{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:42:09Z","timestamp":1760146929404,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NeuroSci"],"abstract":"<jats:p>Background: Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated inflammatory disorder of the central nervous system (CNS), typically characterized by the acute onset of multifocal demyelination. The pathogenesis of ADEM remains unclear, but it is believed to be triggered by an autoimmune response, often following viral infections or vaccinations. Case report: This case report describes a 3-year-old child who developed ADEM after receiving two concurrent influenza vaccines: one for seasonal influenza and one for the 2009 H1N1 pandemic. The patient presented with motor regression, mild pleocytosis in cerebrospinal fluid (CSF), and typical MRI findings of ADEM. Steroid pulse therapy resulted in rapid improvement, and the patient recovered fully without sequelae. Results: Although the influenza vaccine has been linked to ADEM in some studies, it remains uncertain whether the simultaneous administration of both vaccines contributed to the onset of ADEM. While influenza vaccines are considered safe and effective by health organizations such as the CDC, data suggest that the incidence of ADEM and other neurological complications is significantly higher after natural influenza infections compared to vaccination. This highlights the importance of vaccination in preventing severe outcomes. Conclusions: This case underscores the importance of monitoring and reporting adverse events following vaccination to refine our understanding of rare complications like ADEM. While simultaneous vaccine administration warrants further research, the benefits of vaccination in preventing severe complications from natural infections far outweigh the risks. Continued vigilance and improved surveillance systems are essential for maintaining public confidence in vaccination programs.<\/jats:p>","DOI":"10.3390\/neurosci6010001","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T04:10:23Z","timestamp":1735618223000},"page":"1","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and Review"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7691-0460","authenticated-orcid":false,"given":"George","family":"Imataka","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University, Tochigi 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideaki","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University, Tochigi 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigemi","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University, Tochigi 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Massa, S., Fracchiolla, A., Neglia, C., Argentiero, A., and Esposito, S. (2021). Update on Acute Disseminated Encephalomyelitis in Children and Adolescents. Children, 8.","DOI":"10.3390\/children8040280"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"F1","DOI":"10.1016\/j.vaccine.2015.10.080","article-title":"The Safety of Influenza Vaccines in Children: An Institute for Vaccine Safety White Paper","volume":"33","author":"Neal","year":"2015","journal-title":"Vaccine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.smrv.2017.06.006","article-title":"Incidence of Narcolepsy After H1N1 Influenza and Vaccinations: Systematic Review and Meta-Analysis","volume":"38","author":"Sarkanen","year":"2018","journal-title":"Sleep Med. Rev."},{"key":"ref_4","first-page":"288","article-title":"Guillain-Barr\u00e9 Syndrome and Influenza Vaccines: Current Evidence","volume":"32","year":"2019","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1590\/S0004-282X2012000700018","article-title":"Transverse Myelitis with Brown-S\u00e8quard Syndrome After H1N1 Immunization","volume":"70","author":"Vieira","year":"2012","journal-title":"Arq. Neuropsiquiatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1017\/cjn.2016.291","article-title":"Pandemic H1N1 Vaccination and Incidence of Acute Disseminated Encephalomyelitis in Manitoba","volume":"43","author":"Jackson","year":"2016","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1111\/ene.13537","article-title":"Antibody Response to Seasonal Influenza Vaccination in Patients with Multiple Sclerosis Receiving Immunomodulatory Therapy","volume":"25","author":"Olberg","year":"2018","journal-title":"Eur. J. