Neuromyelitis optica associated with yellow fever vaccination

Excerpt

A 26-year old male patient presented with complain of paresthesia in the lower limbs, asthenia, headache, stiff neck and temperature = 37.8 ºC. He has been receiving a yellow fever vaccination two weeks before on neurological examination, and the patient had bilateral tactile hypoesthesia with a sensitive level in T4. Motor function was normal and deep tendon reflexes present. Lhermitte’s phenomenon present. During hospitalization, there was spontaneous resolution of the sensitive level. Analysis of cerebrospinal fluid (CSF) revealed leukocytes of 48 cells/ml (70% mononucleated), and elevated total protein (87 mg/dL). Magnetic resonance imaging (MRI) of the spine sagittal T2-weighted images showed high intensity signal from the C5 spinal cord to the medullary cone, which may correspond to demyelinating disease (Fig. 1).

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