Sex: M
Vaccine: COVID19
Symptoms: Encephalitis autoimmune, Heart rate, Interleukin level, Investigation, Magnetic resonance imaging head
Clinical narrative: Anti-LGI1 encephalitis after mRNA COVID-19 vaccination; This is a literature report for the following literature source(s).  A 56-year-old male patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: ENCEPHALITIS AUTOIMMUNE (hospitalization, medically significant, life threatening), 2 weeks after the suspect product(s) administration, outcome "recovered", described as "Anti-LGI1 encephalitis after mRNA COVID-19 vaccination". The patient underwent the following laboratory tests and procedures: Antibody test: Positive; Blood glucose: elevated; Blood sodium: were significant for hyponatremia; Computerised tomogram abdomen: showed no signs of malignancy; Computerised tomogram pelvis: showed no signs of malignancy; Computerised tomogram thorax: showed no signs of malignancy; CSF immunoglobulin G index: elevated; CSF protein: elevated; CSF test: Positive, notes: for LGI1 antibodies; showed elevated glucose, protein and IgG synthesis, notes: rate; Electroencephalogram: captured frequent faciobrachial dystonic seizures, notes: (FBDS) and three left hemisphere electrographic seizures associated with chills, piloerection and emotional distress (pilomotor seizures); Heart rate: 120-130, notes: Unit: beats/min throughout the recording; Interleukin level (0-13): 38.7 pg/mL, notes: elevated; paraneoplastic panel: Negative; Magnetic resonance imaging head: demonstrated T2/fluidattenuated, notes: inversion recovery signal abnormality involving bilateral mesial temporal lobes, left temporal pole and left insula; Mini mental status examination: 20/30; Polymerase chain reaction: Negative; SARS-CoV-2 test: Negative. Therapeutic measures were taken as a result of encephalitis autoimmune. No follow-up attempts are possible.  Clinical course: A 56-year-old man with no significant past medical history developed episodic heart palpitations and dizziness with chills 2 weeks after his first dose of the BNT162b2 mRNA COVID-19 Vaccine (Pfizer). Symptoms became more frequent after his second dose of the same vaccine (Pfizer). He presented to the neurology clinic with cognitive impairment and behavioral changes 3 months later. Clinically, he displayed impulsive episodes characterized by a sudden rise from a seated position stepping forward with preserved consciousness. His score on the Mini-Mental State Examination was 20/30. The COVID PCR test was negative. He was admitted for long-term video EEG monitoring which captured frequent faciobrachial dystonic seizures (FBDS) and three left hemisphere electrographic seizures associated with chills, piloerection and emotional distress (pilomotor seizures). His heart rate was in the range of 120-130 throughout the recording. MRI brain demonstrated T2/fluidattenuated inversion recovery signal abnormality involving bilateral mesial temporal lobes, left temporal pole and left insula. Labs were significant for hyponatremia and an elevated serum interleukin-6 of 38.7 pg/ml (0-13). CSF analysis showed elevated glucose, protein and IgG synthesis rate. Meningitis/encephala PCR panel and paraneoplastic panel were negative. CT chest, abdomen and pelvis showed no signs of malignancy. No additional pilomotor seizures were recorded after Vimpat was started, but FBDS persisted. IV methylprednisolone (IVMP) 1 g was subsequently started for suspected autoimmune encephalitis based on CSF and MRI brain findings. He improved significantly after IVIMP was initiated. Ultimately, his serum and CSF came back positive for LGI1 antibodies, and he was diagnosed with anti-LGI1 encephalitis. He finished 5 days IVMP followed by IVIG 2 g/kg and discharged on steroid taper. He remained seizure free with a mild executive function deficit 1 year after symptom onset.; Sender's Comments: Based on the available information, the known product safety profile and implied temporal association, a causal relationship between the reported event LGI1 antibody encephalitis and suspect product cannot be excluded. 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-202300457344 Same article/patient/event and different vaccine dose;