Sex: M
Vaccine: COVID19
Symptoms: Cervical radiculopathy, Electromyogram, Magnetic resonance imaging, Magnetic resonance imaging neck, Nerve conduction studies
Clinical narrative: Cervical Radiculitis; Parsonage-Turner Syndrome; This is a literature report.  A 40-year-old male patient received BNT162b2 (BNT162B2), in 2021 as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 mrna vaccine (DOSE 1, SINGLE), administration date: 2021, for covid-19 immunization, reaction(s): "Cervical Radiculitis", "Parsonage-Turner Syndrome"; Influenza vaccine (flu vaccine), administration date: 2008. The following information was reported: CERVICAL RADICULOPATHY (hospitalization, medically significant), 2 weeks after the suspect product(s) administration, outcome "recovering", described as "Cervical Radiculitis"; NEURALGIC AMYOTROPHY (hospitalization, medically significant), 2 weeks after the suspect product(s) administration, outcome "recovering", described as "Parsonage-Turner Syndrome". 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; demonstrating fluid collection, notes: in the subcutaneous space; 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) weakness, notes: 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, notes: in the subcutaneous space. Therapeutic measures were taken as a result of cervical radiculopathy, neuralgic amyotrophy. Clinical course: The author presented a case of 40-year-old gentleman who presented with acute onset burning pain and fasciculations in his right upper extremity following vaccination with the second dose of the Pfizer-BioNTech COVID-19 vaccine. His symptoms progressed to weakness in isolated muscle groups with electromyographic evidence of decreased nerve conduction. MRI of the cervical spine demonstrated multilevel central and foraminal stenosis, suggesting a diagnosis of cervical radiculopathy. The patient underwent a C4-5/C5-6 and C6-7 laminoforaminotomy and tolerated the procedure well. Post-operatively, the patient has experienced gradual symptom improvement with residual right triceps and pectoralis muscle weakness as well as paresthesias of the right elbow and forearm. The author described a case report of PTS in which the patient developed less severe symptoms following an influenza vaccine in 2008, and more severe onset following both doses of COVID-19 mRNA vaccine in 2021.  No follow-up attempts are possible.; Sender's Comments: The causal association of reported events cervical radiculopathy and neuralgic amyotrophy in relation to suspected vaccine BNT162b2 cannot be excluded based on temporal relation and clinical observation post vaccination. Case will be reassess pending new information.  The impact of this report on the benefit/risk profile of the Pfizer product 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-202400075182 Same article/patient/event and different dose;