Gait disturbance

INFLUENZA (FLUZONE) Side Effects Report # 336830
INFLUENZA (FLUZONE) side effect was reported on 01/08/2009. Female patient, 68.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: areflexia, asthenia, asthenia, c-reactive protein normal, fatigue"Patient experienced acute leg weakness progressing to include arm weakness and overall body weakness within a two-week period. Saw family physician on 12/8/08. Extensive lab testing was completed with normal results. Had follow-up visit with family physician who then referred patient to neurologist. Diagnosed by neurologist on 1/5/09 with Guillain-Barre. Patient still experiencing weakness and fatigue. 1/23/2009 MR received from Neurologist for DOS 1/5/2009 with DX: Acute Demyelinating Immune Polyneuropathy (Guillain-Barre syndrome). Appears to be a mild case already improving. Possibly r/t Flu shot although not certain. Pt presented for eval of weakness which developed in mid November 2008. Pt's legs felt rubbery and gait was abnormal. No muscle pain or sensory loss. Remained stable x 1 month, now improving x 2 weeks. More easily fatigued. PE (+) for slight waddling type gait, decreased strength (3/5) of the interossei upper and 4/5 lower extremities, absent tendon reflexes. No tx since pt was improving w/o tx.". None."Allergies: codeine, Medical conditions: hypertension, hypercholesterolemia. PMH: Allergy to codeine. HTN, Depression, Hyperlipidemia""Monoscreen: negative, CRP & thyroid screen: within normal limits." . During the same period patient was treated with "Lisinopril/HCTZ 10/12.5 mg, Zetia 10 mg (discontinued 12/8), Amitriptyline 75 mg, Fioricet (prn only), Darvocet N-100 (prn only)". Patient recovered.


INFLUENZA (FLUZONE) Side Effects Report # 338066
INFLUENZA (FLUZONE) side effect was reported on 10/29/2008. Male patient, 29.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: gait disturbance, joint swelling, , , "Client woke up following morning with right ankle swollen so much he could hardly walk. Used heat, TYLENOL, MOTRIN with relief. No recent injury to ankle. States he does not have money to be seen by MD- vaccine required by employees.". NoneNoneNone . During the same period patient was treated with "PDD, Sanofi Pasteur, C2908AA, ID, LMF, 0". Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 339281
INFLUENZA (FLUZONE) side effect was reported on 02/09/2009. Female patient, 62.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: antinuclear antibody increased, areflexia, asthenia, back pain, blood product transfusion"12/3/08 pt started with "strangled cough" and body aches. 12/12/2008 Had severe vomiting and diarrhea- extremely weak and barely could walk-no stool cultures done. pt prescribed anti-nausea and anti-diarrheal med.12/17/2008 Pt achy, tired, and cough returned. 12/21-12/22/2008 Couldn't walk up steps describes legs feeling like jelly. 12/23/08 extreme pain in back and all extremities, but pain only at night. 12/24/2008 Burning electrical pain continued but only at pm. 12/26/08 pt to emergency room-no reflexes present in lower extremities. admitted to ICU. seen by neurologist and diagnosed with Guillian Barre Syndrome. Pt had lumbar puncture, MRI, nerve conduction tests. Given IVIG for total of 5 days. 2/6/09 Pt still has residual weakness and compacted feeling in hands. 2/11/09 Received hospital medical records of 12/26-12/31/2009. FINAL DX: Guillain Barre syndrome; cervical spinal stenosis Records reveal patient had stomach flu approx 2 wks prior to admit w/N/V/D that resolved after 3 days. Developed weakness/numbness of limbs, difficulty walking, & pain in her back x 3 days prior to admit. Neuro consult done. Areflexia & loss of sensation of legs. LP done. Tx w/IVIG x 5 day w/improvement. D/C to home w/outpatient PT. 2/16/09 Received CSF results.". none"hypertension, and hypothyroidism, chronic back pain s/p mva PMH:panic attack""rpr=non-reative,lyme disease=negative, CSf studies as well as serum protein electrophoresis unremarlable other than CSF protein of 77 and WBC of 1. CSF cytology was unremarkable. MRI of head showed mild chronic ischemic micoangiopathy and p" . During the same period patient was treated with "Synthroid QD, Diovan QD". Patient was hospitalized Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 339882
