Acute disseminated encephalomyelitis after live rubella vaccination

We report here a case involving a 14-year-old boy who developed acute disse minated encephalomyelitis following live rubella vaccination. The patient b ecame febrile and began to experience nuchal pain 16 days after the immuniz ation. By 22 days after immunization, he experienced difficulty in walking. By 24 days, he had developed tetraparesis with retention of urine, and tot al sensory loss below the Th1 dermatomal level. He was febrile at this poin t and showed nuchal rigidity and Lhermitte's sign. Cerebrospinal fluid exam ination revealed elevated cell counts, protein level, and myelin basic prot ein. T2-weighted magnetic resonance imaging detected high intensity lesions in the bilateral cerebral white matter and cervical spinal cord. Following the administration of intravenous corticosteroids, the patient's clinical symptoms improved rapidly. (C) 2000 Published by Elsevier Science B.V. All rights reserved.