chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, VARCEL
Symptoms: Erythema, Oedema peripheral
Clinical narrative: Swelling of Lt arm 2/3/11 swelling decreased 2/4/11 o/e 2 cm x 2 cm erythematous & swelling.
Age: 64.0
Sex: M
Vaccine: FLU3
Symptoms: Injection site pain, X-ray
Clinical narrative: left shoulder pain
Age: 49.0
Sex: F
Vaccine: TD
Symptoms: Back pain, Injection site pain, Pain
Clinical narrative: SHARP SHOOTING PAINS IN MY LEFT SHOULDER/BACK AREA, TRIED MASSAGING AREA, GOT WORSE THROUGHOUT THE NIGHT AND FROM THEN ON.
Age: 18.0
Sex: F
Vaccine: HPV4
Symptoms: Vision blurred
Clinical narrative: Pt called 2/7/11 to state she has had blurred vision in (R) eye since shot administered on 12/16/10. Advised today to see optometrist for vision check.
Age: 19.0
Sex: F
Vaccine: HEPAB
Symptoms: Pruritus, Rash macular
Clinical narrative: FLAT MACULAR DISCOID LESIONS OVER TRUNK, UPPER EXTREMETIES AND NECK; PRURITIC, NO FEVER, NO ERYTHEMA, SIZES RANGE FROM 3mm TO 10mm IN SIZE
Age: 25.0
Sex: M
Vaccine: RAB
Symptoms: Agitation, Computerised tomogram, Computerised tomogram head, Confusional state, Eating disorder
Clinical narrative: After 2nd dose of vaccination, patient noted gradual onset of headache, neck stiffness, nausea, vomiting, myalgias, and difficulty eating.  After the 3rd dose of the vaccination he had increasing symptoms and was sent from work to the ED for confusion and agitation.
Age: 25.0
Sex: M
Vaccine: RAB
Symptoms: Headache, Lumbar puncture, Meningitis, Musculoskeletal stiffness, Myalgia
Clinical narrative: After 2nd dose of vaccination, patient noted gradual onset of headache, neck stiffness, nausea, vomiting, myalgias, and difficulty eating.  After the 3rd dose of the vaccination he had increasing symptoms and was sent from work to the ED for confusion and agitation.
Age: 25.0
Sex: M
Vaccine: RAB
Symptoms: Nausea, Vomiting
Clinical narrative: After 2nd dose of vaccination, patient noted gradual onset of headache, neck stiffness, nausea, vomiting, myalgias, and difficulty eating.  After the 3rd dose of the vaccination he had increasing symptoms and was sent from work to the ED for confusion and agitation.
Age: 20.0
Sex: F
Vaccine: VARCEL
Symptoms: Erythema, Feeling hot, Flushing, Pruritus, Swelling face
Clinical narrative: Patient return to clinic with symptoms of flush and warm feeling on face, some swelling. No reaction on other part of body only face. Pt developed itching and facial erythema.
Age: 67.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Abasia, Contusion, Fungal infection, Joint swelling, Nodule
Clinical narrative: swollen black and blue ankles, black and blue hips, rash from hips to knees, bruises with nodules in the center, sharp constant pain in feet, cannot walk because of pain...60mg prednisone, tylenol w/ codeine as needed, mouth wash for yeast infection, amoxicillin was stopped.
Age: 67.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Pain in extremity, Platelet count decreased, Rash, Red blood cell count decreased, Red blood cell sedimentation rate
Clinical narrative: swollen black and blue ankles, black and blue hips, rash from hips to knees, bruises with nodules in the center, sharp constant pain in feet, cannot walk because of pain...60mg prednisone, tylenol w/ codeine as needed, mouth wash for yeast infection, amoxicillin was stopped.
Age: 67.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Skin discolouration, White blood cell count decreased
Clinical narrative: swollen black and blue ankles, black and blue hips, rash from hips to knees, bruises with nodules in the center, sharp constant pain in feet, cannot walk because of pain...60mg prednisone, tylenol w/ codeine as needed, mouth wash for yeast infection, amoxicillin was stopped.
Age: 67.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Candidiasis, Contusion, Dysphagia, Erythema, Full blood count
Clinical narrative: swollen black and blue ankles, black and blue hips, rash from hips to knees, bruises with nodules in the center, sharp constant pain in feet, cannot walk because of pain...60mg prednisone, tylenol w/ codeine as needed, mouth wash for yeast infection, amoxicillin was stopped.
