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Improvement of advanced postvaccinal demyelinating encephalitis due to plasmapheresis

Authors :
Andreas Rogalewski
Jörg Kraus
Martin Hasselblatt
Christoffer Kraemer
Wolf-Rüdiger Schäbitz
Source :
Neuropsychiatric Disease and Treatment, Vol 2007, Iss Issue 6, Pp 987-991 (2007)
Publication Year :
2007
Publisher :
Dove Medical Press, 2007.

Abstract

Andreas Rogalewski1, Jörg Kraus3, Martin Hasselblatt2, Christoffer Kraemer1, Wolf-Rüdiger Schäbitz11Department of Neurology; 2Institute of Neuropathology, University of Muenster, Germany, 3Paracelsus Private Medical University and Salzburger Landesklinken, Christian-Doppler-Klinik, Department of Neurology, Salzburg, AustriaAbstract: 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.Keywords: ADEM, vaccination, encephalitis, plasmapheresis, demyelination, plasma exchange

Details

Language :
English
ISSN :
11766328 and 11782021
Volume :
2007
Issue :
Issue 6
Database :
Directory of Open Access Journals
Journal :
Neuropsychiatric Disease and Treatment
Publication Type :
Academic Journal
Accession number :
edsdoj.49e8d0aa11d34f7eb0e8c8ad12e74d86
Document Type :
article