Editors' Note: SARS-CoV-2 Vaccination Safety in Guillain-Barré Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, and Multifocal Motor Neuropathy.

Neurology(2023)

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摘要
Dr. Baars and colleagues examined the risk of recurrence of Guillain-Barré syndrome (GBS) and exacerbations of chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in a prospective, multicenter cohort analysis of 521 individuals diagnosed with GBS, CIDP, or MMN. The authors found no increased risk of GBS recurrence and a low-to-negligible risk of worsening of CIDP or MMN-related symptoms after SARS-CoV-2 vaccination and concluded that SARS-CoV-2 vaccination in patients with these immune-mediated neuropathies seems safe. In response, Dr. Harth reports having developed a brachial plexopathy and postural orthostatic tachycardia syndrome after her third coronavirus disease vaccination, noting that it will be challenging to convince people like her to willingly accept another vaccination. Nevertheless, she appreciates the reassuring data presented by the authors. Responding to these comments, the authors note that several patients in their study shared similar concerns about the potential for neurologic complications when obtaining a SARS-CoV-2 vaccination, particularly when they had developed GBS or CIDP after another vaccination. They suggest weighing the risk of developing a serious infection—which could carry a higher risk of neurologic complications—against the chance of developing postvaccination neurologic disease. This exchange highlights important nuances involved in considering vaccination in patients with preexisting neurologic disease. Dr. Baars and colleagues examined the risk of recurrence of Guillain-Barré syndrome (GBS) and exacerbations of chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in a prospective, multicenter cohort analysis of 521 individuals diagnosed with GBS, CIDP, or MMN. The authors found no increased risk of GBS recurrence and a low-to-negligible risk of worsening of CIDP or MMN-related symptoms after SARS-CoV-2 vaccination and concluded that SARS-CoV-2 vaccination in patients with these immune-mediated neuropathies seems safe. In response, Dr. Harth reports having developed a brachial plexopathy and postural orthostatic tachycardia syndrome after her third coronavirus disease vaccination, noting that it will be challenging to convince people like her to willingly accept another vaccination. Nevertheless, she appreciates the reassuring data presented by the authors. Responding to these comments, the authors note that several patients in their study shared similar concerns about the potential for neurologic complications when obtaining a SARS-CoV-2 vaccination, particularly when they had developed GBS or CIDP after another vaccination. They suggest weighing the risk of developing a serious infection—which could carry a higher risk of neurologic complications—against the chance of developing postvaccination neurologic disease. This exchange highlights important nuances involved in considering vaccination in patients with preexisting neurologic disease.
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关键词
chronic inflammatory demyelinating polyneuropathy,multifocal motor polyneuropathy,vaccination,sars-cov,guillain-barr
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