- Letter to the Editor
- Open Access
Partial third nerve palsy after Measles Mumps Rubella vaccination
© Manzotti et al; licensee BioMed Central Ltd. 2010
- Received: 27 July 2010
- Accepted: 10 September 2010
- Published: 10 September 2010
Measles Mumps Rubella (MMR) vaccination is known to cause some serious adverse events, such as fever, rash, gland inflammation and neurologic disorders. These include third and sixth cranial nerve palsies.
The case reported describes a partial recurrent oculomotor palsy associated with systemic symptoms following MMR vaccination in a healthy young child. The oculomotor palsy did not recover completely during the follow-up.
Most of the times, measles, mumps and rubella cause mild illness and discomfort; but can also have serious or fatal sequelae. MMR vaccination has been proved to be safe and to reduce significantly the number of reported infections due to these viruses. However, significant adverse events can occur and paediatricians and public health operators should be aware of this aspect.
- Nerve Palsy
- Aseptic Meningitis
- Autistic Disorder
- Cranial Nerve Palsy
- Rubella Virus
Measles Mumps Rubella (MMR) vaccination is known to cause some serious adverse events. These can include fever, rash, gland inflammation and neurologic disorders like epilepsy, encephalitis, aseptic meningitis and autistic disorders [1, 2].
The case reported below describes a partial recurrent oculomotor palsy following MMR vaccination in a healthy young child.
MMR viruses are neurotropic. Therefore, although the vaccine is obtained by live attenuated viruses, vaccination may produce neurological disorders. Only a few cases of benign, recurrent cranial nerve palsies, secondary to immunization, have been described. Patients with complete palsy of the third  or sixth [4–7] cranial nerve have been reported. In our case, the oculomotor nerve palsy is incomplete i.e. only the inferior oblique muscle is involved in one eye. The previously reported cases resolved spontaneously and completely within several months. In our case, however, a mild deficit of the muscle has persisted several years following vaccination and may be considered permanent.
In conclusion, public confidence in immunization must be maintained because safety and efficacy of MMR vaccination is clearly demonstrated; however potential adverse events must be strictly and carefully monitored.
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