Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2021; 9(24): 7218-7223
Published online Aug 26, 2021. doi: 10.12998/wjcc.v9.i24.7218
Status epilepticus as a complication after COVID-19 mRNA-1273 vaccine: A case report
Robin Šín, Denisa Štruncová
Robin Šín, Department of Infectious Diseases and Travel Medicine, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen, Pilsen 30599, Czech Republic
Robin Šín, Medical Department, Emergency Medical Service of the Pilsen Region, Pilsen 30100, Czech Republic
Denisa Štruncová, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Pilsen, Pilsen 30460, Czech Republic
Denisa Štruncová, Faculty of Medicine, Masaryk University, Brno 62500, Czech Republic
Author contributions: Šín R designed the report, wrote the original draft of the paper, and analyzed the data; Šín R and Štruncová D collected the patent´s clinical data and designed the data visualization; Štruncová D reviewed and edited the paper for important intellectual content.
Informed consent statement: Consent was obtained from the patient after he had been presented with pertinent information, had adequate time to review the consent document, and had all of his questions answered.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Denisa Štruncová, MD, Doctor, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Pilsen, alej Svobody 80, Pilsen 30460, Czech Republic. denisastruncova@seznam.cz
Received: April 4, 2021
Peer-review started: April 4, 2021
First decision: April 28, 2021
Revised: May 11, 2021
Accepted: July 14, 2021
Article in press: July 14, 2021
Published online: August 26, 2021
Processing time: 141 Days and 12.5 Hours
Abstract
BACKGROUND

We present a rare case of status epilepticus in a 56-year-old man which arose as a complication after vaccination with the coronavirus disease 2019 (COVID-19) mRNA-1273 vaccine. The patient's history included well-compensated secondary epilepsy. The root cause of the situation was a fever which had developed as a side effect of the vaccination.

CASE SUMMARY

A 56-year-old man received the first dose of mRNA-1273 vaccine against the severe acute respiratory syndrome-coronavirus-2. The vaccine was administered intramuscularly (100 mg, 0.5 mL). The next morning the man was found to be suffering from fever and headaches while at the same time experiencing general weakness. He lost consciousness suddenly and experienced generalized clonic seizures which turned into status epilepticus. When the Emergency Medical Service arrived the patient was unconscious with spontaneous breathing and generalized clonic seizures. It was necessary to administer diazepam repeatedly. It was also necessary to administer high doses of levetiracetam and temporary propofol. The status epilepticus was brought under control approximately 90 min after the patient’s transport to the Emergency Department. A follow-up electroencephalogram no longer revealed abnormal indications of epileptic fit. The patient was temporarily hospitalized in the Intensive Care Unit and after seven days care was discharged without any further apparent effects.

CONCLUSION

There is currently no specific treatment against COVID-19. Therefore, the benefits of COVID-19 vaccine protection outweigh the risks.

Keywords: SARS-CoV-2; COVID-19; mRNA vaccine; Complication of vaccination; Status epilepticus; Case report

Core Tip: Coronavirus disease 2019 (COVID-19) is a severe viral infection caused by the severe acute respiratory syndrome-coronavirus-2. There is no specific antiviral therapy for the COVID-19 infection but several vaccines have been developed. The safety of currently used mRNA vaccines has been confirmed by extensive research studies and common side effects are observed. However, there is no described case of status epilepticus as a complication after vaccination. In our case of such, involving a patient with epilepsy, the cause was likely a fever and an immune reaction as a side effect after the mRNA COVID-19 vaccine.