title: Improvement of advanced postvaccinal demyelinating encephalitis due to plasmapheresis.
abstract: We report a case of acute demyelinating encephalitis that occurred after viral vaccination against hepatitis A-, hepatitis B-, and poliovirus and vaccination against bacterial toxins of diphtheria and tetanus. After different diagnosis had been excluded, we diagnosed postvaccinal demyelinating encephalitis and started treatment with high dose intravenous methylprednisolone, followed by peroral application in decreasing dosages for three weeks. A few days after the treatment with methylprednisolone had been finished, the patient's medical condition deteriorated again. Thus, we initiated plasma exchange at an advanced state of illness, which led to significant continuous improvement. The role of plasma exchange is discussed controversially, in particular the issue of timing. We report a case that shows improvement due to plasmapheresis several weeks after symptom onset.
authors.affiliation: Department of Neurology, University of Muenster, Albert-Schweitzer-Strasse 33, 48129 Muenster, Germany. rogalewski@uni-muenster.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Rogalewski
authors.forename: Jörg
authors.initials: J
authors.lastname: Kraus
authors.forename: Martin
authors.initials: M
authors.lastname: Hasselblatt
authors.forename: Christoffer
authors.initials: C
authors.lastname: Kraemer
authors.forename: Wolf-Rüdiger
authors.initials: WR
authors.lastname: Schäbitz