Transverse myelitis with Brown-Sèquard syndrome after H1N1 immunization

Mielite transversa manifesta por síndrome de Brown-Sèquard após vacinação contra H1N1

IMAGES IN NEUROLOGY

Transverse myelitis with Brown-Sèquard syndrome after H1N1 immunization

Mielite transversa manifesta por síndrome de Brown-Sèquard após vacinação contra H1N1

Marcelo Adriano da Cunha e Silva Vieira^I; Carlos Henrique N. Costa^II; Chrystiany Plácido de B. Vieira^II; Maria do Amparo S. Cavalcanti^II; Sebastião P. Ferreira-Filho^III

^INeurologist of Nathan Portella Tropical Diseases Institute, Federal University of Piauí, Teresina PI, Brazil

^IINathan Portella Tropical Diseases Institute, Federal University of Piauí, Teresina PI, Brazil

^IIIFaculdade NOVAFAPI, Teresina PI, Brazil

^{Correspondence}

A 52-year-old female had acute urinary hesitancy, constipation, crural spastic asymmetric paraparesis and sensory level at T6 (hypopalesthesia left and thermo-algesic hypoesthesia on the right mainly on sacral dermatomes) one week after H1N1-trivalent immunization.

Magnetic resonance imaging showed thoracic intramedullary lesion (Figure) and absence of brain findings. Cerebrospinal fluid was normal including electrophoresis, viral polymerase chain reactions and cultures. HIV-serology, VDRL, and anti-nuclear antibodies were nonreactive.

Brown-Sèquard syndrome commonly results from traumatic or tumor injury and is rarely found in other etiologies^1,2. Myelitis constitute possible adverse event temporally related to immunization and his notification contribute to post-marketing studies on the safety of immunobiological extensively used in population³.

Received 10 January 2012

Received in final form 09 March 2012

Accepted 16 March 2012.

Conflict of interest: There is no conflict of interest to declare.

• 1. Durrant DH, True JM. Spinal cord syndromes and guide to neurological levels. In: Durrant DH, True JM (Eds). Myelopathy, radiculopathy and peripheral entrapment syndromes. Washington, DC: CRC Press, 2002:139-157.
• 2. Sheerin F, Collison K, Quaghebeur G. Magnetic resonance imaging of acute intramedullary myelopathy: radiological differential diagnosis for the on-call radiologist. Clin Radiol 2009;64:84-94.
• ³
  Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Agência Nacional de Vigilância Sanitária. Protocolo de vigilância epidemiológica de eventos Adversos pós-vacinação: estratégia de vacinação contra o vírus Influenza pandêmico (H1N1). Brasília: Ministério da Saúde, 2010.

Publication Dates

• Publication in this collection
  23 July 2012
• Date of issue
  July 2012