Gait disturbance

INFLUENZA (FLUVIRIN) Side Effects Report # 342851
INFLUENZA (FLUVIRIN) side effect was reported on 03/27/2009. Male patient, 64.0 years of age, was vaccinated with INFLUENZA (FLUVIRIN). After vaccination, patient experienced the following side effects: asthenia, balance disorder, blood culture negative, blood product transfusion, blood sodium decreased"64HM h/o DM, HTN, HLD, BPH p/w weakness that started yesterday midmorning. He first felt weak during work, when he noticed that he could not keep a good grip on his handtools; he had trouble squeezing the trigger on the nailgun and using his screwdriver. The weakness was equal on both sides. Morning of admission, the patient was feeling even more weak, and he fell once in his house because of weakness in his legs, R>L. He has had a lot of problems walking and keeping his balance. There have been no changes to his medication regimen. He has not had any previous episodes of this type of weakness. He says the weakness is equal on both sides. He has not had any blurry vision or double vision. Denies slurred speech, drooping or drooling out of one side of his face, problems swallowing/choking, or confusion/disorientation. He recently got his flu shot 10/16 (about one month prior to presentation). He also had a stomach infection last weekend (seven days prior to presentation) where he had a lot of liquid diarrhea, especially on the day of onset of that illness. He also had nausea and vomiting that weekend, and was unable to keep any food down until Monday. Since Monday, there was complete resolution of his symptoms. He did not try any new foods; he did not eat any old/expired canned foods; no one around him is sick. No recent travels outside the Metroplex. Patiet was felt to have an acute inflammatory demyelinating polyneuropathy (Guillain Barre Syndrome) and was treated with IVIG. Patient is currently in a skilled nursing unit, has a motorized wheelchair. 4/8/09 Received hospital medical records of 11/13-12/1/2008. FINAL DX: Guillian Barre syndrome; SIADH resolved; hypotension resolved. Records reveal patient experienced nausea/vomiting/diarrhea following flu shot & developed progressive distal to proximal weakness. LP done & found to have high protein. Admitted to ICU. Tx w/IVIG x 5 days. Improved slowly & transferred to SNF for inpatient rehab. 4/21/09 Rec". none"diabetes, hypertension, hyperlipidemia, degenerative joint disease PMH: BPH.""LABS: CBC WNL. Sodium 127(L). CSF: protein 130 (H), glucose 78(H), WBC 33(H), lymphs 26%, neutros 73%, RBC 2380(H). EMG/NCS abnormal. Blood, CSF, urine c/s neg, although tx for presumed UTI." . During the same period patient was treated with "rosuvastatin, cyclobenzaprine, naproxen, doxazosin, finasteride". Patient was hospitalized Patient recovered.


INFLUENZA (FLUVIRIN) Side Effects Report # 344947
INFLUENZA (FLUVIRIN) side effect was reported on 04/20/2009. Male patient, 57.0 years of age, was vaccinated with INFLUENZA (FLUVIRIN). After vaccination, patient experienced the following side effects: back pain, blood product transfusion, csf cell count normal, cryptococcus antigen, diabetes mellitus"Flu like symptoms for two to three weeks. Numbness in feet - leg cramps - back pain in spinal area - problem walking (paralysis). Hospitalization - tests and treatment for Guillain-Barre (GBS) and acute rehabilitation - 30 day hospitalization.4/29/09-records received-for DOS 1/20-2/3/09-DC DX: Ascending motor sensory weakness secondary to Guillain-Barre Syndrome following recent viral respiratory tract illness 2-3 weeks prior to admission. Status post IVIG. Uncontrolled diabetes mellitus secondary to noncompliance with diet and medication. Hypertensive emergency improved. Ambulatory dysfunction secondary to gait instability. Hyponatremia. Hypokalemia. Presented with increasing gait instability and lower extremity paresthesia. Increased thirst, increased urination and fatigue. Numbness progressed to upper extremities, right facial weakness, difficulty swallowing and some dyspnea". None 4/29/09-records received-recent viral respiratory tract illness 2-3 weeks prior to admission.None 4/29/09-records received- PMH:testicular cancer. Chronic alcohol use.Hospitalization and Tests 1-21-09 4/29/09-records received-UA glucose 1000 and more than 80 ketones and 100mg/dl protein. Hemoglobin A1c 10.9. MRI brain mild atrophy. MRI thoracic spine unremarkable. MRI lumbar spine disk bulging. CSF cryp . Patient was hospitalized Patient recovered.

