Acute disseminated encephalomyelitis with probable measles vaccine failure

The patient is a 10-year-old male who experienced somnolence and incomplete quadriplegia after headache and vomiting, without exanthema, for 3 days. T he clinical course and magnetic resonance imaging findings of the brain and spinal cord were compatible with acute disseminated encephalomyelitis. The serologic examination revealed that the patient had rubeola because titers of IgM and IgG antibody to measles virus measured by enzyme immunoassay we re 0.91 and 40 (cutoff = 0.80 and 2), respectively, at 5 weeks after the on set, the IgM titer had become negative (0.56), and the IgG titer had decrea sed to 17.7 at 13 weeks after the onset. Because the patient had received a measles-mumps-rubella vaccine at 12 months of age, the acute disseminated encephalomyelitis was thought to be attributed to the modified measles resu lting from measles vaccine failure. (C) 1999 by Elsevier Science Inc. All r ights reserved.