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Al-Quliti, K., Qureshi, A., Quadri, M., Abdulhameed, B., Alanazi, A., and Alhujeily, R. (2022). Acute Demyelinating Encephalomyelitis Post-COVID-19 Vaccination: A Case Report and Literature Review. Diseases, 10.","DOI":"10.3390\/diseases10010013"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100439","DOI":"10.1016\/j.bbih.2022.100439","article-title":"Acute Disseminated Encephalomyelitis Following Vaccination Against SARS-CoV-2: A Case Report","volume":"20","author":"Lazaro","year":"2022","journal-title":"Brain Behav. Immun. Health"},{"key":"ref_10","first-page":"1166","article-title":"Acute Disseminated Encephalomyelitis following Seasonal Influenza Vaccination in an Elderly Patient","volume":"20","author":"Nishikawa","year":"2013","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Pellegrino, P., Carnovale, C., Perrone, V., Salvati, D., Gentili, M., Radice, S., and Clementi, E. (2013). Acute Disseminated Encephalomyelitis Onset: Evaluation Based on Vaccine Adverse Event Reporting Systems. PLoS ONE, 8.","DOI":"10.1371\/annotation\/1d544202-04f5-4848-83f1-696c2de4221e"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1038\/cmi.2017.151","article-title":"Vaccine-induced autoimmunity: The role of molecular mimicry and immune crossreaction","volume":"15","author":"Segal","year":"2018","journal-title":"Cell. Mol. Immunol."},{"key":"ref_13","first-page":"238","article-title":"Acute disseminated encephalomyelitis","volume":"50","author":"Murthy","year":"2002","journal-title":"Neurol. India"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1093\/cid\/ciu005","article-title":"Guillain-Barr\u00e9 Syndrome, Influenza, and Influenza Vaccination: The Epidemiologic Evidence","volume":"58","author":"Vellozzi","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1177\/0961203309345730","article-title":"Transverse myelitis and vaccines: A multi-analysis","volume":"18","author":"Kivity","year":"2009","journal-title":"Lupus"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1016\/j.jocn.2008.05.002","article-title":"Post-vaccination encephalomyelitis: Literature review and illustrative case","volume":"15","author":"Huynh","year":"2008","journal-title":"J. Clin. Neurosci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1093\/cid\/cit222","article-title":"Lack of association of Guillain-Barr\u00e9 syndrome with vaccinations","volume":"57","author":"Baxter","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"309","DOI":"10.2165\/00002018-200932040-00005","article-title":"Vaccines and Guillain-Barr\u00e9 syndrome","volume":"32","author":"Haber","year":"2009","journal-title":"Drug Saf."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1006\/jaut.1999.0346","article-title":"Vaccination and autoimmunity\u2014\u2018vaccinosis\u2019: A dangerous liaison?","volume":"14","author":"Shoenfeld","year":"2000","journal-title":"J. Autoimmun."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2523","DOI":"10.1056\/NEJMoa055414","article-title":"Effectiveness of school-based influenza vaccination","volume":"355","author":"King","year":"2006","journal-title":"N. Eng. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1542\/peds.2004-2373","article-title":"A comparison of 2 influenza vaccine schedules in 6- to 23-month-old children","volume":"115","author":"Englund","year":"2005","journal-title":"Pediatrics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1093\/cid\/ciy1003","article-title":"Immunogenicity and viral shedding of Russian-backbone, seasonal, trivalent, live, attenuated influenza vaccine in a phase II, randomized, placebo-controlled trial among preschool-aged children in urban Bangladesh","volume":"69","author":"Lewis","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"6424","DOI":"10.1016\/j.vaccine.2018.08.032","article-title":"Immunogenicity and safety of MF59-adjuvanted and full-dose unadjuvanted trivalent inactivated influenza vaccines among vaccine-na\u00efve children in a randomized clinical trial in rural Senegal","volume":"36","author":"Diallo","year":"2018","journal-title":"Vaccine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e946","DOI":"10.1016\/S2214-109X(16)30200-5","article-title":"Efficacy of a Russian-backbone live attenuated influenza vaccine among young children in Bangladesh: A randomized, double-blind, placebo-controlled trial","volume":"4","author":"Brooks","year":"2016","journal-title":"Lancet Glob. Health"},{"key":"ref_25","first-page":"318","article-title":"Acute disseminated encephalomyelitis following influenza vaccination","volume":"29","author":"Shoamanesh","year":"2010","journal-title":"Vaccine"}],"container-title":["NeuroSci"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-4087\/6\/1\/1\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:56:32Z","timestamp":1760115392000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-4087\/6\/1\/1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,30]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["neurosci6010001"],"URL":"https:\/\/doi.org\/10.3390\/neurosci6010001","relation":{},"ISSN":["2673-4087"],"issn-type":[{"type":"electronic","value":"2673-4087"}],"subject":[],"published":{"date-parts":[[2024,12,30]]}}}