Acute Disseminated Encephalomyelitis
Acute Disseminated Encephalomyelitis After Influenza Vaccination: A Case Report
“Acute disseminated encephalomyelitis developed in a 42-year-old woman within 3 weeks of receiving the seasonal influenza vaccine. She had 80% recovery after 3 months of treatment with methylprednisolone. Although cases of acute disseminated encephalomyelitis after vaccination for influenza are rare, enough of them have occurred that critical care nurses should be aware of the possibility. Early treatment can prevent serious residual signs and symptoms; therefore, correct and quick diagnosis is important. Medical history obtained from patients with central nervous system problems should include history of recent vaccinations.”
? [Acute disseminated encephalomyelitis after tetanus vaccination of a pregnant woman in Senegal].
Although neurological complications have been described after tetanus vaccinations, they are rare. The authors report a case of acute disseminated encephalomyelitis (ADEM) in a 28-year-old pregnant woman at a gestational age of 10 weeks, admitted 15 days after a tetanus vaccination, with spastic tetraplegia and sphincter disturbances. Corticosteroid treatment led to partial recovery of the neurological deficit. Differential diagnosis of infectious and demyelinating diseases of the central nervous system is difficult in view of clinical and laboratory aspects of post-vaccination ADEM. Without any specific diagnostic markers, the clinical examination, magnetic resonance imaging and negative etiological findings were key to this diagnosis. Medical staff must bear in mind the possible complications of this vaccine.
Acute disseminated encephalomyelitis associated with oral polio vaccine.
“A 27-year-old woman presented with acute paresis after taking an oral polio vaccine (OPV). Deep tendon reflexes were preserved, needle electromyography showed no neurogenic changes, and there were no lesions on spine magnetic resonance imaging (MRI), suggesting that motor neurons of the spinal cord were not affected. Brain MRI showed abnormal lesions in the tegmentum of the upper pons, left cerebral peduncles, truncus of the corpus callosum, and right parietal lobe. Cerebrospinal fluid revealed mild pleocytosis. The most probable diagnosis was acute disseminated encephalomyelitis associated with OPV.”
Acute Disseminated Encephalomyelitis Following Immunization with Human Papillomavirus Vaccines.
Acute disseminated encephalomyelitis following inactivated influenza vaccination in the Brazilian Amazon: a case report
“Here, we describe a case of acute disseminated encephalomyelitis (ADEM) that occurred during a plausible risk interval following inactivated influenza vaccination in a previously healthy 27-year-old man from Manaus, Brazil. He was treated with intravenous methylprednisolone and immunoglobulin. One-month follow-up revealed resolution of the brain lesions, but not of the spinal cord lesions. No recurrence or progression of the main neurological symptoms was observed. After two years of monitoring, the patient continues to experience weak lower limbs and urinary retention. Thus, we recommend that ADEM should be considered in a patient presenting with neurological symptoms after influenza vaccination.”
[Acute disseminated encephalomyelitis following influenza vaccination: report of a case with callosal disconnection syndrome].
Acute Disseminated Encephalomyelitis following Vaccination against Hepatitis B in a Child: A Case Report and Literature Review
“Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system, which has been associated with several vaccines such as rabies, diphtheria-tetanus-polio, smallpox, measles, mumps, rubella, Japanese B encephalitis, pertussis, influenza, and the Hog vaccine. Here, we presented a case of 12-year-old child who suffered from ADEM three weeks after hepatitis B vaccination. He was admitted to our hospital with symptoms of weakness of limbs, high fever, and alteration of consciousness. Some abnormalities were also found in CSF. Treatment with high-dose corticosteroids and intravenous immunoglobulin had significant effect, with marked improvement of the clinical symptoms and the results of CSF. The findings of MRI also detected some abnormal lesions located in both brain and spinal cord. The clinical features, the findings of CSF and MRI, and therapeutic effect may contribute to such diagnosis of ADEM.”
Acute disseminated encephalomyelitis secondary to serogroup B meningococcal vaccine
“•Acute disseminated encephalomyelitis (ADEM) is rare in adults.
