title: Distal acquired demyelinating symmetric neuropathy after vaccination.
abstract: Neuropathy after vaccination is a rare event. Chronic immune-mediated polyneuropathy developing in the postvaccination period is distinctly unusual and not well described. Almost all such patients have been reported as having typical chronic inflammatory demyelinating polyneuropathy. Distal acquired demyelinating symmetric neuropathy, unlike classic chronic inflammatory demyelinating polyneuropathy, is characterized by distally predominant sensory symptoms with no or mild distal weakness. We describe the clinical, laboratory, and neurophysiological findings of 2 patients who developed distal acquired demyelinating symmetric neuropathy after vaccination. Immunomodulatory therapy led to clinical improvement in both cases. The literature is reviewed with attention to the clinical features of chronic immune-mediated neuropathies that follow vaccination.
authors.affiliation: Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
authors.forename: Karissa L
authors.initials: KL
authors.lastname: Gable
authors.forename: Zahra
authors.initials: Z
authors.lastname: Afshari
authors.forename: Robert L
authors.initials: RL
authors.lastname: Sufit
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Allen
mesh_terms: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000009:adverse effects*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007252:Influenza Vaccines / Q000009:adverse effects*; D008297:Male; D009431:Neural Conduction / Q000502:physiology; D011129:Polyradiculoneuropathy / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D016756:Immunoglobulins, Intravenous; D007252:Influenza Vaccines