Age: 14.0
Sex: F
Vaccine: HPV4, HPV4, HPV4
Symptoms: No reaction on previous exposure to drug, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain normal, Pain, Paralysis
Clinical narrative: Third in series  Lot #0653x  Manufacturer Merck  Did not have any unusual reactions after first two  My otherwise healthy, active, athletic 14-year-old daughter has experienced serious neurological symptoms 15 days after her 3rd HPV shot.  She was transported by EMS to Hospital after she experienced sudden onset paralysis that began at her feet and rapidly spread to just below her shoulders within 24 hours.  You could not touch her anywhere below her chest, as even the slightest touch was excruciatingly painful.   Her chest felt as though she had a tight band around it. It was difficult for her to talk, and it became difficult for her to keep them open.   Jolts of pain would surge up her spinal cord into her head.  Her torso muscles front and back swelled.  For three days she could not lift or reposition any part of her body beneath her chest. She lost all reflexes in her legs.  On day four, she began to move again  very slowly, very deliberately, with assistance.  She was released on day 5, with a [[name]], anti-inflammatory and anti-depressant medication.  It took a total of 10 days and extensive Physical Therapy for her to be able to walk "normal" again.  She has seen Neurologists, Neurosurgeons, Pediatricians, Rheumotologists, Internal Specialists, Pediatricians, Physical Therapists, Psychologists, and Social Workers.  They have run MRI's, CT's, Ultrasounds, and x-rays.  She has had two lumbar punctures (they missed the first time), blood tests, and urine tests.  The medical professionals have ruled out Guillain [[name]]e, Epstein [[name]], Acute [[name]] Nile, Lyme disease, encephalitis, meningitis, muscular dystrophy, multiple sclerosis, and bacterial infection but do not have the slightest idea what is going on!  The only abnormal findings include: MRI showed arachnoid cyst with accentrical deviation from T2 to T10, but no impingement or damage noted to spinal cord.  This MRI was repeated in October, and has shown no change in size, and shows no compression.  The Neurosurgeons felt that the cyst was most likely present from birth- and more importantly could not be what was causing her sudden onset of symptoms.  [[name]] Nile was detected in blood, but apparently from exposure along time ago (was not high enough levels to be acute).  Low blood sugar on one test (had not eaten).  A Psychologist is treating her in the event that her symptoms are psychosomatic.  She has experienced at least 6 repeat episodes, the first few lasted 1-2 days in duration but the last two have lasted for several [[name]].  Last 2 required ER visit and hospitalization (3 days in local hospital, 3 days in hospital). Every episode begins with [[name]] surges of pain in her spine, followed by the swelling of the ab muscle just under her left rib cage, and the one just alongside her sternum (each episode this one gets bigger), and the muscles next to her spine as well as those on her lower back.  Ultimately these muscle spasms impact the signal that tells her legs to walk.  At times during each episode she is very shaky, and often her eyes twitch.  Her primary symptoms these days are extreme muscle tightness in her torso area, pain and abnormal gait (periodically).  She has missed 3 [[name]] of school in the last 4 [[name]].  She often uses a wheel chair because walking gets to be too slow and too painful. She is currently taking Gabapentin (300 MG 3x per day) for the nerve pain, skelaxin 800MG to relax muscles, 800 mg of motrin every 8 hours and prilosec.  Her medical history   Normal pregnancy and vaginal delivery;  Birth weight 6lbs 12 oz Born with "club foot" (Positional, not genetic); Surgeries Achilles tendon thinned 3 months, bones in shin rotated and reattached at age 5 (allergic reaction to anesthetic  Fentynl at time); Tendon transfer 2 years ago.    Allergies:  Fentynl (anesthesia); sulfa, Ceclor (hives in all three cases), Nickel (in jewelry or clothing), Codeine (Drop in BP), demmoral (stomach upset),   She was actively involved in softball and volleyball, and weightlifting and was in excellent physical shape prior to [[name]] 23, 2009.  She has not shown any signs of depression or mental stress prior to these episodes.  Normal Highschool life.  Very social, A-B student.  Not overinvolved.  Always completes homework during study hall.  Activities 3 nights a week for maybe an hour ½ after school, but nothing taxing.