A Case Report of Autoimmune Encephalitis after Anti-SARS-CoV-2 Vaccination: The Role of Cognitive Impairments in the Diagnostic Process

Arch Clin Neuropsychol. 2024 Aug 24;39(6):775-781. doi: 10.1093/arclin/acae031.

Abstract

Objective: Autoimmune encephalitis includes a heterogeneous group of rare and complex diseases, usually presenting with severe and disabling symptoms, such as behavioral changes, cognitive deficits, and seizures.

Method: This report presents the case of a 26-year-old man who was diagnosed with autoimmune encephalitis following SARS-CoV-2 vaccination (<40 days). Symptoms first appeared in February 2022 with a temporal seizure, associated with confusion and memory loss. Psychiatric manifestations such as disorientation and altered thought contents emerged soon after.

Results: Neuroimaging testing showed signs of hypometabolism in occipital, prefrontal, and temporal regions, whereas an extensive neuropsychological assessment revealed the presence of multiple alterations in memory, executive, and visuoconstructive processes.

Conclusions: In this case, a combination of neuroimaging testing, psychiatric evaluation, and neuropsychological assessment provided evidence for a diagnosis of autoimmune encephalitis post-vaccination. Early recognition is essential in order to prevent clinical progression; avoid intractable epilepsy, brain atrophy, and cognitive impairment; and improve prognosis.

Keywords: Autoimmune encephalitis; Case report; Neuropsychological deficits; Psychiatric symptoms; SARS-CoV-2 vaccination; Temporal seizure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • COVID-19 / complications
  • COVID-19 Vaccines / adverse effects
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / etiology
  • Encephalitis* / diagnosis
  • Encephalitis* / etiology
  • Hashimoto Disease / complications
  • Hashimoto Disease / diagnosis
  • Humans
  • Male
  • Neuropsychological Tests
  • Vaccination / adverse effects

Substances

  • COVID-19 Vaccines

Supplementary concepts

  • Hashimoto's encephalitis