INFLUENZA (FLUZONE) side effect was reported . Male patient, child 12.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: areflexia, arthralgia, asthenia, axonal neuropathy, blood immunoglobulin a decreased"Received Flu and MENACTRA 10/31/07. By Thanksgiving he had foot droop of left foot. Seen by primary in Feb. '08 for ankle pain. Referred to Orthopedist and Neurologist. He has subsequently developed foot drop in right and is being treated for an acquired neuropathy. 3/3/09 MR received for DOS 7/21-24/2008 with D/C DX: Inflammatory Neuropathy as well as multiple out pt visits and diagnostic studies. Pt initially presented in 11/2007 with a L foot drop and inability to move his toes resulting in a limping gait. Genetic testing done and negative for CMT. EMG/NCS c/w axonal neuropathy, repeat with chronic inflammatory neuropathy. Developed R foot drop in 5/2008. PE 6/1/08 (+) for decreased strength on plantar/dorsiflexion bilaterally and difficulty with gait and stance. DTRs absent in lower extremities. Admitted for IVIG 7/21/08. Devloped some H/A with tx. D/C for outpt f/u on prednisone. Later with DX: CIDP. Wearing ankle/foot braces to assist with ambulation. Muscle wasting noted 10/6/08 and hand tremor 12/24/08. Some improvement in strength noted. 8/25/09 CDC's CISA staff has confirmed VAERS 339882 as CIDP.". NoneNone. PMH: mild cold sxEMG/NCV: Possible CIDP; Spinal Fluid increased at 58. Labs and Diagnostics: EMG/NCS abnormal. MRI brain and spine WNL. CSF protein 58. CSF cx (-). Serum IgA (L) at 58. DEXA (+) for osteoporosis and osteopenia. . Patient was hospitalized Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 340100
INFLUENZA (FLUZONE) side effect was reported on 02/14/2009. Male patient, child 1.9 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: ataxia, balance disorder, cerebellar ataxia, clumsiness, encephalitis"Ataxic gait on 12/3/08, Flu vaccine 11/17. 3/19/09 MR received from PCP which include neuro consults. Pt seen 11/17/08 for URI sx. Flu vax given. TC from parent 12/5/08 reporting child's balance is off, falling alot x 4 days. No other sx. Seen 12/6/08. PE (+) for clumsy gait, otherwise WNL. To observe. Assessment: Clumsiness. Seen in neuro consult 12/9 and 12/12/08. PE (+) for wide-based ataxic gait and increased muscle tone in extremities. DX: Likely post-infectious cerebellitis. ? oposclonus-myoclonus ataxia syndrome. Improving by 12/30/08 but some intermittent hand tremulousness noted by parent. Final dx: cerebellar ataxia.". URIs/p NEC; 25 week premie. PMH: 25 wk premie."Labs and Diagnostics: Brain MRI (+) for ventriculomegaly and prior grade II hemorrhage, repeat (-) for brainstem or cerebellar abnormality. Urine VMA and HVA WNL" . Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 340712
INFLUENZA (FLUZONE) side effect was reported on 02/24/2009. Male patient, child 4.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: gait disturbance, injection site erythema, injection site swelling, , Within 30 minutes patient experienced moderate swelling and mild erythema of left thigh extending to superior portion of knee joint. The joint was not involved. No warmth noted. From of knee and hip. Reflexes and motor strength were normal and limping was observed. Treated with Motrin and Benadryl as needed.. Swallowed foreign body in alimentary tractReactive Airway Disease . During the same period patient was treated with "Pulmicort, Albuterol, Tylenol". Patient recovered.


INFLUENZA (FLUZONE) Side Effects Report # 340800
INFLUENZA (FLUZONE) side effect was reported on 02/26/2009. Male patient, 16.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: areflexia, blood product transfusion, csf culture negative, csf glucose normal, csf protein increased"Vaccine administered on 1/14/2009 and developed neurologic symptoms on or about 1/23/2009. He was subsequently diagnosed with Guillian Barre. He was treated with IVIG and did remarkably well. He is almost back to baseline but not quite. In PT. 4/10/09 Received hospital medical records for 1/27-2/5/2009. FINAL DX: Guillain Barre syndrome Records reveal patient experienced progressive difficulty walking, dysesthesias, paresthesias, loss or reflexes x 2-4 days. Admitted ICU. Tx w/IVIG x 5 days. Gradually improved but reflexes remained absent at transfer to inpatient rehab facility.". nonePenicillin allergic"LABS: MRI spine WNL. CSF: RBC 2, WBC 5, protein 77(H), glucose 69, c/s neg." . During the same period patient was treated with none. Patient was hospitalized Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 341889
