Age: 1.4
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Deafness, Hypoacusis, Speech disorder
Clinical narrative: Information has been received from a nurse practitioner concerning a 17 month old female who on 06/08/98 was vaccinated with MMRII. On 08/06/98, the patient began to lose her hearing. **Follow-up report on 9/26/02: In follow-up, the MD reported that the PT's mother would "scream at her at times" and nothing happened. The PT was talking more in the first yr. of life, which seemed to decrease during each ear infection episode. There was no family history of hearing loss, but this was only known on the father's side in that the PT's mother was adopted. The mother's pregnancy, labor, and perinatal period were unremarkable, and the PT had no history of any head trauma. In Oct. 98, the PT underwent tympanograms, which were noted to be "almost flat". The MD felt the PT might be a candidate for myringotomy, and consulted an ear, nose, and throat (ENT) specialist for evaluation. On 12/11/98, the PT was seen by an ENT, who documented the following: "Physical examination revealed a retracted ear drum on the right, and the left drum was mobile. The rest of the head and neck exam was unremarkable and tonsils were 2+ in size". "Tympanograms revealed a normal curve on the left and a Type C negative pressure curve on the right. Impression: Eustachian tube dysfunction, rule out congenital deafness". The PT was diagnosed w/sensory neural hearing loss, moderate to severe, bilaterally symmetric, "cause undetermined", and hearing aids were recommended. On 2/3/99, the PT was evaluated by speech pathology, w/the following documentation noted: "At present" the PT "demonstrates a severe communication deficit 2ndary to moderate to severe hearing impairment. Total language score on the Preschool Language Scale-3 was obtained at 66 which converted to a Percentile of 1 and an age-equivalent of 1 yr 2 mts (chronological age: 2-0). This total score falls 2 standard deviations below the mean. Speech therapy is necessary for this child in order to develop a functional communication system by which wants, needs and ideas may be expressed". On 6/9/99, the MD reported that the PT was seen in his office and the PT was very active, bright, alert, and verbalizing. The PT's submaxillary glands were normal. On physical examination the postauricular areas and external auditory canals were normal. The tympanic membranes computed axial tomography (CAT scan) for cochleovestibular abnormality, which revealed the following: "vestibules were slightly enlarged bilaterally, but structurally the semicircular canals and cochleas appear otherwise normal". On 6/23/99, the MD reported that the PT's review of systems was unchanged and that the PT was being followed by speech and hearing therapy on a weekly basis, w/the use of hearing aid amplification.** The patient was diagnosed with sensory neural hearing loss, and as of 07/01/02, it was reported that the patient had lost 80% of her hearing. It was reported that the patient sought unspecified medical attention. Upon internal review, it has been determined that the patient's sensory neural hearing loss to be an other important medical event (OMIC). The reporter felt that the PT's sensory neural hearing loss was a serious event which resulted in a persistent or significant disability that required medical treatment. Additional information is not expected.