Case Study: Acute Disseminated Encephalomyelitis (“ADEM”)
Diagnosis: Acute Disseminated Encephalomyelitis (“ADEM”)
A 67-year-old man received the influenza (“flu”) vaccination, then the PPSV23 vaccination four weeks later. Approximately five weeks after his flu vaccine and one week after PPSV23 vaccine, he began to experience impaired speech, facial droop, and difficulty standing and walking. Ultimately, he was admitted to the hospital and diagnosed with acute disseminated encephalomyelitis (“ADEM”). His ongoing symptoms included weakness, seizures, and cognitive impairment. He required long-term home health care, as well as ongoing occupational, physical and speech therapies, and continues to utilize a walker or wheelchair to ambulate.
Case Study: Autoimmune limbic encephalitis
Diagnosis: Autoimmune limbic encephalitis
An 11-year-old child received the Tdap and Menactra vaccinations. Within three days, she experienced the onset of headache and fever. Within one week of receiving her vaccinations, she experienced the onset of an ultimately intractable seizure disorder, and was diagnosed with autoimmune limbic encephalitis. She was placed in a medically induced coma, underwent a tracheostomy and was placed on a G Tube for feeding, and required inpatient care for more than seven months. The child remains cognitively impaired and requires 24-hour care. She continues to experience seizures daily.
Case Study: Guillain-Barré syndrome (GBS)
Diagnosis: Guillain-Barré syndrome (GBS)
A 55-year-old man received the Tdap and seasonal flu vaccines. Approximately two weeks after his vaccinations, he began to experience numbness and tingling in his hands and toes. Over the next several hours, numbness ascended to his feet, thighs, and arms. The petitioner was admitted the hospital for neurologic evaluation and electrodiagnostic testing. His symptoms progressed to include loss of reflexes, weakness and fatigue, and he was diagnosed with GBS. He was treated with IVIG and physical therapy. He required prescription medication for his ongoing neuropathic pain.
Case study: Guillain-Barré syndrome (GBS)
Diagnosis: Guillain-Barré syndrome (GBS)
A 64-year-old man received the seasonal flu vaccine. Approximately one week after his vaccination, he began to experience the sudden onset of numbness and tingling in his hands, arms, feet and tongue. The petitioner was admitted the emergency department for neurologic evaluation and testing. His symptoms progressed to include progressive loss of reflexes, generalized weakness and fatigue. He was diagnosed with GBS and treated with IVIG, and required extensive inpatient rehabilitation. The petitioner required ongoing treatment for management of neuropathic pain in his feet, decreased reflexes and weakness.
Case Study: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
Diagnosis: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
A 49-year-old man received a Tdap vaccine and, two weeks later, an MMR vaccine. Approximately four weeks after his first vaccine and two weeks after the second, he began to experience numbness and tingling in his fingers and toes. Over the next several weeks, numbness ascended to include his feet, thighs, back, hands and nose. The petitioner was referred to a neurologist for evaluation and electrodiagnostic testing. His symptoms progressed to include weakness and fatigue, and he was diagnosed with CIDP. He has been treated with IVIG, and is expected to receive frequent IVIG treatments for life.
Case Study: SIRVA
Diagnosis: A seasonal flu vaccine was improperly administered into the right shoulder causing rotator cuff tendinosis
A 64-year-old man received a flu shot high in his right deltoid at a local pharmacy. He immediately experienced the onset of excruciating pain with the injection. The pain persisted and limited his mobility. Two weeks after the vaccination, he presented to his primary care doctor for treatment. He was prescribed pain medicine, which did not manage his pain, and was referred to physical therapy. He consulted with an orthopedic surgeon and received a cortisone injection, which helped only for a limited time. Ultimately, petitioner had arthroscopic surgery to treat his injured shoulder approximately five months after vaccination. His post-operative treatment consisted of physical therapy and orthopedic follow-up care. However, despite surgical intervention, petitioner was left with residual pain and limited range of motion in his right shoulder.
Case Study: SIRVA
Diagnosis: Moderate to severe subacromial subdeltoid bursitis with bursal-sided tear of the infraspinatus. Impingement syndrome.
A 47-year-old female received a seasonal flu vaccine in her left deltoid, which resulted in severe left shoulder pain. She presented to urgent care the day after her vaccination due to her pain. After consultation with an orthopedic surgeon approximately six weeks post-vaccine, she received her first cortisone injection and was referred to physical therapy. The effects of the initial cortisone injection subsided after two months. MRI of the shoulder revealed moderate to severe subacromial-subdeltoid bursitis with a bursal-sided tear of the infraspinatus. A second cortisone injection was administered, but the benefits did not last. Nine months after the causal flu vaccine, petitioner underwent arthroscopic surgery of her left shoulder. Surgery followed by physical therapy led to improvement of petitioner’s pain and limited range of motion, but she continued to experience residual symptoms. Approximately one year following her initial surgery, she returned to orthopedic treatment because her residual symptoms gradually worsened. She attended additional physical therapy, underwent a second MRI revealing pathology consistent with the first MRI. A third cortisone injection was attempted, however, petitioner’s pain and limited range of motion continued. Three years removed from her causal flu vaccine, petitioner underwent a second left shoulder surgery. Post-surgical physical therapy followed.
Case Study: Transverse Myelitis (TM)
Diagnosis: Transverse Myelitis (TM)
A 40-year-old man received a seasonal flu shot. Seven weeks later, he presented to the emergency room with symptoms of urinary retention. He also experienced back pain, abdominal discomfort, and numbness and tingling in his legs and feet. He was subsequently hospitalized for one week, underwent MRIs, and was diagnosed with transverse myelitis. His treatment included a 5-day course of IVIG, physical therapy, outpatient neurology and urology follow-up care. His residual symptoms include weakness and fatigue.