title: Longitudinally extensive transverse myelitis following vaccination with nasal attenuated novel influenza A(H1N1) vaccine.
abstract: BACKGROUND
  Transverse myelitis has been reported in association with vaccination, including influenza vaccination.
  
  
  OBJECTIVE
  To describe a case of longitudinally extensive transverse myelitis associated with vaccination with a nasal attenuated novel influenza A(H1N1) vaccine.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Sanford University of South Dakota Hospital. Patient A 27-year-old woman with longitudinally extensive transverse myelitis.
  
  
  RESULTS
  Four days following novel influenza A(H1N1) vaccination, the patient developed longitudinally extensive transverse myelitis. Extensive diagnostic evaluation effectively ruled out causes other than vaccination-associated transverse myelitis. Following treatment with corticosteroids and plasmapheresis, the patient made a significant recovery.
  
  
  CONCLUSIONS
  Transverse myelitis may be associated with vaccination against novel influenza A(H1N1). Additionally, we believe this to be the first report of longitudinally extensive transverse myelitis associated with any vaccine.
authors.affiliation: Center for Family Medicine, 1115 E 20th St, Sioux Falls, SD 57105, USA.
authors.forename: Wafa
authors.initials: W
authors.lastname: Akkad
authors.forename: Bassel
authors.initials: B
authors.lastname: Salem
authors.forename: Jerome W
authors.initials: JW
authors.lastname: Freeman
authors.forename: Mark K
authors.initials: MK
authors.lastname: Huntington
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000009:adverse effects*; D007251:Influenza, Human / Q000517:prevention & control; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D009188:Myelitis, Transverse / Q000209:etiology* / Q000276:immunology / Q000473:pathology
chemical_list: D007252:Influenza Vaccines