 vaccine

Published:December 30, 2022DOI:https://doi.org/10.1016/j.seizure.2022.12.008

      Key words

      We thank Dr. Finsterer for his interest and critical appraisal of our publication entitled “Myoclonus status revealing COVID 19 infection ”.
      In his comment, the author raised concerns regarding the possible link between myoclonus and anti-COVID 19 vaccination, especially that the patient did not present any respiratory symptoms.
      However, our patient presented diarrhea which is recognized as one of the main COVID-19 infection symptoms [
      • Allahyari F
      • Molaee H
      • Hosseini Nejad J.
      Covid-19 vaccines and neurological complications: a systematic review.
      ]. Therefore, it is difficult to incriminate the vaccine in myoclonus genesis in presence of confirmed infection. Besides, more cases of COVID-19 related [
      • Shimohata T.
      Neuro-COVID-19.
      ] than vaccine-related myoclonus [
      • Garg RK
      • Paliwal VK.
      Spectrum of neurological complications following COVID-19 vaccination.
      ] have been reported in the literature. However, vaccine-aggravating effect could be considered especially since worsening of preexistant myoclonus was previously reported [
      • Oonk NGM
      • Ettema AR
      • van Berghem H
      • de Klerk JJ
      • van der Vegt JPM
      • van der Meulen M.
      SARS-CoV-2 vaccine-related neurological complications.
      ]. Thus, in our case, the myoclonus was more likely related to the COVID-19 infection with possible vaccine potentiator effect.
      The author also pointed out the crucial role of magnetic resonance imaging (MRI) contrast agents in the context of a clinical immune-encephalitis work-up.
      Indeed, the patient underwent a brain MRI with gadolinium but there no pathological enhancement was seen.
      We appreciate peer review both before and after publication, as this is necessary to ensure the accuracy of reported findings and strengthens the conclusions.

      Declaration of Competing Interest

      We, Dina Ben Mohamed, Rania Zouari, Jihen Ketata, Fatma Nabli, and Samia Ben Sassi, authors of the article “Letter to editor response: Why myoclonus is linked to COVID19 infection, Not to anti-COVID 19 vaccine” attest that we have none declared under financial, general and institutional competing interests

      References

        • Allahyari F
        • Molaee H
        • Hosseini Nejad J.
        Covid-19 vaccines and neurological complications: a systematic review.
        Z Naturforschung C J Biosci. 2022 Sep 12;
        • Shimohata T.
        Neuro-COVID-19.
        Clin Exp Neuroimmunol. 2022 Feb; 13: 17-23
        • Garg RK
        • Paliwal VK.
        Spectrum of neurological complications following COVID-19 vaccination.
        Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol. 2022 Jan; 43: 3-40
        • Oonk NGM
        • Ettema AR
        • van Berghem H
        • de Klerk JJ
        • van der Vegt JPM
        • van der Meulen M.
        SARS-CoV-2 vaccine-related neurological complications.
        Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol. 2022 Apr; 43: 2295-2297