Sex: M
Vaccine: COVID19
Symptoms: Physical examination, Radiculitis brachial, Transferrin, Ultrasound scan
Clinical narrative: acute right C5 and C6 radiculopathy; probable concomitant brachial neuritis; This is a literature report.  A 40-year-old male patient received COVID-19 Vaccine - Manufacturer Unknown, in 2021 as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Influenza vaccine (burning pain and nocturnal right upper extremity fasciculations), administration date: 2008, for flu vaccine, reaction(s): "burning pain and nocturnal right upper extremity fasciculations", "burning pain and nocturnal right upper extremity fasciculations". The following information was reported: CERVICAL RADICULOPATHY (medically significant), outcome "recovering", described as "acute right C5 and C6 radiculopathy"; RADICULITIS BRACHIAL (medically significant), outcome "recovering", described as "probable concomitant brachial neuritis". The patient underwent the following laboratory tests and procedures: Electromyogram: results demonstrated positive, notes: sharp waves in the biceps, rhomboids, serratus anterior and cervical paraspinal muscles suggesting acute right C5 and C6 radiculopathy with probable concomitant brachial neuritis; revealed positive sharp waves in the triceps,, notes: pronator teres and C7 paraspinal muscles suggesting an acute right C7 neuropathy with subtle denervation over the ipsilateral C7 myotome. There were not any electrodiagnostic findings of brachial plexopathy of the upper trunk at this time. A second EMG done four weeks after the second dose of the COVID-19 vaccine and subsequent worsening of symptoms; Magnetic resonance imaging: demonstrated a fluid pocket in the, notes: subcutaneous space; Magnetic resonance imaging neck: demonstrated C5-C6 and C6-C7 disc herniations, notes: with bilateral foraminal stenosis at those levels in addition to C7-T1 facet hypertrophy and bilateral foraminal  stenosis. Sagittal cervical spine image showing multilevel cord compression from vertebral disc herniations. Coronal cervical spine image at C3-4 disc space demonstrating normal CSF enhancement around spinal  cord. Coronal cervical spine image at C6-7 disc space demonstrating cord compression and limited CSF enhancement around spinal cord. prior to surgery; demonstrating fluid collection in the subcutaneous, notes: space. T2-weighted MRI cervical spine image following surgical decompression with multilevel laminoforaminotomy; Nerve conduction studies: results demonstrated positive, notes: sharp waves in the biceps, rhomboids, serratus anterior and cervical paraspinal muscles suggesting acute right C5 and C6 radiculopathy with probable concomitant brachial neuritis; physical examination: there was mild (4+/5), notes: weakness with right elbow flexion and slight (5-/5) weakness with shoulder abduction. Range motion was full but painful with activation of serratus anterior, biceps and rhomboids; demonstrated mild (4+/5) elbow, notes: and wrist extension with an otherwise normal exam. A subsequent physical exam separated by about 4 weeks; Transferrin: negative; Ultrasound scan: demonstrated a fluid pocket in the, notes: subcutaneous space. Therapeutic measures were taken as a result of cervical radiculopathy, radiculitis brachial.  Clinical information: A 40-year-old male presented to our outpatient clinic with burning pain and nocturnal right upper extremity fasciculations two weeks after receiving the second dose of the COVID-19 vaccine. He experienced symptom aggravation with lifting of his right arm or tucking of his chin. He reported similar complaints following previous injections, including the first dose of the COVID-19 vaccine one month prior, in addition to a flu vaccine in 2008. Prior episodes had been self-limited and not as severe. On physical examination, there was mild (4+/5) weakness with right elbow flexion and slight (5-/5) weakness with shoulder abduction. Range motion was full but painful with activation of serratus anterior, biceps and rhomboids. A subsequent physical exam separated by about 4 weeks demonstrated mild (4+/5) elbow and wrist extension with an otherwise normal exam. T2-weighted magnetic resonance imaging (MRI) of the cervical spine demonstrated C5-C6 and C6-C7 disc herniations with bilateral foraminal stenosis at those levels, in addition to C7-T1 facet hypertrophy and bilateral foraminal stenosis. Following the first dose of the COVID-19 vaccine and onset of symptoms similar to those  described above, the patient had undergone electromyography (EMG) and nerve conduction velocity testing. These results demonstrated positive sharp waves in the biceps, rhomboids, serratus anterior and cervical paraspinal muscles suggesting acute right C5 and C6 radiculopathy with probable concomitant brachial neuritis (Table I). The patient was administered 40 mg oral prednisone, which was tapered down over 12 days, along with an epidural steroid injection that collectively offered significant, though temporary, symptom improvement.  No follow-up attempts are possible.; Sender's Comments: Based on the current available limited information in the case provided, the causal association between the events Cervical radiculopathy and Radiculitis brachial and the use of suspect product cannot be fully excluded. The impact of this report on the benefit-risk profile of the Pfizer product and on the conduct of the study is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-202400075121 Same article/drug/patient and different event;