New-onset refractory status epilepticus following the ChAdOx1 nCoV-19 vaccine

J Neuroimmunol. 2021 Aug 15:357:577629. doi: 10.1016/j.jneuroim.2021.577629. Epub 2021 Jun 7.


Coronavirus is a novel human pathogen causing fulminant respiratory syndrome (COVID-19). Developing an effective and reliable vaccine was emergently pursued to control the dramatic spread of the global pandemic. The standard stages for vaccine development were unprecedentedly accelerated over a few months. We report a case of new-onset refractory status epilepticus (NORSE) after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. We attribute the occurrence of NORSE to the vaccine due to the temporal relationship and the lack of risk factors for epilepsy in the patient. This report adds to the literature a possible rare side effect of a COVID-19 vaccine and contributes to the extremely limited literature on potential neurological side effects of viral vector vaccines. Healthcare providers should be aware of the possibility of post-vaccination epilepsy. The patient had recurrent seizures that were refractory to conventional antiepileptic drug therapy with a dramatic response to immunotherapy with pulse steroids and plasmapheresis. This likely reflects an underlying autoimmune mechanism in the genesis of post-vaccination generalized seizures without fever. Further research is needed to probe and study the exact mechanism at a more molecular level.

Keywords: COVID-19; ChAdOx1 nCoV-19; Seizure; Status epilepticus; Vaccine.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • COVID-19 Vaccines / adverse effects*
  • ChAdOx1 nCoV-19
  • Drug Resistant Epilepsy / chemically induced*
  • Drug Resistant Epilepsy / diagnostic imaging*
  • Drug Resistant Epilepsy / therapy
  • Female
  • Humans
  • Status Epilepticus / chemically induced*
  • Status Epilepticus / diagnostic imaging*
  • Status Epilepticus / therapy


  • COVID-19 Vaccines
  • ChAdOx1 nCoV-19