Small fiber neuropathy following vaccination for rabies, varicella or Lyme disease

Nizar Souayah*, Senda Ajroud-Driss, Howard W. Sander, Thomas H. Brannagan, Arthur P. Hays, Russell L. Chin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)7322-7325
Number of pages4
Issue number52
StatePublished - Dec 9 2009


  • Lyme vaccination
  • Neuropathy
  • Rabies Vaccination
  • Small fibers
  • Vaccination

ASJC Scopus subject areas

  • General Veterinary
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Molecular Medicine
  • General Immunology and Microbiology


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