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2. Hospital-based observational study of neurological disorders in patients recently vaccinated with COVID-19 mRNA vaccines

Author

Koh, Jasmine Shimin, Hoe, Rebecca Hui Min, Yong, Ming Hui, Chiew, Hui Jin, Goh, Yihui, Yong, Kok Pin, Tu, Tian Ming, Chan, Derrick Wei Shih, Tan, Benjamin Yong-Qiang, Yeo, Leonard Leong Litt, Quek, Amy May Lin, Siow, Isabel, Saini, Monica, Angon, Jasmyn, Rathakrishnan, Sharmini, Chen, Geraldine Jiangyan, Hui, Andrew Che-Fai, Ahmad, Aftab, Shwe, Moe Pearl, Tan, Kevin, Seet, Raymond Chee Seong, Cai, Mingshi, Kuo, Si Min, Foo, Ling Li, and Umapathi, Thirugnanam

Published
2021
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3. Neurology of COVID-19 in Singapore

Author

Koh, Jasmine Shimin, De Silva, Deidre Anne, Quek, Amy May Lin, Chiew, Hui Jin, Tu, Tian Ming, Seet, Christopher Ying Hao, Hoe, Rebecca Hui Min, Saini, Monica, Hui, Andrew Che-Fai, Angon, Jasmyn, Ker, Justin Ruixin, Yong, Ming Hui, Goh, Yihui, Yu, Wai-Yung, Lim, Tchoyoson Choie Cheio, Tan, Benjamin Yong Qiang, Ng, Kay Wei Ping, Yeo, Leonard Leong Litt, Pang, Yu Zhi, Prakash, Kumar M., Ahmad, Aftab, Thomas, Terrence, Lye, David Chien Boon, Tan, Kevin, and Umapathi, Thirugnanam

Published
2020
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4. Low incidence of neurological recurrent side-effects following COVID-19 reimmunization

Author

Koh, Jasmine Shimin, primary, Hoe, Rebecca Hui Min, additional, Chen, Geraldine Jiangyan, additional, Goh, Yihui, additional, Tan, B enjamin Y Q, additional, Yong, Ming Hui, additional, Hui, Andrew Che-Fai, additional, Tu, Tian Ming, additional, Yong, Kok Pin, additional, Angon, Jasmyn, additional, Tan, Kevin, additional, Quek, Amy May Lin, additional, Umapathi, Thirugnanam, additional, and Seet, Raymond Chee Seong, additional

Published
2022
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6. Low incidence of neurological recurrent side-effects following COVID-19 reimmunization.

Author

Koh, Jasmine Shimin, Hoe, Rebecca Hui Min, Chen, Geraldine Jiangyan, Goh, Yihui, Tan, Benjamin Y Q, Yong, Ming Hui, Hui, Andrew Che-Fai, Tu, Tian Ming, Yong, Kok Pin, Angon, Jasmyn, Tan, Kevin, Quek, Amy May Lin, Umapathi, Thirugnanam, and Seet, Raymond Chee Seong

Subjects
*COVID-19, *DISABILITIES, *COVID-19 vaccines, *ODDS ratio, *VACCINATION, *EPILEPSY
Abstract

Background Individuals who suffered a neurological adverse event after the Coronavirus disease (COVID-19) vaccine could hesitate and defer reimmunization. Aim We examine the risk of recurrence following reimmunization among patients who developed a neurological event after the first dose of the COVID-19 mRNA vaccine. Design Observational study. Methods Individuals who developed an adjudicated neurological adverse event (based on Brighton Collaboration criteria) within 6 weeks of the first dose of the COVID-19 vaccine requiring hospitalization were enrolled into a multicenter national registry in Singapore. Neurological recurrence, defined by the development of another neurological event within 6 weeks of the second vaccine dose, was reviewed. Clinical characteristics were compared between patients who chose to proceed or withhold further vaccination, and between those who received timely (3–6 weeks) or delayed (>6 weeks) reimmunization. Results From 235 patients (median age, 67 years; 63% men) who developed an adjudicated neurological event after their first dose of mRNA vaccine between 30 December 2020 and 20 April 2021, 181 (77%) chose to undergo reimmunization. Those who decided against reimmunization were older (median age, 74 vs. 66 years) and had greater physical disability following their primary neurological event (46% vs. 20%, P  < 0.001). Patients who suffered greater physical disability were three times more likely to delay their reimmunization (odds ratio 3.36, 95% confidence interval: 1.76–6.40). Neurological recurrence was observed in only four individuals (three with seizures and one with myasthenia gravis exacerbation). Conclusions A prior neurological event should not necessarily preclude reimmunization and the decision to proceed with reimmunization should consider the overwhelming benefits conferred by vaccination toward ending this pandemic. [ABSTRACT FROM AUTHOR]

Published
2023
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7. Hospital-based Observational Study of Neurological Disorders in Patients Recently Vaccinated with COVID-19 mRNA Vaccines (P10-12.001)

