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Recurrent 6th nerve palsy in a child following different live attenuated vaccines: case report

Daryl R Cheng1, Nigel W Crawford, Michael Hayman

  • 1Central Medical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia.

BMC Infectious Diseases
|May 2, 2012
PubMed

Insights

Recurrent benign sixth nerve palsy (cranial nerve VI palsy) can occur after live attenuated vaccines. This case highlights the importance of considering vaccine-associated neurological events in children.

Area of Science:

  • Pediatric Neurology
  • Ophthalmology
  • Immunology

Background:

  • Recurrent benign sixth nerve palsy (cranial nerve VI palsy) is rare in children.
  • Previous cases linked to infections and immunizations exist.
  • No prior reports link it to two different live attenuated vaccines.

Observation:

  • A 12-month-old boy experienced recurrent benign sixth nerve palsy.
  • Palsy episodes followed measles-mumps-rubella and varicella vaccinations.
  • Full recovery occurred after each episode.

Findings:

  • Extensive investigations ruled out other causes for the palsy.
  • This is the first reported case of recurrent benign sixth nerve palsy after two distinct live attenuated vaccines.
  • The exact pathophysiology remains unclear, with autoimmune or viral mechanisms proposed.

Implications:

  • Benign sixth nerve palsies generally have a good prognosis.
  • Careful evaluation is crucial to exclude sinister causes.
  • Future immunizations in such cases require individualized risk-benefit assessment.
Abstract

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