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Neurologic complications of Semple-type rabies vaccine

Clinical and immunologic studies

Department of Medicine (Drs. Hemachudha, Phanuphak, Ratanavongsiri, and Siriprasomsup), Chulalongkorn University Hospital, Bangkok, Thailand; and the Department of Neurology (Drs. Hemachudha, Johnson, and Griffin), The Johns Hopkins Medical Institutions, Baltimore, MD.

We studied 61 patients with complications of Semple-type postexposure rabies immunization. Thirty-six had neurologic signs, and 25 had only fever, headache, or myalgia. Thirty-two patients had CNS complications, and 4 had an acute peripheral neuropathy. Disease was acute and monophasic in 33, but 3 patients had progressive disease, including 1 patient with a relapsing-remitting course. No clinical features, including CSF content of myelin basic protein, were prognostic indicators. In three of six patients with encephalomyelitis, lymphocytes showed a proliferative response to myelin.

Address correspondence and reprint requests to Dr. Hemachudha, Department of Neurology, Meyer 6-181, The Johns Hopkins Medical Institutions. Baltimore, MD 21205.

Supported in part by a grant from Chulalongkorn University, a Fogarty Fellowship to Dr. Hemachudha, and a grant from the National Multiple Sclerosis Society.

Received May 12, 1986. Accepted for publication in final form July 11, 1986.

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