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Recurrent isolated sixth nerve palsy after consecutive annual influenza vaccinations in a child

Yannek I Leiderman1, Simmons Lessell, Dean M Cestari

  • 1Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|March 17, 2009
PubMed

Insights

Recurrent sixth nerve palsy, a rare condition in children, was observed following annual influenza vaccinations in an otherwise healthy boy. Investigations found no underlying neurological abnormalities, suggesting a possible link to the immunizations.

Area of Science:

  • Neurology
  • Pediatrics
  • Immunology

Background:

  • Recurrent isolated sixth nerve (abducens) palsy is uncommon in pediatric patients without other neurological deficits.
  • Identifying the etiology of recurrent cranial nerve palsies in children is crucial for diagnosis and management.

Observation:

  • A case study of a 2-year-old boy experiencing recurrent isolated sixth nerve palsy.
  • The palsy episodes occurred annually, temporally associated with influenza vaccinations.
  • Comprehensive investigations, including MRI of the brain and orbits, revealed no structural or neurological abnormalities.

Findings:

  • The patient presented with recurrent isolated sixth nerve palsy.
  • No underlying structural brain abnormalities or other neurological conditions were identified.
  • A temporal association was noted between the palsy episodes and annual influenza immunizations.

Implications:

  • This case highlights a potential, though unproven, association between influenza vaccination and recurrent sixth nerve palsy in children.
  • Further research is warranted to investigate the potential immunologic mechanisms linking influenza vaccines to abducens nerve palsy.
  • Clinicians should consider vaccination history when evaluating children with recurrent sixth nerve palsy, even in the absence of other findings.

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