In addition, a 62-year-old man has been reported with acute chorea after getting a Sars-Cov-2 infection, and the authors concluded that inflammation may have played a role in the development of chorea in this patient. She responded to steroids, which supported an autoimmune mechanism as the pathophysiology. On the contrary, Decio et al reported an 11-year-old girl who developed chorea after the human papillomavirus vaccine. These include focal immune-mediated endotheliopathy induced by the spike protein 2 and functional disturbance in contralateral thalamus, which was confirmed by single-photon emission computed tomography. The pathophysiology of hemichorea in these cases is not clear, but several theories have been described for hemichorea after COVID-19 vaccination. Three cases with hemichorea have been reported previously, 2 after AZD1222 vaccination and 1 after Pfizer-BioNTech COVID-19 vaccination, but all reported patients were in their 80s.

This is a description of hemichorea in two adolescents after Sinopharm vaccination, which is one of the most widely used COVID-19 vaccines globally. At 1-month follow-up, patient 1 improved, and patient 2 still had mild choreic movements. īoth were treated with intravenous methylprednisolone (1 g/d) for 3 days followed by oral prednisolone (50 mg/d) and tetrabenazine (25 mg/d), which caused moderate improvement after a 2-week follow-up ( Video S1-B). Sagittal fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) imaging (top image) shows multiple white matter lesions, and axial T1 with gadolinium (bottom image) demonstrates a juxtacortical gadolinium-enhancing lesion.

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