INFLUENZA (FLUZONE) side effect was reported on 03/01/2009. Male patient, child 5.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: abdominal discomfort, abdominal distension, arthralgia, blood pressure decreased, c-reactive protein normal"By 11/28 evening upper left arm was red, swollen, itchy. Following day, more swelling, hot to touch, very itchy. 4 a.m. 12/14, severe swelling in knees, wrists, entire left arm huge and hot, hives over whole body, fever, itchy pain. ER, vomiting, dropping blood pressure, swelling and rash whole body. Dx serum sickness. Symptoms lasted 3-4 weeks. 2 days in hospital. Wheezing, swollen lips, trouble walking. A lot of joint pain. 3/20/09 Received PCP medical records of 12/3/08-3/2/2009. FINAL DX: serum sickness, amoxicillin vs vaccines Records reveal patient w/persistent cough & postnasal drip x 3-4 wks when seen 12/3 w/poor sleep secondary to cough. Initially had URI w/croup, phlegm now dx w/sinusitis & tx w/oral antibiotics. Exam on 12/12 was well child, had been seen in OT but stopped some time prior, being watched for social lag. RTC 12/16 s/p hospital admit visit for swelling of lips, knees & wrists. Tx w/nebs & antihistamines. Now had tongue tickling, sleepiness, urticarial rash all over, left arm very swollen, purplish, hot, swollen joints. Followup w/allergist. Allergy consult 1/9/09. FINAL DX: serum sickness like reaction likely penicillin allergy Suggested patient have FluMist in future. Continued to have wheezing & tx w/nebs. Abdominal distension/discomfort was likely due to constipation. Had trace proteinuria in hospital & UA repeated but not included. Was to return in 2 wks. 4/10/09 Received hospital medical records of 12/14-12/15/2008. FINAL DX: serum sickness Records reveal patient experineced pruritic erythematous maculopapular lesions and red swollen left arm, bilateral knee pain w/swelling x 2 days. Tx w/antihistamines, NSAIDs & nebs. Had orthostatic hypotension w/dizziness & nausea/vomiting in ER & tx w/IVF w/improvement. D/C to home w/PCP f/u. Clinic visit 12/29/2008 s/p hospitalization. FINAL DX: serum sickness like reaction, suspect amoxicillin reaction Doing well w/rare use of NSAID for joint pain, daily zyrtec & intermittent albuterol for coughing. Meds were". "Cough (lingering) ("sinusitis")""none PMH: recent sinusitis & on amoxicillin at admit. Hives, viral illness, bronchitis, OM, nosebleeds. Family hx: eczema, hypothyroidism, GERD, IBS.""Serum Sickness LABS:WBC 15.85(H), lymphs 22.0(L), neutros 72.4(H). ESR 5(N), CRP<0.5(N). Complement C3(N), C4 15.4(L). UA w/trace ketones/protein." . During the same period patient was treated with "amoxicillin, Day 10". Patient was hospitalized Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 342868
INFLUENZA (FLUZONE) side effect was reported on 03/28/2009. Male patient, child 4.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: arthralgia, full blood count normal, gait disturbance, haemoglobin normal, injection site pain"Received Flu vaccine on 3/12/09. Had R leg pain starting on 3/18 and fever on 3/17. Seen in the office on 3/19 and noted to be walking slowly on toes, mainly wanting to be carried every where. On exam he had pain in hip with internal and external rotation, but no tenderness. CBC and ESR normal. I suspect he has transient synovitis. I called home today - a couple days after I saw him he was fine to 2 days. since that time he has intermittently c/o hip pain. Never as severe as on 3/19.". noneAsthma"see above - ESR 7, WBC 7.0 with 2 Bands, 36 SEGS and 43 lymph and 14 MONO. Hgb 12.9" . During the same period patient was treated with pulmicort and or albuterol. Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 348294
INFLUENZA (FLUZONE) side effect was reported on 05/26/2009. Male patient, 57.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: back pain, blood alkaline phosphatase, blood calcium decreased, blood creatinine increased, blood glucose increased"Numbness in face, body, hands, feet BELL's Palsy in face. Losing ability to walk. Low blood pressure readings. Kidney (not normal readings). MRI's (5-6). Spinal tap. Plasma phoresis (5). Surgery to insert shunt. 6/22/09 Hospital records DC summary received DOS 12/29/08 to 01/11/09. Assessment: Guillain-Barre versus CIDP Patient presents with unsteady gait and lower back pain. Facial weakness and numbness of all extremities. Sensation impaired for pain and proprioception. Plasmapherisis performed. ICD-9 Codes: 781.2 Abnormality of Gait, 357.0 Ac Infect Polyneuritis, 357.81 Chr Inflam Polyneuritis, 458.29 Iatrogenic Hypotension, 276.51 Dehydration, 401.9 Hypertension, 720.0 Ankylosing Spondylitis, 721.0 Cervical Spondylosis.". No"ankylosing spondylitis; neuropathy; hypertension. 6/22/09 Hospital records DC summary received DOS 12/29/08 to 01/11/09. Had cold within the past week. Obesity, herniated disc, neuropathy secondary to unknown causes. Hypertension."Urine samples; Surgery to insert shunt; MRI's; Spinal tap; Plasma Phoresis; blood-work. 6/22/09 Hospital records DC summary received DOS 12/29/08 to 01/11/09. LABS and DIAGNOSTICS: No EMG or Nerve Conduction Studies. MRI Thoracic Spine . During the same period patient was treated with see other side. Patient was hospitalized Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 348342
