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Yıl:2023; Cilt: 60; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2023;60(4):376-379
mRNA BNT162b2 COVID-19 Aşısı Sonrası Oküler Flutter-Myoklonus-Ataksi Sendromu: Bir Olgu Bildirimi
T Poyraz , A Varol , HA Uysal
İzmir Ekonomi Üniversitesi, İzmir
Oküler flutter (OF) nadir görülen bir okulomotor sendromdur. En yaygın etiyolojiler; paraneoplastik, postenfeksiyöz ve toksik-metabolik nedenlerdir. Ancak aşı sonrası OF nadiren bildirilmiştir. Burada oligoklonal bantlar (OKB’ler) ile ilişkili OF-myoklonus ve ataksiyle karakterize bir aşı sonrası klinik sendrom bildirilmiştir. İkinci mRNA BNT162b2 Covid-19 aşısından üç gün sonra başlayan baş dönmesi, dengesiz yürüyüş, istemsiz hareketler, istemsiz göz hareketleri ve ekstremitelerde sıçramaları olan 60 yaşında bir erkek hasta sunulmaktadır. Rutin biyokimyasal ve serolojik testleri normal sınırlar içinde saptandı. Beyin Manyetik Rezonans imajlarında patolojik bulgu saptanmadı. Beyin omurilik sıvısında (BOS) bakılan paraneoplastik ve otoimmün ensefalit testlerinde anlamlı bulgu saptanmadı. Beyin omurilik sıvısında OKB tip 2 pozitif saptandı. Bu olgu, SARS-CoV-2’ye karşı geliştirilen aşılar ve OF, Miyoklonus ve Ataksi (OFMAS) klinik sendromu arasındaki ilişkinin bildirildiği ilk yayındır. Humoral bağışıklık mekanizmaları, OFMAS’ta önemli bir rol oynuyor gibi gözükmektedir. BOS’ta OKB’lerin varlığı bu durumla ilişkili olabilir.
Ocular Flutter-Myoclonus-Ataxia Syndrome After mRNA BNT162b2 COVID-19 Vaccine:A Case Report
Ocular flutter (OF) is a rare oculomotor syndrome. The most common etiologies are paraneoplastic, postinfectious and toxic-metabolic. However post-vaccinal etiology was rarely reported in OF. Here, we reported a post-vaccinal clinical syndrome characterized by OFmyoclonus and ataxia associated with oligoclonal bands (OCBs). A 60-year-old male who presented with dizziness, unsteady gait, involuntary tremors, involuntary conjugate eye oscillations and extremity jerks that started 3 days after the second dose of mRNA BNT162b2 Covid-19 vaccine. Routine biochemical and serological analysis were within normal limits. No pathological finding was detected in Brain MRI. Paraneoplastic and autoimmune encephalitis tests were unremarkable in cerebrospinal fluid (CSF). Oligoclonal bands were positive in CSF. This is the first description of the relationship between vaccines against SARS-CoV-2 and the clinical syndrome of OF, Myoclonus and Ataxia (OFMAS). Humoral immune mechanisms seem to play an important role in OFMAS. Presence of OCBs in CSF may also be associated with this condition

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