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Postvaccinal parkinsonism
R S Alves1, E R Barbosa, M Scaff
1Department of Neurology, General Hospital, University of São Paulo Medical School, Brazil.
Abstract:
A 5-year-old boy, with a history of fever beginning 15 days after a vaccination for measles, developed a rigid-akinetic syndrome 3 days after the fever began. A spinal tap obtained 1 week after the onset of fever showed pleocytosis with a monocellular pattern. A CT scan of the head and EEG did not disclose any abnormality. An MRI performed 3 months after the event, however, showed clear-cut evidence of bilateral substantia nigra lesions, suggesting secondary gliosis. The response to levodopa was good, but adverse reactions appeared early. The child is now 7 years old. Bromocriptine, deprenyl, and levodopa have produced a remarkable improvement of the parkinsonian features.
Insights
A child developed parkinsonism after measles vaccination, confirmed by MRI showing substantia nigra lesions. Early treatment with levodopa and other medications led to significant symptom improvement.
Area of Science:
- Neurology
- Immunology
- Pediatrics
Background:
- Investigating potential adverse events following childhood vaccinations.
- Understanding the neurological sequelae of post-vaccination syndromes.
Observation:
- A 5-year-old boy presented with fever post-measles vaccination, followed by a rigid-akinetic parkinsonian syndrome.
- Cerebrospinal fluid analysis revealed a monocellular pleocytosis.
- Initial neuroimaging (CT, EEG) was unremarkable, but later MRI showed bilateral substantia nigra lesions.
Findings:
- The patient exhibited clinical features consistent with parkinsonism.
- Magnetic resonance imaging (MRI) revealed specific lesions in the substantia nigra, indicative of secondary gliosis.
- The patient showed a positive, albeit early-adverse-reaction-prone, response to levodopa therapy.
Implications:
- This case suggests a possible link between measles vaccination and the development of parkinsonism in susceptible individuals.
- Early diagnosis and multi-drug therapy (levodopa, bromocriptine, deprenyl) can effectively manage parkinsonian symptoms.
- Further research is warranted to elucidate the immunopathogenesis of vaccine-induced parkinsonism.