Recurrent 6th nerve palsy in a child following different live attenuated vaccines: case report
Recurrent 6th nerve palsy in a child following different live attenuated vaccines: case report
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DOI：
10.1186/1471-2334-12-105
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发表时间：
2012-04-30
影响因子：
3.7
通讯作者：
Buttery, Jim P.
中科院分区：
文献类型：
--
作者：
Cheng, Daryl R.;Crawford, Nigel W.;Buttery, Jim P.
背景：良性第六神经麻痹复发在儿科年龄组是罕见的，但已被描述后病毒和细菌感染。它也被暂时与免疫接种，但没有以前描述的两种不同的减毒活疫苗。病例介绍：一个12个月大的白人男孩与复发性良性第6神经麻痹麻疹，腮腺炎，风疹和水痘疫苗后，在单独的场合与完全恢复后，每次发作。没有替代的潜在病因被确定，尽管广泛的调查和review.Conclusions：大多数良性第6神经麻痹没有险恶的原因，并有良好的预后，在大多数情况下，预计恢复。确切的病理生理学是未知的，尽管包括自身免疫机制和直接病毒入侵的假设可以解释免疫相关神经麻痹背后的病理生理学。重要的是要通过全面的病史、体格检查和调查来排除其他病因。文献中关于在这种情况下重复接种活疫苗的安全性的信息有限。今后的免疫接种应逐案考虑。
Background: Recurrent benign 6th nerve palsy in the paediatric age group is uncommon, but has been described following viral and bacterial infections. It has also been temporally associated with immunization, but has not been previously described following two different live attenuated vaccines.Case presentation: A case is presented of a 12 month old Caucasian boy with recurrent benign 6th nerve palsy following measles-mumps-rubella and varicella vaccines, given on separate occasions with complete recovery following each episode. No alternate underlying etiology was identified despite extensive investigations and review.Conclusions: The majority of benign 6th nerve palsies do not have a sinister cause and have an excellent prognosis, with recovery expected in most cases. The exact pathophysiology is unknown, although hypotheses including autoimmune mechanisms and direct viral invasion could explain the pathophysiology behind immunization related nerve palsies. It is important to rule out other aetiologies with thorough history, physical examination and investigations. There is limited information in the literature regarding the safety of a repeat dose of a live vaccine in this setting. Future immunizations should be considered on a case-by-case basis.