Postvaccinal parkinsonism.
A 5-year-old boy, with a history of fever beginning 15 days after a vaccination for measles, developed a rigid-akinetic syndrome 3 days after the fever began. A spinal tap obtained 1 week after the onset of fever showed pleocytosis with a monocellular pattern. A CT scan of the head and EEG did not disclose any abnormality. An MRI performed 3 months after the event, however, showed clear-cut evidence of bilateral substantia nigra lesions, suggesting secondary gliosis. The response to levodopa was good, but adverse reactions appeared early. The child is now 7 years old. Bromocriptine, deprenyl, and levodopa have produced a remarkable improvement of the parkinsonian features.
Department of Neurology, General Hospital, University of São Paulo Medical School, Brazil.
R S
RS
Alves
E R
ER
Barbosa
M
M
Scaff
D001971:Bromocriptine / Q000008:administration & dosage; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D008458:Measles Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D009460:Neurologic Examination / Q000187:drug effects; D010301:Parkinson Disease, Postencephalitic / Q000175:diagnosis* / Q000188:drug therapy; D013378:Substantia Nigra / Q000473:pathology
D008458:Measles Vaccine; D001971:Bromocriptine; D007980:Levodopa