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October 1978

Possible Interactions Between Rabies Vaccination and a Progressive Degenerative CNS Disease

Author Affiliations

Bldg 10, Rm 4N-248 National Institutes of Health Bethesda, Md 20014

Arch Neurol. 1978;35(10):693. doi:10.1001/archneur.1978.00500340069015

To the Editor.—  The similarities between postvaccinal encephalomyelitis and the progressive form of multiple sclerosis have been described.1-3 The following case illustrates the difficulties in separating these entities on clinical and laboratory grounds. A history of rabies vaccination four years prior to the onset of neurologic symptoms provides the interest for this letter.

Report ofa Case.—  A 24-year-old man had been bitten by a rabid cat at age 10 years and received 14 intra-abdominal injections of Semple vaccine, starting two days after the bite. No reactions to the vaccine were noted. It is not known whether the patient received equine serum immune globulin. Four years later, symptoms of a slowly progressive CNS disease developed, characterized initially by visual disturbances and dementia, followed by ataxia, abnormal involuntary movements, and a profound short-term memory loss after 19 years of age.

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