Small fiber neuropathy following vaccination for rabies, varicella or Lyme disease.
Vaccine. 2009 Dec 9;27(52):7322-5. Epub 2009 Oct 4. PMID: 19808027
Department of Neurology, New Jersey Medical School, 90 Bergen Street, DOC 8100, Newark, NJ 07103, United States. firstname.lastname@example.org
Neuropathy following vaccination has been reported; however, biopsy-confirmed small fiber neuropathy has not been described. We report five patients who developed paresthesias within one day to two months following vaccination for rabies, varicella zoster, or Lyme disease. On examination, there was mild sensory loss in distal extremities, preserved strength, normal or minimally abnormal electrodiagnostic findings, and decreased epidermal nerve fiber densities per skin biopsy. Empiric immunomodulatory therapy was tried in two patients and was ineffective. All patients' symptoms have improved, but persist. We conclude that an acute or subacute, post-vaccination small fiber neuropathy may occur and follow a chronic course.