日本脳炎ワクチン接種後の神経症状
1971 年 83 巻 1-2supplement 号 p. 25-31
詳細
1971 年 83 巻 1-2supplement 号 p. 25-31
There are 23 case reports on neurological complications accompanying Japanese B encephalitis vaccination for the 5-year period from 1966 to 1970. Clinical features of these symptoms were analyzed and they were roughly classified into 5 groups, though their neurological symptoms proved to be variable. Namely, 1) meningoencephalitic type, 2) demyelinating type, 3) paroxysmal disorder type, 4) polyneuritic type and 5) others.
Group I (meningoencephalitic type) includes 3 cases of 5, 8 and 44 years old. One of them had the onset of neurological symptoms 63 days after the vaccination, and was diagnosed as Japanese B encephalitis by immunological test. The remaining two cases developed symptoms within 4 days after vaccination, and their principal symptoms were headache, vomiting, stiffness of the neck, involuntary movement, drowsiness and pleocytosis in C. S. F.. Their prognosis proves to be fair.
Group II (demyelinating type) includes 3 cases of 7, 24 and 44 years old, and they had developed the disease 3 to 9 days after vaccination. Their main symptoms were cranial nerve palsy, optic atrophy, spastic paraplegia, cerebellar ataxia, and their prognosis is poor.
Group III (paroxysmal disorder type) is consisted of 4 cases of age ranging 6 to 23 years old. Two of them had episodes of epileptic seizure prior to the vaccination. They had attack within a few hours to 6 days after vaccination, and their principal symptom was epileptic seizure of grand mal type.
Group IV (polyneuritic type) includes 6 cases of the age ranging 3 years to 60 years old, and they had the onset of disease within several hours to 17 days after the vaccination. Two cases of the six had Guillain-Barré syndrome as their main symptom, and the others cranial nerve palsy. Their prognosis proves to be fair.
Group V (others) includes 7 cases of which 4 had cerebral vascular attack after the vaccination.
A discussion was made on the pathophysiological mechanism of these neurological symptoms on the basis of characteristics of clinical features, the age of onset and the latent period.
