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[Neurological involvement following triple virus vaccine]
A Palao Sánchez1, C Leiva-Santana, C Muñoz-Ruiz
1Servicio de Neurologia, Hospital General Universitario, Alicante, España.
Insights
Four young girls experienced immediate arm symptoms and neurological changes after receiving the measles, rubella, and mumps vaccine. Their recovery was complete, with altered immune responses noted.
Area of Science:
- Pediatric Neurology
- Vaccinology
- Immunology
Background:
- Routine prophylactic immunization against measles, rubella, and mumps utilizes a trivalent vaccine, with the second dose recommended at 11-12 years of age.
- Neurological complications, typically occurring days post-vaccination, have been previously documented following measles and rubella vaccination.
Observation:
- Four girls aged 10-11 years presented with immediate post-vaccination symptoms in the vaccinated arm, including pain, paresthesia, coldness, pallor, and sweating.
- Subsequent days revealed progressive loss of strength and sensory alterations in the affected limb.
- Extensive laboratory, radiological, neurophysiological, and psychiatric evaluations yielded normal results.
Findings:
- Immunological studies indicated an altered immunohumoral response to the trivalent vaccine in the affected patients.
- Despite initial neurological symptoms, all patients achieved complete recovery.
Implications:
- The findings suggest a potential link between the trivalent vaccine and acute neurological complications, possibly related to sympathetic nervous system dysfunction.
- Further investigation into the immunohumoral response is warranted to understand the mechanisms behind these rare post-vaccination events.
- Differential diagnosis should consider conditions like reflex sympathetic dystrophy in cases of unusual post-vaccination neurological presentations.
Introduction:
Prophylactic immunization against measles, rubella and mumps is carried out using a trivalent vaccine. The second dose is recommended at 11-12 years-old. Neurological complications have been described after vaccination for measles and rubella. All cases occurred several days after vaccination.
Clinical Cases:
We describe four girls aged between 10 and 11 years old who were vaccinated on the same day. Almost immediately they complained of symptoms in the vaccinated arm. These were pain, paresthesia, coldness, pallor and sweating of the hand. On the following days there was loss of strength and alterations in sensation. All laboratory, radiological, neurophysiological and psychiatric studies were normal. Immunological study showed changes in the immunohumeral response to the vaccine. Complete recovery was made.
Conclusions:
The different types of post-vaccination complications described to date are reviewed, together with conditions showing features such as those described, particularly the reflex sympathetic syndrome. Possible reasons for the poor immunohumoral response to the vaccine in these patients are discussed.