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Postvaccinal neurological complications

2013; Thieme Medical Publishers (Germany); Volume: 71; Issue: 9B Linguagem: Inglês

10.1590/0004-282x20130163

1678-4227

Getúlio Daré Rabello,

Infectious Encephalopathies and Encephalitis

Case reportCHCYL, female, white, 30 years old.On May 21 st 2010 the patient was vaccinated against H1N1 flu.After few days, she developed neurological signs characterized by paresthesias in the left side of the body.Subsequently she developed central vestibular syndrome, with hiccups and uncontrollable vomi ting.The patient was admitted to the Hospital Samaritano on June 8 th 2010 and the MRI has showed lesions of demyelina ting and inflammatory character in the medulla oblonga and high cervical spinal cord.Cerebrospinal fluid (CSF) examination has showed lymphocytic pleocytosis.In addition, she developed pancreatitis, confirmed with MRI of the abdomen.After receiving dexamethasone she improved.In early August 2010, her condition got worse, starting with gait ataxia, complete horizontal ophthalmoplegia, intense paresthesia and areflexia in the left upper limb.The patient was re-admitted and the MRI has showed worsening of inflammatory demyelinating lesions.CSF maintained the previous characteristics.She had received methylprednisolone pulse 1 g / EV for 5 consecutive days and then she was discharged with oral prednisone, which was withdrawn in a few months, with reversal of the situation.In November 2011, the neurological disorder was presented again and it was characterized by central vestibular syndrome and bilateral internuclear ophthalmoplegia.The new MRI showed new lesions with the same character in the pons.It was conducted research of antiacquaporin-4 antibody in the blood, which was negative.Facing this evolution, diagnose was defined: Multiple Scle rosis.The question is: the vaccine is directly responsible for all problems ("prolonged" ADEM) or it simply deflagrated an immune disease that was underlying?This doubt, that we had in this particularly case, is the keynote of the most neurological complications after vaccination.In this exhibition we will try to set the most current data about this issue.