Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging head, Metabolic function test, Neurological examination, Physical examination, SARS-CoV-2 test
Clinical narrative: New-Onset Chorea; Mild coronavirus disease (COVID-19); This literature-non-study case was reported in a literature article and describes the occurrence of CHOREA (New-Onset Chorea) in a 91-year-old female patient who received mRNA-1273 (Spikevax) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below.   Concurrent medical conditions included Hypothyroidism.   On an unknown date, the patient received dose of mRNA-1273 (Spikevax) (unknown route) 1 dosage form. On an unknown date, received dose of mRNA-1273 (Spikevax) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced CHOREA (New-Onset Chorea) (seriousness criterion disability) and COVID-19 (Mild coronavirus disease (COVID-19)). The patient was treated with TETRABENAZINE at a dose of 6.25 milligram once a day. At the time of the report, CHOREA (New-Onset Chorea) was resolving and COVID-19 (Mild coronavirus disease (COVID-19)) had resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood test: serum paraneoplastic panels -unremarkable. On an unknown date, Computerised tomogram head: neuroimaging with computed tomography of the head - unremarkable. On an unknown date, Full blood count: complete blood count with peripheral smear-unremarkable. On an unknown date, Magnetic resonance imaging head: unremarkable. On an unknown date, Metabolic function test: unremarkable. On an unknown date, Neurological examination: choreiform movements in the face and bilateral upper and lower extremities, albeit her left side was more predominantly affected.. On an unknown date, Physical examination: choreiform movements in the face and bilateral upper and lower extremities, albeit her left side was more predominantly affected.. On an unknown date, SARS-CoV-2 test: (Positive) nasopharyngeal swab. On an unknown date, Thyroid function test: unremarkable.     For mRNA-1273 (Spikevax) (Unknown), the reporter did not provide any causality assessments.   Concomitant medication not reported. Patient was referred to clinic for evaluation of abnormal involuntary movements. Six months before the evaluation, she had a bout of mild flu-like symptoms (cough, rhinorrhea, fatigue) and was diagnosed with COVID-19. She did not require admission from the infection and recovered in home isolation without medical intervention. Patient had received two Moderna vaccines about 10 months prior to her presentation.  Two weeks after the flu-like symptoms, she developed excessive involuntary movements of the tongue, jaw, and face. Over the ensuing months, she developed excessive movements involving the arms, legs, and torso.  She lived alone and was able to perform her activities of daily living before the onset of these involuntary movements. Systemic and neurological examinations were normal, except for choreiform movements in the face and bilateral upper and lower extremities, albeit her left side was more predominantly affected. Patient was started on tetrabenazine and experienced more than 90% improvement in both facial and appendicular symptoms at one month and one year follow-up.  Company comment: This is a literature non-study case concerning a 91-year-old female patient with medial history reported of Hypothyroidism, who experienced the serious (due to disability) unexpected, event of chorea. The event occurred 10 months after the second dose of mRNA-1273 vaccine. Physical examination: choreiform movements in the face and bilateral upper and lower extremities, albeit her left side was more predominantly affected. . Diagnostic test performed were unremarkable. The outcome of the event was reported as recovering. Patient was treated with Tetrabenazine with good response The patient also experience the non serious case of COVID-19.The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.   Most recent FOLLOW-UP information incorporated above includes: On 13-Jul-2023: Follow-up received by safety on 13-Jul-2023, contains significant information. Reporter details, Lab data, treatment products and events updated.