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

Am J Case Rep. 2014 Aug 31;15:368-73. doi: 10.12659/AJCR.891416.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Angiography
  • Diagnosis, Differential
  • Encephalomyelitis, Acute Disseminated / chemically induced*
  • Encephalomyelitis, Acute Disseminated / diagnosis
  • Follow-Up Studies
  • Humans
  • Influenza Vaccines / adverse effects*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed
  • Ultrasonography, Doppler, Duplex
  • Vaccination / adverse effects*

Substances

  • Influenza Vaccines