Acute cervical transverse myelitis after anti-hepatitis B vaccination: time course of anti-HBs antibodies

BACKGROUND: The cause and effect relationship between anti-HBV immunization using recombinant vaccine and the development of a neurological event incl uding flare-ups of multiple sclerosis, is a widely debated issue. CASE REPORT: A previously asymptomatic 16-year-old girl was a hyper-respond er to anti-HBV vaccine. Subsequent to a booster shot of anti-HBV recombinan t vaccine, she developed regressive acute cervical transverse myelitis with intrathecal oligochonal Ige secretion and a hypersignal on the MRI T2 sequ ences of the cord. DISCUSSION: The distinction between a first episode of multiple sclerosis o r post-vaccinal acute myelitis in this case will depend upon subsequent cou rse but this observation points out the very high level of persistent post- vaccinal immunization which can be acquired by a hyper-responder.