Huynh William, Cordato Dennis J, Kehdi Elias, Masters Lynette T, Dedousis Chris
Department of Neurology, Liverpool Hospital, Liverpool, New South Wales, Australia.
J Clin Neurosci. 2008 Dec;15(12):1315-22. doi: 10.1016/j.jocn.2008.05.002. Epub 2008 Oct 30.
Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system that is usually considered a monophasic disease. ADEM forms one of several categories of primary inflammatory demyelinating disorders of the central nervous system including multiple sclerosis, optic neuropathy, acute transverse myelitis, and neuromyelitis optica (Devic's disease). Post-infectious and post-immunisation encephalomyelitis make up about three-quarters of cases, where the timing of a febrile event is associated with the onset of neurological disease. Post-vaccination ADEM has been associated with several vaccines such as rabies, diphtheria-tetanus-polio, smallpox, measles, mumps, rubella, Japanese B encephalitis, pertussis, influenza, hepatitis B, and the Hog vaccine. We review ADEM with particular emphasis on vaccination as the precipitating factor. We performed a literature search using Medline (1976-2007) with search terms including "ADEM", "acute disseminated encephalomyelitis", "encephalomyelitis", "vaccination", and "immunisation". A patient presenting with bilateral optic neuropathies within 3 weeks of "inactivated" influenza vaccination followed by delayed onset of ADEM 3 months post-vaccination is described.
急性播散性脑脊髓炎（ADEM）是一种中枢神经系统的炎性脱髓鞘疾病，通常被认为是单相性疾病。ADEM是中枢神经系统原发性炎性脱髓鞘疾病的几种类型之一，包括多发性硬化症、视神经病变、急性横贯性脊髓炎和视神经脊髓炎（德维克病）。感染后和免疫接种后脑脊髓炎约占病例的四分之三，其中发热事件的时间与神经系统疾病的发作相关。接种疫苗后发生的ADEM与多种疫苗有关，如狂犬病疫苗、白喉-破伤风-脊髓灰质炎疫苗、天花疫苗、麻疹疫苗、腮腺炎疫苗、风疹疫苗、日本乙型脑炎疫苗、百日咳疫苗、流感疫苗、乙型肝炎疫苗和猪瘟疫苗。我们对ADEM进行综述，特别强调接种疫苗作为诱发因素。我们使用Medline（1976 - 2007年）进行文献检索，检索词包括“ADEM”、“急性播散性脑脊髓炎”、“脑脊髓炎”、“接种疫苗”和“免疫接种”。本文描述了一名患者，在接种“灭活”流感疫苗后3周内出现双侧视神经病变，接种疫苗3个月后延迟发生ADEM。
