Longitudinally extensive transverse myelitis following vaccination with nasal attenuated novel influenza A(H1N1) vaccine

Arch Neurol. 2010 Aug;67(8):1018-20. doi: 10.1001/archneurol.2010.167.


Background: Transverse myelitis has been reported in association with vaccination, including influenza vaccination.

Objective: To describe a case of longitudinally extensive transverse myelitis associated with vaccination with a nasal attenuated novel influenza A(H1N1) vaccine.

Design: Case report.

Setting: Sanford University of South Dakota Hospital. Patient A 27-year-old woman with longitudinally extensive transverse myelitis.

Results: Four days following novel influenza A(H1N1) vaccination, the patient developed longitudinally extensive transverse myelitis. Extensive diagnostic evaluation effectively ruled out causes other than vaccination-associated transverse myelitis. Following treatment with corticosteroids and plasmapheresis, the patient made a significant recovery.

Conclusions: Transverse myelitis may be associated with vaccination against novel influenza A(H1N1). Additionally, we believe this to be the first report of longitudinally extensive transverse myelitis associated with any vaccine.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intranasal
  • Adult
  • Female
  • Humans
  • Influenza A Virus, H1N1 Subtype / immunology*
  • Influenza Vaccines / adverse effects*
  • Influenza, Human / prevention & control
  • Longitudinal Studies
  • Magnetic Resonance Imaging / methods
  • Myelitis, Transverse / etiology*
  • Myelitis, Transverse / immunology
  • Myelitis, Transverse / pathology


  • Influenza Vaccines