Case Reports
Below are pictures of 2 such patients, one with 3rd+4th paresis after Covishield(Astrazeneca). The other was 7th nerve paresis after same vaccine.
The patients recovered completely after a short (3 weeks course) of steroids in 4-6 weeks.
Case I
Case II
This 64 yrs gentleman had Right 7th cranial nerve paresis 6 days after vaccination. He was COVID negative. Complete recover at 8th week wit a 4 weeks tapering course of steroids.
Case III
This was a case of Mucormycosis, commonly nowadays creating havoc as 'Black Fungus'.
However, being detected very early and started on Amphotericin(liposomal), could be controlled although the eye had to be sacrificed but the brain was spared as it didn't progress to the brain.
In 2 cases of Mucor, that I have seen, it was observed that both were referred from outside.
Both received Oxygen from hired cylinders from unknown sources and tap water instead of Distilled water was used in the connector. Probably this could be alarming as Mucor can occur in immunocompromised (Chemo patients,AIDS patients etc,but the crux was in Covids (immunosupressed) patients, have mostly had mucor in the area where the mask is worn.
Maybe other factors under study (like Zinc etc be responsible), but seems unlikely as in several of my Wilson's disease Zinc has been used for years, they never developed mucor.
Also, almost most Multivitamin Capsules for half a century also contain Zinc, mucor was not reported.
Since hospitals where there are own Oxygen plants, mucor has been unusual; it raises the question whether contaminated Oxygen cylinders are actually the source.
Case IV
How to examine a case of Cerebellar Stroke (Lesion was an ischemic stroke in right cerebellar hemisphere encroaching up to vermis).
Case V
Post vaccination covid complication
This 56-year-old lady had covid in mid-2020. She recovered.
She was maintining otherwise good health except some residual weakness. Thereafter on time got vaccinated.
She was not tested for Covid prior to her 2nd dose.
Post vaccination after, 5 days onwards started developing throat cramps progressing to upper limbs, trunk then lower limbs.
On examination no sensory level was found but jerks were mildly increased and right plantar was up.
Blood counts, CRP, CPK. Vitamin D3 and B12 were all normal.
MRI revealed an early small cervico-dorsal myelopathic change.
She was put on Deflazocort and is presently after a week started improving in her symptoms.
Morale is before 2nd dose of vaccine, ideally the patient should be tested and confirmed that is not suffering from Covid.
Case VI
Memory Loss Patient
A 54 year lady, Follower of Islam, had to manage her living as a Beef (raw meat) seller.
She developed rapidly progressive loss of memory. There was no incontinence initially nor any gait disturbance.
Progressively she developed increased forgetfulness, along with abnormal behaviour like aggressiveness, abusiveness and paranoid changes. At this time she was seen by a neurologist. On examination she was found to have word finding difficulty and a bedside minimental score of 16/30.
Her limb power was normal, no sensory deficit, but there was ataxia, Rigidity and falls.
She has developed dysphagia and had to be on RT feeding and was on silastic catheter.
At this time, roughly 7 months from onset of disease developed Myoclonic jerks and that increased in 2months, in spite of Levitiracetam. She was added Valproate and clonazepam.
Presently she is not communicable but alert with fluctuation in sensorium and gross rigid limbs.She had 3 episodes of GTCS and Lacosamide was added.
All paraneoplatic and immune markers including Anti-TPO were negative.
CSF study was showing a slightly elevated protein with normal cells. 14.1.1 protein was not done.A onsillar biopsy was done which came
negative for any prion.
Her EEG done serially showed loss of any definite background with triphasic waves.
Her MRI of brain showed Fronto-Temporo-Parietal rimming of cortex in T2 weighted images.
She was diagnosed as a rapidly progressive dementia case, likely sporadic CJD.
Although CJD has not been shown from handling raw meat but has been reported from eating infected cattle.
Sporadic CJD may show rimming of cortices unlike Thalamic changes (Pulvinar sign) in new variant CJD.
The carerers have been advised a PEG and asked to handle her by wearing gloves.
The prognosis has been explained which is poor with an expectant death in 1 year of initial symptoms.
