DOI QR코드

DOI QR Code

Guillain-Barré Syndrome-like Neurological Symptoms after COVID-19 Vaccination Treated with Traditional Korean Medicine: A Case Report

  • Hyeon-muk, Oh (College of Korean Medicine, Daejeon University) ;
  • Chang-gue, Son (Liver and Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University)
  • Received : 2022.11.22
  • Accepted : 2022.12.28
  • Published : 2022.12.30

Abstract

Objective: To report a clinical case of Guillain-Barré syndrome-like neurological symptoms, including limb weakness, phantosmia, and nausea/vomiting after COVID-19 vaccination (AstraZeneca) that was improved by traditional Korean medicine (TKM) treatment. Methods: A 73-year-old male complained of extreme limb weakness, severe phantosmia, and nausea/vomiting after COVID-19 vaccination. No abnormalities had appeared in various radiological and laboratory tests, but the symptoms had continued to worsen for three months before visiting our clinic. Results: The patient was diagnosed with neurological complications suspicious of Guillain-Barré syndrome after COVID-19 vaccination. The patient was treated with acupuncture, moxibustion, herbal drugs (Banhabakchulchunma-tang), and nasal inhalation therapy with Aquilariae Lignum. Three weeks after Korean medicine treatment, his neurological symptoms had improved. Nausea/vomiting and phantosmia continued to show improvement, and muscle strength was gradually recovered in both lower limbs. Conclusion: Traditional Korean medicine could be a choice for the treatment of neurological complications after COVID-19 vaccination.