•This is the first published case of ADEM secondary to serogroup B meningococcal vaccine.
•Vaccination must be considered in the differential diagnosis of ADEM.”
A Case Report of Post Rabipur (Purified Chick Embryo Rabies Vaccine) Acute Disseminated Encephalomyelitis.
“Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease that typically occurs following a viral infection or vaccination. The incidence of ADEM following vaccination has become very low since introduction of non-neural rabies vaccine and only few cases had been reported due to pure chick embryo derived rabies vaccine (PCERV). Here we are reporting a rare case of delayed post vaccinal ADEM.”
Characteristics of pediatric multiple sclerosis: The Turkish pediatric multiple sclerosis database. (2017)
“The earlier-onset group had a higher rate of infection/vaccination preceding initial attack, initial diagnosis of ADEM, longer interval between first 2 attacks, and more disability accumulating in the first 3 years of the disease.”
Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
? Demyelinating disease and polyvalent human papilloma virus vaccination
“Since its inception, the polyvalent vaccine against the human papilloma virus (HPV), Gardasil, has generated some controversies as a temporal relationship between the administrations of the vaccine and the development of a few autoimmune diseases, such as acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS) and Guillain–Barre syndrome have been reported.1–3 We encountered two cases whose initial presentation of CNS demyelination followed in close time relationship the administration of Gardasil vaccine and we discuss their possible association.
Case No 1
A 19-year-old woman received two doses of Gardasil, 3 months apart, and approximately 1 month after the second dose, she developed numbness to the right foot that within 1 day extended to the contralateral foot and was associated with mid-thoracic back pain. Her neurological examination was only significant for the altered perception to touch to the feet. Deep tendon reflexes were normal and plantar reflexes in flexion. MRI of cervical and thoracic spine revealed a total of three lesions with characteristic demyelinating appearance, one of those in the thoracic spine was contrast-enhancing (figure 1A–C). MRI brain demonstrated one additional white matter lesion also consistent with a demyelinating process.”
Idiopathic Parkinson’s disease(s) may follow subclinical episodes of perivenous demyelination.
“Three case studies of postvaccinal parkinsonism (PVP) demonstrated signs and symptoms identical to conventional diagnostic standards of idiopathic Parkinson’s disease (PD). PVP is a sub-type of acute disseminated encephalomyelitis (ADE) that also includes postinfectious parkinsonism (PIP) and postinfectious encephalomyelitis (PIE).”
Influenza vaccine-induced CNS demyelination in a 50-year-old male.
Post-vaccination encephalomyelitis: literature review and illustrative case.
Simultaneous development of acute disseminated encephalomyelitis and Guillain-Barré syndrome associated with H1N1 09 influenza vaccination.
“A 36-year-old man was admitted to our hospital because of urinary retention and muscle weakness affecting all 4 limbs after receiving a H1N1 09 influenza vaccination. Magnetic resonance imaging demonstrated multiple lesions in his brain and spinal cord. Furthermore, nerve conduction study showed acute sensorimotor neuropathy, and anti-GM2 antibodies were detected in his serum. Based on the temporal association and exclusion of alternative etiologies, we made a diagnosis of acute disseminated encephalomyelitis (ADEM) and Guillain-Barré syndrome (GBS). To our knowledge, this is the first case of co-morbid ADEM and GBS after influenza vaccination with positive anti-ganglioside antibodies.”
Two Cases of Acute Disseminated Encephalomyelitis Following Vaccination Against Human Papilloma Virus.
“We herein present two cases of acute disseminated encephalomyelitis (ADEM) following vaccination against human papilloma virus (HPV). Case 1 experienced diplopia and developed an unstable gait 14 days after a second vaccination of Cervarix. Brain magnetic resonance imaging (MRI) showed an isolated small, demyelinating lesion in the pontine tegmentum. Case 2 experienced a fever and limb dysesthesia 16 days after a second vaccination of Gardasil. Brain MRI revealed hyperintense lesion in the pons with slight edema on a T2-weighted image. Both cases resolved completely. It is important to accumulate further data on confirmed cases of ADEM temporally associated with HPV vaccination.”