INFLUENZA (FLUVIRIN) Side Effects Report # 345173
INFLUENZA (FLUVIRIN) side effect was reported on 04/29/2009. Male patient, 34.0 years of age, was vaccinated with INFLUENZA (FLUVIRIN). After vaccination, patient experienced the following side effects: areflexia, areflexia, balance disorder, blood calcium increased, blood creatine phosphokinase increased"The first signs begin with a pain in my right arm three-four days after my vaccine. I was not able to raise it above my head. The pain moved to my shoulder and across to my other arm. I went to an ER a week after my vaccine and they did blood and a mono test but all came back normal and prescribed ibuprofen. Within the next week I began having difficulty walking and going up stairs. I notice pins and needs along with numbness in my toes. I went to another ER exactly a week following the first visit. They did additional blood test (CBC) and it came back normal. My blood pressure was high when I came in but it went back down to normal. They recommended a brain MRI to rule out MS. However, they stated it would have to be done by my PCP. I went the following week to my primary care physician and he wanted to do additional blood work prior to a brain MRI. He noticed I did not have any reflexes. He did tests for lupus, Lyme disease, metal, HIV. After a week waiting, all tests came back negative. At this point numbness, weakness and pins and negatives moved to my fingers and my legs. I went to a third ER a week after the PCP visit. They did some additional tests and were led to believe it was Guillain Barre. They admitted me that night. They following day I had a Brain MRI, Spinal tap and EMG. The Brain MRI came back negative. The Spinal tap showed high protein but ruled out meningitis. The EMG showed a decrease in the number of motor units. I was diagnosed with GBS. They began treating me with IV/IG over the course of 5 days. Physical and Occupational therapy began and I have been doing that ever since. I still have pain and swelling in feet. Have abnormal gait along with balance issues and struggle climbing stairs. I am taking Gabapentin and Hydrocodone for the pain and neuropathy. Records received - 05/04/2009, hosp admission 11/24/2008 to 11/30/2008. Patient previously seen and discharged by two other ED's. Admitted for evaluation of progressive weakness and paresthesias post influenza vaccinat". None"Asthma from 5-13 years of age. Allergic to penicillin, solumendrol and decadron.""Mono Test negative; Completed all blood tests, Lyme Disease Negative; Heavy Metal Negative, HIV Negative, Brain MRI was normal; Spinal Tap showed high count of protein >100. EMG showed a decrease in the number of motor units. Labs: He" . During the same period patient was treated with None. Patient was hospitalized Patient recovered.

INFLUENZA (FLUVIRIN) Side Effects Report # 347265
INFLUENZA (FLUVIRIN) side effect was reported on 05/26/2009. Male patient, 14.0 years of age, was vaccinated with INFLUENZA (FLUVIRIN). After vaccination, patient experienced the following side effects: agitation, alanine aminotransferase increased, areflexia, aspartate aminotransferase increased, bacterial culture positive"Several weeks (end of November) after getting flu vaccine, client began experiencing weakness in legs with numbness in feet and toes. He began walking with a cane and 2 days later he was in a wheelchair. Family took client to the ER when he couldn't swallow. Admitted to hospital on December 3rd, 2007, and diagnosed with Guillian-Barre Syndrome. He was on life support X 17 days and in ICU X 1 month. Transferred to rehab center. 5/27/09-records submitted with report-Presented on 12/2/08 with 10 day history of increasing weakness and numbness of feet which made an ascending pattern up entire body. 4 days prior began with feelings of breathlessness and day before presenting to ED C/O trouble with swallowing and muffled speech. Elevated BP on admission 148/99 and subsequent transient increase in BP. Treated with IVIG. Mechanical ventilation required with intubation and subsequent extubation. NG feedings. DX: Guillain-Barre syndrome. One month hospitalization. Office visit follow up 1/23/09 residual weakness on both sides of face, CN VII focally affected R>L. 6/26/09 Hospital records and DC summary recieved. DOS 12/02/07 to 01/04/08. Assessment: Ascending paralysis, probable Guillain-Barre. Patient presented with ascending numbness and weakness. Nausea and vomitjng. Numbness in feet. Difficulty swallowing liquids. Unable to walk or sit up on his own. DTR's absent. Stregnth diminished upper and lower extremities. Fever, headache. Sedation/Analgesia dependence. Agitation with respiratory distress. Hypertension. IVIG administered. Transferred to rehabilitation facility. ICD-9 Codes: 357.0, 518.81, V46.11, 707.03, 292.0, 304.01, 112.0, 401.9, 075, 726.87, 041.5, 564.00, 110.5". NONENONEMedical records from Hospital included (will be faxed to VAERS) 5/27/09-records received- WBC 12.5. Positive mono spot. Positive EVB titers. Respiratory culture positive for haemophilus influenza and streptococcus pneumonia.LFTs elevated w . During the same period patient was treated with NONE. Patient was hospitalized Patient recovered.

INFLUENZA (FLUVIRIN) Side Effects Report # 350464
INFLUENZA (FLUVIRIN) side effect was reported on 06/24/2009. Male patient, 33.0 years of age, was vaccinated with INFLUENZA (FLUVIRIN). After vaccination, patient experienced the following side effects: alanine aminotransferase increased, arthralgia, aspartate aminotransferase increased, asthenia, blood albumin normal"Pt. developed onset of paresthesias (tingling) in B/L hands, neck stiffness, occas. hand numbness, hip pain, & feeling flushed on eve of 11/17/08. Flu shot given 11/4/08. NV on 11/18/08 -> referred to PCP. Eval. at ER 11/28/08 -> D/C with script for anxiolytic. Increasing ext pain -> ER 11/29/08 -> inpt. x8 days for daily plasmaphoresis. 7/1/09 Hospital records received DOS 11/30/09 to 12/07/08. Assessment: Guillain-Barre syndrome. Patient presented with tingling of hands and fingers, followed by flu-like symptoms with myalgias and arthralgias in several muscles and joints. Could barely ambulate and unable to work. Decreased muscle strength upper and lower extremities. Gait is wide-based, slow, and unsteady. Daily plasmaphoresis.". None known"None known or specified . PMH: back pain, right tibia / fibula fracture requiring ORIF.""LABS and DIAGNOSTICS: NCS - abnormal. Total CPK is 91. Alkaline Phosphatase is 97, SGOT 128, SGPT 301, Total Bilirubin is 0.4, albumin 4, globulin 3.8, BUN 16, creatinine 0.8. Hematocrit is 45, WBC 10400, platelet count 316000. CSF glucose" . During the same period patient was treated with None at time of vaccination -> currently on METOPROLOL.. Patient was hospitalized Patient recovered.