Keywords

References

  1. World Health Organization. 12 January 2021. WHO Coronavirus (COVID-19) Dashboard. The World Health Organization. Accessed 1 Aug 2021. Available from: URL:https://covid19.who.int/
  2. Centers for Disease Control and Prevention, 2020. COVID. Available from: URL:https://www.cdc.gov/coronavirus/2019-ncov/index.html
  3. Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): A multicenter European study. Eur Arch Otorhinolaryngol 2020;277(8):2251-61. https://doi.org/10.1007/s00405-020-05965-1
  4. Spinato G, Fabbris C, Polesel J, Cazzador D, Borsetto D, Hopkins C, et al. Alterations in smell or taste in mildly symptomatic outpatients with SARS-CoV-2 infection. JAMA 2020;323(20):2089-90. https://doi.org/10.1001/jama.2020.6771
  5. Kashte S, Gulbake A, El-Amin SF, Gupta A. COVID-19 vaccines: rapid development, implications, challenges and future prospects. Human cell 2021;34(3):711-33. https://doi.org/10.1007/s13577-021-00512-4
  6. Garg RK, Paliwal VK. Spectrum of neurological complications following COVID-19 vaccination. Neurological Sciences 2021:1-38.
  7. Goss AL, Samudralwar RD, Das RR, Nath A. ANA investigates: neurological complications of COVID-19 vaccines. Annals of neurology 2021;89(5):856-7. https://doi.org/10.1002/ana.26065
  8. European Medicines Agency (EMA). COVID-19 vaccine safety update VAXZEVRIA AstraZeneca AB. 2021. Available from: URL: https://www.ema.europa.eu/en/medicines/human/EPAR/vaxzevria
  9. Correa DG, Canete LAQ, Dos Santos GAC, de Oliveira RV, Brandao CO, da Cruz Jr LCH. Neurological symptoms and neuroimaging alterations related with COVID-19 vaccine: Cause or coincidence? Clinical Imaging 2021;80:348-52. https://doi.org/10.1016/j.clinimag.2021.08.021
  10. Lu L, Xiong W, Mu J, Zhang Q, Zhang H, Zou L, et al. The potential neurological effect of the COVID-19 vaccines: a review. Acta Neurologica Scandinavica 2021;144(1):3-12.
  11. Fragkou PC, Dimopoulou D. Serious complications of COVID-19 vaccines: A mini-review. Metabolism open 2021;12:100-45.
  12. Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, et al. The CARE guidelines: consensus-based clinical case reporting guideline development. Journal of medical case reports 2013;7(1):1-6.
  13. Ciesla N, Dinglas V, Fan E, Kho M, Kuramoto J, Needham D. Manual muscle testing: a method of measuring extremity muscle strength applied to critically ill patients. JoVE (Journal of Visualized Experiments) 2011;50(1):e2632.
  14. Rahmy S, Setianto C, Munir B. Phantosmia as a rare neurological manifestation in patient infected with COVID-19: A case report. Journal of the Neurological Sciences 2021;429:119910.
  15. Neto DB, de Rezende Pinna F. COVID-19 and Anosmia: Remaining Gaps to Knowledge. International Archives of Otorhinolaryngology 2021;25(04):e479-80. https://doi.org/10.1055/s-0041-1736563
  16. Keir G, Maria NI, Kirsch CF. Unique Imaging Findings of Neurologic Phantosmia Following Pfizer-BioNtech COVID-19 Vaccination: A Case Report. Topics in Magnetic Resonance Imaging 2021;30(3):133-7. https://doi.org/10.1097/RMR.0000000000000287
  17. Shahrizaila N, Lehmann HC, Kuwabara S. Guillain-Barre syndrome. The Lancet 2021;397(10280):1214-28. https://doi.org/10.1016/S0140-6736(21)00517-1
  18. Doets AY, Verboon C, Van Den Berg B, Harbo T, Cornblath DR, Willison HJ, et al. Regional variation of Guillain-Barre syndrome. Brain 2018;141(10):2866-77. https://doi.org/10.1093/brain/awy232
  19. McKean N, Chircop C. Guillain-Barre syndrome after COVID-19 vaccination. BMJ Case Reports CP 2021;14(7):e244125.
  20. Garcia-Grimshaw M, Michel-Chavez A, Vera-Zertuche JM, Galnares-Olalde JA, Hernandez-Vanegas LE, Figueroa-Cucurachi M, et al. Guillain-Barre syndrome is infrequent among recipients of the BNT162b2 mRNA COVID-19 vaccine. Clinical Immunology 2021;230:108818.
  21. Rao SJ, Khurana S, Murthy G, Dawson ET, Jazebi N, Haas CJ. A case of Guillain-Barre syndrome following Pfizer COVID-19 vaccine. Journal of Community Hospital Internal Medicine Perspectives 2021;11(5):597-600. https://doi.org/10.1080/20009666.2021.1954284
  22. Schessl J, Koga M, Funakoshi K, Kirschner J, Muellges W, Weishaupt A, et al. Prospective study on anti-ganglioside antibodies in childhood Guillain-Barre syndrome. Archives of disease in childhood 2007;92(1):48-52. https://doi.org/10.1136/adc.2006.098061
  23. Abu-Rumeileh S, Abdelhak A, Foschi M, Tumani H, Otto M. Guillain-Barre syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases. Journal of neurology 2021;268(4):1133-70. https://doi.org/10.1007/s00415-020-10124-x
  24. Alberti MA, Alentorn A, Martinez-Yelamos S, Martinez-Matos JA, Povedano M, Montero J, et al. Very early electrodiagnostic findings in Guillain-Barre syndrome. Journal of the Peripheral Nervous System 2011;16(2):136-42.
  25. Aggarwal A, Singhal T, Bhatt M. Neurology and COVID-19: Acting now. Preparing for future. Annals of Indian Academy of Neurology 2020;23(4):433-40. https://doi.org/10.4103/aian.AIAN_513_20
  26. Nath A. Neurologic complications of coronavirus infections. Neurology 2020;94(19):809-10. https://doi.org/10.1212/wnl.0000000000009455
  27. Willison HJ, Jacobs BC, van Doorn PA. Guillainbarre syndrome. The Lancet 2016;388(10045):717-27. https://doi.org/10.1016/S0140-6736(16)00339-1
  28. Cheong KB, Zhang JP, Huang Y, Zhang ZJ. The effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting-a systematic review and meta-analysis. PloS one 2013;8(12):e82474.
  29. Li W, Li L. Effect of moxibustion on prevention and treatment of nausea and vomiting caused by cisplatin in lung cancer. Zhongguo zhen jiu= Chinese acupuncture & moxibustion 2018;38(7):695-9.
  30. Vent J, Wang DW, Damm M. Effects of traditional Chinese acupuncture in post-viral olfactory dysfunction. Otolaryngology--Head and Neck Surgery 2010;142(4):505-9. https://doi.org/10.1016/j.otohns.2010.01.012
  31. Dai Q, Pang Z, Yu H. Recovery of olfactory function in postviral olfactory dysfunction patients after acupuncture treatment. Evidence-Based Complementary and Alternative Medicine 2016;2016:1-6.
  32. Park JS, Kil BH, Kim DW, Jung DH, Jo HM, Kim CW, et al. Two Case Reports of Anxiety Disorder Patients with Gastrointestinal Symptoms Treated with Traditional Korean Medicine. The Journal of Internal Korean Medicine 2020;41(2):177-85. https://doi.org/10.22246/jikm.2020.41.2.177
  33. Lee HK, Jin C, Kwon S, Jang B, Jeon JP, Lee YS, et al. Treatment of nausea and vomiting associated with cerebellar infarction using the traditional herbal medicines Banhabaekchulcheonma-tang and Oryeong-san: Two case reports (CARE-complaint). Explore 2021;S1550-8307(21)00246-9.
  34. Kim SY, Won HY, Choi CW, Kim KS, Kim KO, Lee DW. The effects of Banhabaekchulchunma -Tang (BCT) on Dementia induced by focal brain ischemic injury in rats. Journal of Oriental Neuropsychiatry 2006;17(2):61-73.
  35. Lee YS, Han OK, Park CW, Yang CH, Jeon TW, Yoo WK, et al. Pro-inflammatory cytokine gene expression and nitric oxide regulation of aqueous extracted Astragali radix in RAW 264.7 macropharge cells. J Ethnopharmacol 2005;100(3):289-94. https://doi.org/10.1016/j.jep.2005.03.009
  36. Rhyu DY, Kang KS, Sekiya M, Yokozawa T. Antioxidant effect of Wen-Pi-Tang and its component crude drugs on oxidative stress. Am J Chin Med 2007;35(1):127-37. https://doi.org/10.1142/S0192415X07004680
  37. Rios JL. Chemical constituents and pharmacological properties of Poria cocos. Planta Med 2011;77(7):681-91. https://doi.org/10.1055/s-0030-1270823
  38. Lee JS, Kim WY, Jeon YJ, Lee SK, Son CG. Aquilariae Lignum extract attenuates glutamateinduced neuroexcitotoxicity in HT22 hippocampal cells. Biomedicine & Pharmacotherapy 2018;106:1031-8. https://doi.org/10.1016/j.biopha.2018.07.032
  39. Lee JS, Jeon YJ, Kang JY, Lee SK, Lee HD, Son CG. Aquilariae Lignum Methylene Chloride Fraction Attenuates IL-1β-Driven Neuroinflammation in BV2 Microglial Cells. International journal of molecular sciences 2020;21(15):5465.