Author

Koh, Jasmine Shimin, primary, Hoe, Rebecca Hui Min, additional, Yong, Ming Hui, additional, Chiew, Hui Jin, additional, Goh, Yihui, additional, Yong, Kok Pin, additional, Tu, Tian Ming, additional, Chan, Derrick Wei Shih, additional, Tan, Benjamin Yong Qiang, additional, Yeo, Leonard Leong Litt, additional, Quek, Amy May Lin, additional, Siow, Isabel, additional, Saini, Monica, additional, Angon, Jasmyn, additional, Rathakrishnan, Sharmini, additional, Chen, Geraldine Jiangyan, additional, Hui, Andrew Che-Fai, additional, Ahmad, Aftab, additional, Shwe, Moe Pearl, additional, Tan, Kevin, additional, Seet, Raymond Chee Seong, additional, Cai, Mingshi, additional, Kuo, Simin, additional, Foo, Ling Li, additional, and Thirunagnam, Umapathi, additional

Published
2022
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8. Incidence of Cerebral Venous Thrombosis Following SARS-CoV-2 Infection vs mRNA SARS-CoV-2 Vaccination in Singapore

Author

Tu, Tian Ming, primary, Yi, Shen Jia, additional, Koh, Jasmine Shimin, additional, Saffari, Seyed Ehsan, additional, Hoe, Rebecca Hui Min, additional, Chen, Geraldine Jiangyan, additional, Chiew, Hui Jin, additional, Tham, Carol Huilian, additional, Seet, Christopher Ying Hao, additional, Yong, Ming Hui, additional, Yong, Kok Pin, additional, Hui, Andrew Che-Fai, additional, Fan, Bingwen Eugene, additional, Tan, Benjamin Yong-Qiang, additional, Quek, Amy May Lin, additional, Seet, Raymond Chee Seong, additional, Yeo, Leonard Leong Litt, additional, Tan, Kevin, additional, and Thirugnanam, Umapathi N., additional

Published
2022
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10. Corrigendum to ‘Neurology of COVID-19 in Singapore’ [Journal of the Neurological Sciences Volume 418, 15 November 2020, 117118]

Author

Koh, Jasmine Shimin, De Silva, Deidre Anne, Quek, Amy May Lin, Chiew, Hui Jin, Tu, Tian Ming, Seet, Christopher Ying Hao, Hoe, Rebecca Hui Min, Saini, Monica, Hui, Andrew Che-Fai, Angon, Jasmyn, Ker, Justin Ruixin, Yong, Ming Hui, Goh, Yihui, Yu, Wai-Yung, Lim, Tchoyoson Choie Cheio, Tan, Benjamin Yong Qiang, Ng, Kay Wei Ping, Yeo, Leonard Leong Litt, Pang, Yu Zhi, Prakash, Kumar M., Ahmad, Aftab, Thomas, Terrence, Lye, David Chien Boon, Tan, Kevin, and Umapathi, Thirugnanam

Published
2021
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11. Cerebral venous thrombosis post BNT162b2 mRNA SARS‐CoV‐2 vaccination: A black swan event

Author

Fan, Bingwen Eugene, primary, Shen, Jia Yi, additional, Lim, Xin Rong, additional, Tu, Tian Ming, additional, Chang, Cheng Chieh Ray, additional, Khin, Hnin Su Wai, additional, Koh, Jasmine Shimin, additional, Rao, Jai Prashanth, additional, Lau, Soon Lee, additional, Tan, Guat Bee, additional, Chia, Yew Woon, additional, Tay, Kay Yaw, additional, Hameed, Shahul, additional, Umapathi, Thirugnanam, additional, Ong, Kiat Hoe, additional, and Prasad, Banumukala Madhava Rao Vishnu, additional

Published
2021
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12. Acute Ischemic Stroke During the Convalescent Phase of Asymptomatic COVID-2019 Infection in Men

Author

Tu, Tian Ming, primary, Seet, Christopher Ying Hao, additional, Koh, Jasmine Shimin, additional, Tham, Carol Huilian, additional, Chiew, Hui Jin, additional, De Leon, Jasmyn Angon, additional, Chua, Christopher Yuan Kit, additional, Hui, Andrew Che-Fai, additional, Tan, Shaun Shi Yan, additional, Vasoo, Shawn Sushilan, additional, Tan, Benjamin Yong-Qiang, additional, Umapathi, N. Thirugnanam, additional, Tambyah, Paul Anantharajah, additional, and Yeo, Leonard Leong Litt, additional

Published
2021
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13. Neurological Disorders associated with COVID-19 in Singapore (1707)

