Sacheli Aaron, Bauer Raymond
Cracchiolo Inpatient Rehabilitation Center, St. John Hospital & Medical Center, Detroit, USA.
Am J Case Rep. 2014 Aug 31;15:368-73. doi: 10.12659/AJCR.891416.
Male, 50.
Acute post-vaccination CNS demyelinating disorder.
Blurred vision • hemiparesis • hemiplegia • hypertonia • itching • paresthesia.
-.
MRI.
Neurology.
Rare disease.
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.
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.
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.
男性，50岁。
急性疫苗接种后中枢神经系统脱髓鞘疾病。
视力模糊、偏瘫、半身不遂、张力亢进、瘙痒、感觉异常。
未提及。
磁共振成像（MRI）。
神经科。
罕见病。
原发性炎性脱髓鞘疾病有几类，它们具有临床相似的神经后遗症。值得注意的是，临床孤立综合征（CIS）和急性播散性脑脊髓炎（ADEM）是中枢神经系统（CNS）的两种脱髓鞘疾病，其临床相似性给明确诊断带来了重大挑战。然而，对于近期接种疫苗后出现神经体征和症状的患者，这两种疾病仍是重要的临床考虑因素。
我们报告一例50岁白种男性病例，该患者在接种流感疫苗后24小时内出现进行性、局灶性神经功能缺损。后续检查显示可能是流感疫苗继发的急性中枢神经系统（CNS）脱髓鞘发作，最恰当的描述为CIS或ADEM。
先前已有接种疫苗后发生中枢神经系统脱髓鞘的病例报告，最常见于近期接种流感疫苗的情况下。本报告记录了一例中年患者在接种流感疫苗24小时后发生中枢神经系统脱髓鞘的病例，并将描述关于CIS和ADEM鉴别诊断的一些显著特征及其潜在治疗方法。
