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

Mika Matsui1, Hiroe Kawano, Makoto Matsukura

  • 1Department of Child Development, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860-0811, Japan.

Brain & Development
|April 6, 2002
PubMed

Insights

Japanese B encephalitis (JBE) vaccination can trigger acute transverse myelitis (ATM), a severe spinal cord inflammation. Early treatment with methylprednisolone may reduce swelling but long-term neurological deficits can persist.

Area of Science:

  • Neurology
  • Immunology
  • Vaccinology

Background:

  • Japanese B encephalitis (JBE) is a serious mosquito-borne viral disease.
  • Vaccination is crucial for preventing JBE, but potential adverse effects require monitoring.

Observation:

  • A 4-year-old girl developed acute transverse myelitis (ATM) within 24 hours after JBE vaccination.
  • Clinical presentation included ascending flaccid paraplegia, sensory disturbance, bladder dysfunction, and meningeal signs.

Findings:

  • Cerebrospinal fluid analysis revealed neutrophil pleocytosis and elevated protein.
  • MRI showed diffuse cervical and lumbar cord swelling, indicative of meningo-radiculomyelopathy.
  • High-dose methylprednisolone therapy led to reduced cord swelling, suggesting anti-inflammatory efficacy.

Implications:

  • Despite treatment, the patient experienced persistent neurological deficits, indicating severe spinal cord pathology.
  • A potential cellular autoimmune mechanism triggered by JBE vaccination is suspected.
  • This case highlights the importance of vigilance for rare neurological complications post-vaccination.

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