title: Post Tick-Borne Encephalitis Virus Vaccination Narcolepsy with Cataplexy.
abstract: Narcolepsy with cataplexy (NC) is a chronic neurological disorder thought to result from an altered immune response based on a genetic predisposition coupled with environmental factors. Pandemrix vaccination has been reported to increase the risk of narcolepsy. We aimed at identifying other vaccines associated with the onset of narcolepsy.
  
  
  
  Case series and retrospective database study.
  
  
  
  We identified four cases of NC following a tick-borne encephalitis (TBE) vaccination with FSME Immun. Additional four cases could be detected in the database of the Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines in Germany.
  
  
  
  Our findings implicate TBE vaccination as a potential additional environmental factor for the development of NC and add additional evidence for an immunological mechanism in the pathogenesis of the disease.
authors.affiliation: Neurocenter Rhine-Lahn, Clinic Katzenelnbogen, Katzenelnbogen, Germany.
authors.forename: Hildegard
authors.initials: H
authors.lastname: Hidalgo
authors.affiliation: Neurocenter Rhine-Lahn, Clinic Katzenelnbogen, Katzenelnbogen, Germany.|Department of Neurology, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Ulf
authors.initials: U
authors.lastname: Kallweit
authors.affiliation: Department of Neurology, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Mathis
authors.affiliation: Department of Neurology, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Claudio L
authors.initials: CL
authors.lastname: Bassetti
mesh_terms: D000293:Adolescent; D000328:Adult; D002385:Cataplexy / Q000175:diagnosis* / Q000209:etiology* / Q000235:genetics; D002648:Child; D016208:Databases, Factual; D004669:Encephalitis Viruses, Tick-Borne / Q000235:genetics; D004675:Encephalitis, Tick-Borne / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005858:Germany; D006801:Humans; D007252:Influenza Vaccines / Q000009:adverse effects; D008297:Male; D009290:Narcolepsy / Q000175:diagnosis / Q000209:etiology / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D014611:Vaccination / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; C556153:pandemrix
keywords: cataplexy; dendritic cells; granzyme; hypocretin; narcolepsy; tick-borne encephalitis virus vaccination