Influenza Vaccine-Induced CNS Demyelination in a 50-Year-Old Male

Abstract

Patient: Male, 50Final Diagnosis: Acute post-vaccination CNS demyelinating disorderSymptoms: Blurred vision • hemiparesis • hemiplegia • hypertonia • itching • paresthesiaMedication: —Clinical Procedure: MRISpecialty: NeurologyObjective:Rare diseaseBackground:There are several categories of primary inflammatory demyelinating disorders, which comprise clinically similar neurologic sequelae. Of interest, clinically isolated syndrome (CIS) and acute disseminated encephalomyelitis (ADEM) are 2 demyelinating conditions of the central nervous system (CNS), whose clinical similarity pose a significant challenge to definitive diagnosis. Yet, both remain important clinical considerations in patients with neurologic signs and symptoms in the context of recent vaccination.Case Report:We report a case of a 50-year-old Caucasian male with a course of progressive, focal, neurologic deficits within 24 h after receiving the influenza vaccine. Subsequent work-up revealed the possibility of an acute central nervous system (CNS) demyelinating episode secondary to the influenza vaccine, best described as either CIS or ADEM.Conclusions:Case reports of CNS demyelination following vaccinations have been previously noted, most often occurring in the context of recent influenza vaccination. This report serves to document a case of CNS demyelination occurring 24 h after influenza vaccination in a middle-aged patient, and will describe some salient features regarding the differential diagnosis of CIS and ADEM, as well as their potential management.