A case of antirabies inoculation encephalitis with a long clinical course.

In 1950, a 24-year-old man developed gait disturbance, incontinence of urine and increasing lethargy a week after a course of antirabies vaccination. He was diagnosed as having post-rabies vaccination encephalitis and had been in hospital for 37 years before he died in 1987. This is one of the rare cases in which the course of this disease was traced for an exceptionally long period. His personality began to deteriorate at an early stage of the illness, but his intellectual faculties seemed to be maintained rather well until a few years prior to his death. A neuropathological study revealed disseminated, patchy and somewhere perivascularly located demyelinated lesions in the cerebral white matter. Inflammatory lymphocytic infiltration was also remarkable in the CNS regions. But while the superimposed lesions due to convulsive attacks, traumatic contusion and terminal anoxia were remarkable, the whole aspect of neuropathological changes in rabies inoculation encephalitis cannot be observed.