Author

Hoe, Rebecca Hui Min, primary, Koh, Jasmine Shimin, additional, De Silva, Deidre Ann, additional, Quek, Amy May Lin, additional, Chiew, Hui Jin, additional, Tu, Tian Ming, additional, Seet, Christopher Ying Hao, additional, Saini, Monica, additional, Hui, Andrew Che-Fai, additional, Angon, Jasmyn, additional, Ker, Justin Ruixin, additional, Yong, Ming Hui, additional, Goh, Yihui, additional, Yu, Wai-Yung, additional, Lim, Tchoyoson Choie Cheio, additional, Tan, Benjamin Yong Qiang, additional, Ng, Kay Wei Ping, additional, Yeo, Leonard Leong Litt, additional, Pang, Yu Zhi, additional, Kumar, Prakash M., additional, Ahmad, Aftab, additional, Thomas, Terrence, additional, Lye, David Chien Boon, additional, Tan, Kevin, additional, and Thirugnanam, Umapathi, additional

Published
2021
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15. Early Aggressive Immunotherapy Improves Functional Outcome in Chronic Immune Sensory Polyradiculopathy

Author

Koh, Jasmine Shimin, Tung, James Wei Min, Tan-Yu, Genevieve Lynn Yu, and Umapathi, Thirugnanam

Subjects
Article Subject
Abstract

Chronic immune sensory polyradiculopathy (CISP) is an uncommon and treatable inflammatory disorder of the proximal sensory nerve roots. Patients typically present with severe sensory ataxia, normal motor examination, unsteady gait, and normal nerve conduction studies (NCS). We describe an elderly man who presented with a two-week history of progressive numbness of both legs and recurrent falls. He had hyporeflexia, normal strength, severe proprioceptive, and vibration sense loss in both lower limbs and was unable to stand or walk because of severe sensory ataxia. The NCS and MR scan of the spine were normal. Tibial somatosensory evoked potentials revealed proximal conduction defect and localized the pathology to the lumbar sensory nerve roots proximal to the dorsal root ganglion. Cerebrospinal fluid showed cytoalbuminergic dissociation suggestive of inflammation. CISP was diagnosed; he was given aggressive immunotherapy consisting sequentially of corticosteroids with mycophenolate mofetil and three cycles of intravenous immunoglobulin after which he regained independent mobility. Unlike previous reports where patients presented months-years after symptom onset and improved after single-line immunotherapy, our patient presented fairly acutely and made dramatic improvement only after aggressive combination therapy. We urge physicians to recognize this uncommon neurologic cause of sensory ataxia where early aggressive treatment is crucial for better functional outcomes.

Published
2020
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16. Delayed Acute Ischemic Stroke as a Late Manifestation of Asymptomatic COVID-19: The Silent 'Long Haul' Wave of the Pandemic?

Author

Tu, Tian Ming, primary, Seet, Christopher Ying Hao, additional, Koh, Jasmine Shimin, additional, Tham, Carol Huilian, additional, Chiew, Hui Jin, additional, De Leon, Jasmyn Angon, additional, Chua, Christopher, additional, Hui, Andrew Che-Fai, additional, Tan, Shaun Shi Yan, additional, Vasoo, Shawn Sushilan, additional, Tan, Benjamin Yong-Qiang, additional, Thirugnanam, Umapathi N., additional, Tambyah, Paul Anantharajah, additional, and Yeo, Leonard Leong Litt, additional

Published
2020
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17. Nosocomial treatment-induced neuropathy of diabetes : an important cause of painful and autonomic neuropathy in hospitalized diabetes mellitus patients

Author

Koh, Jasmine Shimin, Tung, James Wei Min, Lee, Benjamin Jun Hwee, Wong, Xin Yi, Soh, Randy Jing Hang, Thirugnanam, Umapathi N., and Lee Kong Chian School of Medicine (LKCMedicine)

Subjects
Treatment-induced Neuropathy, Medicine [Science], Insulin Neuritis
Abstract

Treatment-induced neuropathy of diabetes (TIND) is an acute painful autonomic small-fiber neuropathy that develops following an abrupt improvement in glycaemia control. Recent reports suggest TIND is a significant problem in tertiary neuropathy clinics. TIND in hospitalized patients with poor initial glycaemia control, that we refer to as nosocomial TIND, has not been well-studied. We describe the demographic, clinical features and indices of glycaemia control in 5 consecutive nosocomial TIND patients. TIND was defined using recently published criteria. Pre-meal capillary blood glucose recordings performed during the period of HbA1c decline was used to calculate glycaemic variability. All the nosocomial TIND patients were hospitalized for prolonged periods for serious medical conditions that warranted good glycaemia control, namely severe sepsis, diabetic ketoacidosis, stroke, heart failure and traumatic head injury. They had raised, double-digit, HbA1c levels at admission that subsequently dropped precipitously with tight in-patient glycaemia control protocols. These patients had multiple, largely asymptomatic, hypoglycaemic episodes. Glycaemic variability also appeared to be high in this cohort. TIND may be a significant cause of morbidity in hospitalized diabetic patients with poor glycaemia control. Not all patients developed both autonomic and painful neuropathies, raising the possibility of forme-fruste TIND. Published version

Published
2019

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