CLINICAL REPORT NEUROLOGICAL COMPLICATIONS FOLLOWING SECONDARY VACCINATION A REPORT OF TWO CASES

NEUROLOGICAL complications following vaccination against smallpox have been recognized since 1860 when the first case was recorded by Heine. Subsequent reports of the incidence of these complications vary widely. In Greenberg and Appelbaum's series (1948) the frequency was 1:110,000, while Seeleman (1960) reported an incidence of 1:10,805 primary vaccinations in patients under 4 years of age, but in patients over 4 years of age the incidence was as high as 1:2,226. Neurological complications are more common following primary vaccination than after revaccination. In Conybeare's (1948) series of 222 cases, 110 of which were fatal, 16 cases followed revaccination, but in another 36 cases the previous vaccinial state was not known. In Miller's (1953) series of 27 cases drawn from the records of the Ministry of Pensions from 1939 to 1946, in 19 of which recovery occurred, only two cases followed revaccination, and in one of these T.A.B. inoculation had been given at the same time. The two cases which are presented here were recently seen at King's College Hospital, and are reported to draw attention to an uncommon complication o