Peripheral neuropathy after multiple tetanus toxoid injections

This case documents the 14th reported patient with peripheral neuropathy following tetanus toxoid injection. A 33-year-old man developed profound mixed sensorimotor peripheral neuropathy after receiving 2 tetanus toxoid injections over a 5-month period. Periodic serial electromyographic and nerve conduction studies performed over 2 years suggested both segmental demyelination and axonal neuropathy. The patient experienced partial recovery. Analysis of this case and 13 others reported in literature indicates that in almost all cases (85%), patients had received multiple tetanus toxoid injections. Also, it appears that a prolonged interval of 14 or more days between the tetanus toxoid injection and the onset of neurological symptoms is associated with a poorer prognosis for complete recovery.