Influenza vaccine-induced CNS demyelination in a 50-year-old male.

Autor: Sacheli A; Cracchiolo Inpatient Rehabilitation Center, St. John Hospital & Medical Center, Detroit, USA., Bauer R; Cracchiolo Inpatient Rehabilitation Center, St. John Hospital & Medical Center, Detroit, USA.
Jazyk: angličtina
Zdroj: The American journal of case reports [Am J Case Rep] 2014 Aug 31; Vol. 15, pp. 368-73. Date of Electronic Publication: 2014 Aug 31.
DOI: 10.12659/AJCR.891416
Abstrakt: Patient: Male, 50.
Final Diagnosis: Acute post-vaccination CNS demyelinating disorder.
Symptoms: Blurred vision • hemiparesis • hemiplegia • hypertonia • itching • paresthesia.
Medication: -.
Clinical Procedure: MRI.
Specialty: Neurology.
Objective: Rare disease.
Background: There are several categories of primary inflammatory demyelinating disorders, which comprise clinically similar neurologic sequelae. Of interest, clinically isolated syndrome (CIS) and acute disseminated encephalomyelitis (ADEM) are 2 demyelinating conditions of the central nervous system (CNS), whose clinical similarity pose a significant challenge to definitive diagnosis. Yet, both remain important clinical considerations in patients with neurologic signs and symptoms in the context of recent vaccination.
Case Report: We report a case of a 50-year-old Caucasian male with a course of progressive, focal, neurologic deficits within 24 h after receiving the influenza vaccine. Subsequent work-up revealed the possibility of an acute central nervous system (CNS) demyelinating episode secondary to the influenza vaccine, best described as either CIS or ADEM.
Conclusions: Case reports of CNS demyelination following vaccinations have been previously noted, most often occurring in the context of recent influenza vaccination. This report serves to document a case of CNS demyelination occurring 24 h after influenza vaccination in a middle-aged patient, and will describe some salient features regarding the differential diagnosis of CIS and ADEM, as well as their potential management.
Databáze: MEDLINE