Journal
JOURNAL OF CLINICAL NEUROSCIENCE
Volume 15, Issue 12, Pages 1315-1322Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2008.05.002
Keywords
Influenza vaccination; Optic neuropathy; Acute disseminated encephalomyelitis; Multiphasic disseminated encephalomyelitis; Corticosteroid therapy
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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). Postinfectious 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. Crown Copyright (C) 2008 Published by Elsevier Ltd. All rights reserved.
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