INFLUENZA (FLUZONE) side effect was reported on 06/02/2009. Female patient, child 2.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: amino acid level abnormal, ataxia, back pain, balance disorder, chest x-ray normal"Progressing ataxia with onset approximately 11/08. Severe gross motor and fine motor impairment noted. 6/15/09 Received PCP medical records for 11/19/07-04/2009. FINAL DX: ataxia, hypertonia, tremors Records reveal when patient seen 11/19 experienced progressive walking abnormality, falls, irritability, balance difficulty, leg pain, weight loss, shaking, confusion, rhinorrhea, speech regression x 3 wks. Parent reported symptoms had been present prior to flu vaccine. Developed fatigue, back pain, excessive sleeping, otitis media w/effusion. Neuro -ophtho consult done 12/07 dx w/seizure disorder; normal optic nerves & retina; normal hyperopis. RTC 10/08 w/cough, decreased appetite, nasal congestion/drainage, fever, chills, shaking, falls, unsteady gait. Dx w/viral URI, gait disturbance. Referred to Neuro & Ophtho. Dx w/nystagmus thought to be neurological rather than optho in origin. Referred to genetics & eval of 4/09 revealed amino acid deficiencies.". none"none PMH: anemia. Family hx: early death secondary to amebiasis, childhood leukemia, DM, asthma.""Currently undergoing numerous neurological testing: CT scan, MRI, MRS, muscle testing. LABS: MRI brain, EKG, CXR, EMG WNL." . Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 349822
INFLUENZA (FLUZONE) side effect was reported on 06/02/2009. Male patient, 63.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: anaemia, areflexia, asthenia, axonal neuropathy, bedridden"112408 - Pt c/o pain in feet; 112508 pain cont, now can't pick up objects with hands; 112608 requires assist to walk into ER; 112708 is now bedbound. Test, plasmapheresis - anemia - RBC given - rehab 7/7/09 MR received for DOS 12/20/2008-01/08/2009 with D/C DX: Guillain_Barre Syndrome, axonal type. HTN. DM. Mild tachycardia. Pt presented with progressive weakness in LEs, then hands. PE (+) for decreased strength and sensation. Absent reflexes. Pt c/o severe pain and muscle spasm of lower extremities, 1-2+ LE edema. DVTs noted in LEs tx with anticoagulants. Plasmapheresis with little improvement. One dose of IVIG with some improvement. Transferred for rehab on 1/8/09. ICD9: V5783. 3570. 4019. /". None"NIDDM; HTN PMH: HTN. DM. Tachycardia.Sinus surgery. appy. Herniated disc w/ surgery. Nausea, diarrhea and vomiting 11/2008.""Dx: Guillain-Barre Synd; Electromyography; CXR, MRI Spine; Lumbar puncture Labs and diagnostics: LP traumatic but WNL. MRI sppine (+) for degenerative changes and stenosis. EMG/NCS abnormal. BS 67-175. PT 20.1-29.1. Venous dopplers (+)" . During the same period patient was treated with None. Patient was hospitalized Patient recovered.

INFLUENZA (FLUZONE) Side Effects Report # 352739
INFLUENZA (FLUZONE) side effect was reported on 07/19/2009. Male patient, 67.0 years of age, was vaccinated with INFLUENZA (FLUZONE). After vaccination, patient experienced the following side effects: aphasia, csf glucose increased, csf protein increased, chest x-ray abnormal, computerised tomogram normal"May 26, 2007 couldn't walk right - took him to ER they admitted him to hospital at that time. his condition kept getting worse - May 28, 07 he went Code Blue - twice - had ventilator put in and on oxygen - totally paralyzed from that time on. Approx 1 1/2-2 wks later had a spinal tap, found he had GUILLAIN BARRE Syndrome. He couldn't move talk nothing. 8/5/09 MR received for DOS 5/26-6/13/07 with D/C DX: Guillaine Barre Syndrome. Pt presented with arm and leg numbness/weakness. PE (+) for facial droop, dysarthria, sensation loss, upper and lower extremity weakness and difficulty with ambulation. Progressed to full respiratory arrest and pt intubated and later trached. PEG tube placed. Still very weak and unable to lift arms/legs. Transferred for intensive rehab.". high BP"Blind in left eye; loss of hearing left ear; High BP. PMH: COPD, high cholesterol. HTN. back surgery."Labs and Diagnostics: Head CT (-). EEG abnormal. EMG c/w post-infectious neuropathy/GBS. CSF glucose 120. CSF protein 64. CSF cx (-). Sputum (+) for staph aureus. MRI brain (-). CXR (+) infiltrates. . Patient was hospitalized Patient recovered.