PMID: 11934518Apr 6, 2002Paper

Acute transverse myelitis after Japanese B encephalitis vaccination in a 4-year-old girl

Brain & Development
Mika MatsuiTeruhisa Miike

Abstract

Fourteen days after Japanese B encephalitis (JBE) vaccination, a 4-year-old girl developed the full clinical manifestation of ATM within 24h. She showed acute ascending flaccid paraplegia with sensory disturbance, bladder dysfunction and meningeal sign. Cerebrospinal fluid examination revealed neutrophil pleocytosis and elevated protein level. Magnetic resonance imaging (MRI) showed diffuse swelling of the cervical and lumbar cord with low signal intensity on T1 and high signal intensity on T2-weighted imaging. These findings suggested that she had developed meningo-radiculomyelopathy. Since sequential MRI studies showed prompt reduction of the cord swelling, the high-dose methylprednisolone therapy employed seemed to have been effective for improvement of inflammation. Even with such potent drug treatment, she still has substantial flaccid diplegia and sphincter disorder 1 year later, and so we are convinced that the pathological change of the cord was as severe as in necrotizing myelopathy. Although the pathological process remains unknown, cellular autoimmune mechanism against the JBE vaccination is suspected.

References

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Citations

May 13, 2009·Southern Medical Journal·Riamiza Natalie MominVui Heng Chong
Dec 13, 2006·Travel Medicine and Infectious Disease·Franco Giovanetti
Feb 3, 2004·Immunology and Allergy Clinics of North America·Anne-Marie Plesner
Apr 16, 2013·Case Reports in Infectious Diseases·Varshney Ankur NandanAnand Arvind
Jan 12, 2017·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Kelly K Koeller, Robert Y Shih
Nov 3, 2009·Lupus·N Agmon-LevinY Shoenfeld

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