Postvaccination acute disseminated encephalomyelitis and guillain-barré syndrome.

guillain-Barré syndrome (gBS) are monophasic inflammatory diseases of the central and peripheral nervous systems, respectively. Both adem and gBS are immune-mediated neurological complications mostly associated with recent infection or vaccination.1,2 according to the theory of molecular mimicry, microbial antigens can induce aberrant cross-reactive immune responses and putative targets are specific myelin components and/or oligodendrocytes. Subsequent neural damage occurs as a result of cellular and/or humoral inflammatory activation. neurologic complications occur mostly within a few months of immunization. postvaccination adem occurs in a minority of cases and is more frequent in children and adolescents.3 although there are no pathognomonic symptoms, a combination of multifocal neurologic disturbances and altered consciousness is the main feature of the disease. the most common form of gBS following vaccination is acute inflammatory demyelinating polyneuropathy (aidp) while acute motor axonal neuropathy (aman) occurs rarely. most case reports of adem and gBS evolving after vaccination describe patients who developed one of these complications, rather than both simultaneously. in the case presented, patient developed paraparesis and signs of encephalopathy several weeks after influenza vaccination. Based on clinical course and findings, upon exclusion of other possible causes, the patient was diagnosed with adem and pure motor axonal form of gBS presumably as a consequence of influenza vaccination. to our knowledge, this may be the first reported case of co-occurrence of adem and aman following influenza vaccination.