Gait disturbance

INFLUENZA (FLUMIST) Side Effects Report # 337347
INFLUENZA (FLUMIST) side effect was reported on 01/14/2009. Female patient, child 6.0 years of age, was vaccinated with INFLUENZA (FLUMIST). After vaccination, patient experienced the following side effects: aphonia, asthenia, asthenia, barium swallow, blood albumin normal"SHE RECEIVED THE FLU SHOT IN MID-OCTOBER AND DISPLAYED A FEVER DURING VETERAN'S DAY WEEKEND WITH NO OTHER SYMPTOMS. SHE FELL OFF THE MONKEY BARS AT SCHOOL ON NOV 13 AND STARTED TO COMPLAIN OF TINGLING AND LOSS OF 'CONTROL' OF LIMBS ON RIGHT SIDE ON NOV 14. SHE STARTED LOSING HER VOICE NOV 30. SHE COMPLAINED OF HER HEAD TINGLING ON DEC 9 AND SUBSEQUENTLY WENT TO DOCTOR ON DEC 10 AND HAS HAD MRI'S, NERVE CONDUCTION TESTS, ETC AND WAS FINALLY DIAGNOSED WITH GBS ON/ABOUT DEC 12. 1/16/09-records received for DOS 12/10-12/13/08-DC DX: Guillain-Barre syndrome. Presented with C/O tingling all four extremities for about 4 weeks, back pain and leg pain. Day prior to hospitalization fell from monkey bar approximately 6 feet high. Subsequently C/O tingling in all 4 extremities. Seen by chiropractor. Few days later lost voice, whispery and hypophonic. DX: sciatica and recommended bedrest for 1 month. PE: reflexes absent ankle and knee jerk bilaerally.12/29/08-follow-up visit with neurology, after 12/25/08 developed left facial palsy and at time of visit nearly resolved. Voice remains with whisper and occasionally chokes on liquids. Jerky gait. Mild weaknesses throughout. 1/9/09-admitted with multiple cranial nerve palsy. Began IVIG. Discharged 1/13/09.". NONENONE"NERVE CONDUCTION, MRI, BARIUM SWALLOW TEST, 1/16/09-records received-CSF: protein 77, glucose 52.NCV abnormal, F-wave. MRI normal. Nerve conduction studies and electromyelography:general acquired sensorimotor polyneuropathy, mixed. CBC, BM" . Patient was hospitalized Patient recovered.


INFLUENZA (FLUMIST) Side Effects Report # 337473
INFLUENZA (FLUMIST) side effect was reported on 01/15/2009. Male patient, child 6.0 years of age, was vaccinated with INFLUENZA (FLUMIST). After vaccination, patient experienced the following side effects: abnormal behaviour, activities of daily living impaired, affect lability, angiogram, arteriovenous malformation"Acute icshemic stroke (basilar artery thrombus). Underwent mechanical thrombectomy 11/25/08. 2/2/09 Received ER medical records of 11/19/2008. FINAL DX: acute non-specific HA Records reveal patient experienced worsening HA x 5 days w/cloudy vision left eye, fatigue, irritability & nausea. Had been seen by PCP 2 days prior & dx w/left otitis media. Tx w/oral antibiotics. Exam in ER was WNL & tx w/IVF & IV meds. Improved & d/c to home. 2/3/09 Received PCP office records of 11/17/08-1/18/2009. FINAL DX: left OM w/viral URI Records reveal patient experienced left eye vision deficit, decreased hearing left ear, left side headache, decreased appetite & energy. Tx w/oral antibiotics & would refer to Ophtho if s/s persisted. RTC 11/21 s/p ER visit w/URI & OM resolving. RTC 11/22 w/persistent but intermittent HA & had missed school. OM had resolved but tx w/oral antibiotics. Referred for MRI. RTC 1/12/09 s/p recent hospitalization for acute ischemic stroke with basilar artery thrombus occlusion s/p mechanical thrombectomy on 11/25/08 & having vomiting. Sent for urgent MRI. RTC 1/15/09 for conference. 2/09/09 Received hospital medical records of 11/24-12/3/2008. FINAL DX: acute ischemic stroke, basilar artery thrombus occlusion w/resultant bilateral posterior circulation strokes; s/p mechanical thrombectomy 11/25/08. D/C Summary mixed in with records which reveal patient had been transferred to PICU from outlying ER. Patient experienced retroorbital eye pain & HA x 10 days prior to admit. One week prior to admit had trouble catching ball from left side. Five days prior to admit had severe HA behind left eye. One day prior to admit had dizziness, vomiting, peripheral vision loss but no pain. On day of admit, had generalized pain, abnormal behavior, talking nonsense, incomplete sentences. Deficits at d/c included: right arm dysmetria w/minimal weakness, LLE dysmetria, quandrantanopia, dysarthria & left side sensory deficit, required assist to walk due to incoordination. D/C to inpatient re". PMH: URI s/s x 1 mo. Recurrent OM & ear tube insertion."LABS: WBC 20.9, ANC 17.8(H), lymphs 10.3%(l). Creatinine 0.3(L), ALK 150(L), AST 58(H). CT brain abnormal. Protein C 0.72(L), protein S antigen, free 54(L). CT angiogram abnormal & c/w acute left PCA distribution ischemic infarct. Echoc" . Patient was hospitalized Patient recovered.

INFLUENZA (FLUMIST) Side Effects Report # 338640
INFLUENZA (FLUMIST) side effect was reported on 01/28/2009. Female patient, child 8.0 years of age, was vaccinated with INFLUENZA (FLUMIST). After vaccination, patient experienced the following side effects: abasia, acute disseminated encephalomyelitis, anion gap increased, antibody test negative, aphasia"Pt has received FLUMIST in previous years. Received FLUMIST 1/15/09. Seen in ER 1/17/09 for presumed viral illness. Admitted to PICU 1/19/09 with encephalomyelitis. 3/25/09 Received hospital medical records of 1/19-2/9/2009. FINAL DX: viral meningeal encephalitis Records reveal patient experienced pharyngitis before Christmas, tx w/oral antibiotics, improved then relapsed & tx w/second round of oral antibiotics. Improved & given flu shot. Developed sore throat, cough, fever, runny nose& URI s/s again. Seen in ER 1/17 & dx w/viral syndrome. D/C to home then developed dizziness, falls, HA, emesis, eye deviation to right, sudden onset of inability to walk or talk. Episodes of unresponsiveness thought to be seizures. Neuro & ID consults done. Admitted PICU. Tx w/IV antibiotics, antivirals, steroids, antiseizure meds w/limited improvement. Feeding tube inserted. Labs & clinical status improved slowly but remained nonverbal w/very limited movement & unable to walk unassisted w/unsteady gait. Transferred to rehab.". None PMH: hypocalcemia resolved; fever requiring hospitalization; developmental delays & in special ed class. Had received flu shot prior years w/o reaction. Family hx: congenital heart defect."Bact'l cultures (-). Viral panel (-). DFA (-). MRI c/w acute disseminated encephalomyelitis LABS:WBC 7.9(N), lymphs 27.7(L). Creatinine 0.42(L), anion gap 17(H). CSF: RBC 130(H), WBC 520(H), lymphs 92(H), monos 5(L), glucose 51(N) & pr" . Patient was hospitalized Patient recovered.