Guillain-Barré syndrome after Pfizer and Astra-Zeneca vaccinations against
COVID-19 has been previously reported in the literature. The objective of this study was to report the first case of Guillain-Barré following the
COVID-19 vaccination with the
Johnson & Johnson COVID-19 vaccine. We report the case of a 53-year-old female who presented to the Emergency Department complaining of bilateral lower extremity weakness,
paresthesias, and gait difficulties 14 days after having received the Johnson & Johnson
COVID-19 vaccination. MRI of the lumbar spine with and without contrast revealed enhancement of the cauda equina nerve roots suggestive of
acute inflammatory demyelinating polyradiculoneuropathy. Cerebrospinal fluid (CSF) analysis reported mildly elevated
protein low white blood cells (WBCs).
Ganglioside (GM1 and GQ1b)
antibodies were reported as negative. After
intravenous immunoglobulin (
IVIg), the patient had significant improvement in her weakness and
paresthesia and was discharged home. The case was reported to the Centers for Disease Control and Prevention (CDC)
Vaccine Adverse Event Reporting System.
Guillain-Barré syndrome after
COVID-19 immunization remains a rare complication. A clear mechanism of disease has not been clarified; however, it is believed that there could be some type of molecular mimicry between the spike
glycoprotein produced with the help of the
vaccines and proteins in the myelin sheath.