Crémieux G, Dor J F, Mongin M
Acta Neurol Belg. 1978 Sep-Oct;78(5):279-300.
A case of facial diplegia with albuminocytologic dissociation of cerebrospinal fluid after antirabies vaccination prompts the author to attempt a retrospective study of post-antirabies-vaccination neuropathies, with facial or extensive involvement. Fifty-seven cases are considered. Irrespective of vaccine type, certain clinical similarities emerge, notably the age of occurrence (adult), the early onset of the paralysis (during vaccine therapy or in the following week), and the prognosis (good survival rate, severity of functional impairment varying with extent of involvement). The author attributes the main pathogenic role to the peripheral myelinic basic protein contained in varying proportions in conventional vaccines, the corollary being that such accidents should disappear completely with the new vaccination based on tissue culture material. A therapy programme comprising the discontinuation of vaccine therapy and administration of corticoids is proposed.
1例抗狂犬病疫苗接种后出现脑脊液蛋白细胞分离的面瘫病例促使作者尝试对有面部或广泛受累的抗狂犬病疫苗接种后神经病变进行回顾性研究。共考虑了57例病例。不论疫苗类型如何,都出现了某些临床相似之处,特别是发病年龄(成人)、麻痹的早期发作(在疫苗治疗期间或随后一周内)以及预后(存活率高,功能损害的严重程度因受累程度而异)。作者将主要致病作用归因于传统疫苗中不同比例含有的外周髓鞘碱性蛋白,由此推断此类意外情况应会随着基于组织培养材料的新型疫苗接种而完全消失。提出了一个包括停止疫苗治疗和给予皮质类固醇的治疗方案。