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NMOSD triggered by yellow fever vaccination – An unusual clinical presentation with segmental painful erythema

  • Author Footnotes
    1 Both authors contributed equally.
    F. Schöberl
    Correspondence
    Correspondence to: Department of Neurology, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
    Footnotes
    1 Both authors contributed equally.
    Affiliations
    Department of Neurology, Ludwig-Maximilians-University, Munich, Germany

    German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany
    Search for articles by this author
  • Author Footnotes
    1 Both authors contributed equally.
    E. Csanadi
    Footnotes
    1 Both authors contributed equally.
    Affiliations
    Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
    Search for articles by this author
  • O. Eren
    Affiliations
    German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany
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  • M. Dieterich
    Affiliations
    Department of Neurology, Ludwig-Maximilians-University, Munich, Germany

    German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University, Munich, Germany

    SyNergy, Munich Cluster for Systems Neurology, Munich, Germany
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  • T. Kümpfel
    Affiliations
    Department of Neurology, Ludwig-Maximilians-University, Munich, Germany

    Institute of Clinical Neuroimmunology, Ludwig-Maximilians-University, Munich, Germany
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  • Author Footnotes
    1 Both authors contributed equally.
Published:November 26, 2016DOI:https://doi.org/10.1016/j.msard.2016.11.009

      Highlights

      • Unique clinical presentation with a painful erythema in neuromyelitis optica.
      • First case of neuromyelitis optica onset with an area postream syndrome triggered by a yellow fever vaccination.
      • Correlation of the area postrema syndrome and painful erythema with MRI-images.
      • Photo image of the painful erythema for illustration.

      Abstract

      Neuromyelitis Optica Spectrum Disorder (NMOSD) is an immune-mediated disease of the central nervous system with the presence of aquaporin 4-antibodies (AQP4-abs) in most cases. We describe a patient who developed NMOSD after a yellow fever vaccination. He presented to us with an unusual painful erythema Th7-9 triggered by touch in the respective skin area due to a cervical spinal cord lesion affecting the dorsolateral parts of C6/7. To our knowledge, this is the first case of NMOSD with such a clinical presentation expanding the clinical spectrum of NMOSD. It is important to be aware of that a yellow fever vaccination can trigger NMOSD.

      Keywords

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