Atypical Optic Neuritis After Inactivated Influenza Vaccination

Abstract

The existence of vaccine-associated optic neuritis is essentially based on the temporal relationship between the administration of a vaccine and the development of optic neuritis in patients with no other known aetiologies for infectious or non-infectious inflammation that could account for the optic neuritis. Influenza vaccine (inactivated or live attenuated) is considered to be one of vaccines that could be related to optic neuritis. The authors describe a rare case of bilateral asymmetric optic neuritis with leptomeningeal enhancement on magnetic resonance imaging (MRI) in a previously healthy young woman who received inactivated influenza vaccination 2 weeks before the onset of symptoms.

Keywords: Influenza vaccination; MRI; leptomeningealenhancement; optic neuritis.

Figure 1.

Magnetic resonance imaging (MRI) of the brain with and without gadolinium. (A) T1 axial with contrast showed enhancement of the right optic nerve (arrow). (B) T1 axial with contrast showed enhancement of the leptomeninges on the right frontoparietal lobes. (C) FLAIR axial showed increased intensity of the leptomeninges on the right frontoparietal lobes.