Article Options  • Full text  • PDF  • Send to a Friend  • Readers Reply    •Submit a reply  • Related articles in this issue  • Similar articles in this journal  Literature Track  • Add to File Drawer  • Download to Citation Manager  • PubMed citation  • Articles in PubMed by    •Miravalle A    •Roos KL  • Contact me when this article is cited  Topic Collections  • Immunization  • Review  • Encephalitis  • Drug Therapy  • Adverse Effects  • Public Health  • Collection E-mail Alerts

Encephalitis Complicating Smallpox Vaccination

Augusto Miravalle, MD; Karen L. Roos, MD
 

Arch Neurol. 2003;60:925-928.

A smallpox vaccination program has been initiated. The vaccine is a live virus that was used in the last century. Postvaccinal encephalitis is a complication of this vaccine. The clinical presentation, course, neuroimaging findings, and spinal fluid abnormalities are similar to a disorder that physicians are familiar with, acute disseminated encephalomyelitis. This complication can be prevented with the administration of antivaccinia gamma globulin at the time of vaccination. Antivaccinia gamma globulin is not efficacious once this complication occurs. Intravenous methylprednisolone is the recommended therapy, although intravenous immunoglobulin and plasmapheresis should be investigated in the treatment of postvaccinal encephalitis.
From the Department of Neurology, Indiana University School of Medicine, and Indiana University Hospital, Indianapolis.

RELATED ARTICLES IN ARCHIVES OF NEUROLOGY

This Month in Archives of Neurology
Arch Neurol. 2003;60:922.