Functional Recovery Following Post-vaccination Neurological Syndrome With Demyelinating Findings on Magnetic Resonance Imaging (MRI): A Case Report

Rare neurological syndromes have been reported following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, although a causal relationship remains uncertain. We report the case of a 62-year-old woman who developed progressive neurological impairment temporally associated with BNT162b2 (Pfizer-BioNTech) COVID-19 vaccination, resulting in wheelchair dependence. Brain magnetic resonance imaging (MRI) demonstrated multiple periventricular T2-weighted/fluid-attenuated inversion recovery (T2/FLAIR) hyperintense lesions, including lesions oriented perpendicular to the lateral ventricles, consistent with demyelinating features. A multimodal therapeutic approach was implemented, including gut-directed therapy, intravenous gold-induced cytokine (GOLDIC®) therapy, hyperbaric oxygen therapy (HBOT), intranasal exosome therapy, and structured neurorehabilitation. Over the course of treatment, the patient showed substantial clinical improvement, including recovery of ambulation and functional neurological status. While this case highlights the potential for significant neurological involvement following SARS-CoV-2 vaccination and the possibility of recovery with a multimodal therapeutic approach, the contribution of the individual therapies cannot be determined. Further research is needed to better understand the underlying mechanisms and to evaluate emerging therapeutic strategies, including GOLDIC, in this setting.