Age: 67.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Intensive care, Laboratory test, Nodule, Patient isolation, Protein total
Clinical narrative: swollen black and blue ankles, black and blue hips, rash from hips to knees, bruises with nodules in the center, sharp constant pain in feet, cannot walk because of pain...60mg prednisone, tylenol w/ codeine as needed, mouth wash for yeast infection, amoxicillin was stopped.
Age: 67.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Rash macular, Swelling face, White blood cell count decreased
Clinical narrative: swollen black and blue ankles, black and blue hips, rash from hips to knees, bruises with nodules in the center, sharp constant pain in feet, cannot walk because of pain...60mg prednisone, tylenol w/ codeine as needed, mouth wash for yeast infection, amoxicillin was stopped.
Age: 0.5
Sex: F
Vaccine: DTAPIPVHIB, HIBV, PNC13
Symptoms: Rash
Clinical narrative: Mom noticed "tiny bumps" on back-"small rash".
Age: 34.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site swelling, Pain, Pain in extremity, Pruritus
Clinical narrative: 0700 when I awoke there was a swollen & raised red bump ~ 3.5" in length on back of arm @ injection site.  Immense pain upon flexion of arm, and a dull pain at rest. Began itching about 1400.   By 1900 the site had reduced to ~ 2" in diameter. 1700 on 7-Feb-2011 the size of irritation is about 1" in diameter, still red and swollen and itching like crazy.
Age: 33.0
Sex: F
Vaccine: FLU3
Symptoms: Blood test normal, Chest discomfort, Cough, Dyspnoea, Headache
Clinical narrative: 6PM COUGH BEGAN. VERY DEEP COUGH. COUGHING EVENTUALLY BECAME UNCONTROLLABLE BY 8PM, TROUBLE BREATHING, CHEST TIGHTNESS, AND WHEEZING AT THAT HOUR. WENT TO EMERGENCY ROOM AND WAS ADMINISTERED ALBUTEROL (INHALED). AFTER 1.5 HRS OR SO, BREATHING PROBLEMS AND COUGH SUBSIDED. INTENSE BODY ACHES FOLLOWED WITH NAUSEA AND HEADACHE.
Age: 33.0
Sex: F
Vaccine: FLU3
Symptoms: Nausea, Pain, Wheezing
Clinical narrative: 6PM COUGH BEGAN. VERY DEEP COUGH. COUGHING EVENTUALLY BECAME UNCONTROLLABLE BY 8PM, TROUBLE BREATHING, CHEST TIGHTNESS, AND WHEEZING AT THAT HOUR. WENT TO EMERGENCY ROOM AND WAS ADMINISTERED ALBUTEROL (INHALED). AFTER 1.5 HRS OR SO, BREATHING PROBLEMS AND COUGH SUBSIDED. INTENSE BODY ACHES FOLLOWED WITH NAUSEA AND HEADACHE.
Age: 76.0
Sex: F
Vaccine: FLU3
Symptoms: Pain in extremity
Clinical narrative: (L) arm still hurts 11 days later.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site swelling, Lip swelling, Pharyngeal oedema
Clinical narrative: At 15 minutes post injection patient noticed swelling at injection site, lips and throat. I administered 2 doses of EPIPEN.
Age: 2.0
Sex: M
Vaccine: HIBV, PNC13
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: Same vaccines were administered 13 days apart.
Age: 0.76
Sex: M
Vaccine: FLU3
Symptoms: Full blood count normal, Pyrexia
Clinical narrative: 1-Fever, 100.0 F, 8hrs after shot. 2-ER visit 18hrs after shot. Fever 104F with Acetaminophen and Ibuprofen being given. 3-Office visit for follow-up 26 hrs. after vaccine. 4-Phone call from parents w/questions about possible febrile seizure activity and persistent fever 103 to 104 F continuing 4 days post vaccine. 5-Office follow up scheduled 7 days post vaccine. Afebrile 6 days post vaccine.
Age: 38.0
Sex: F
Vaccine: TDAP
Symptoms: Erythema, Induration, Oedema peripheral, Skin warm
Clinical narrative: 4 days post receiving TDAP developed diffuse red, warm, swollen indurated lateral arm extending to lateral condyle.
Age: 1.12
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Discomfort, Herpes zoster
Clinical narrative: Shingles L3 dermatome. No pain. Minimal discomfort. Photo available - call with or e-mail & I will send. It is impressive!
Age: 52.0
Sex: M
Vaccine: TD
Symptoms: Erythema, Induration, Wrong drug administered
Clinical narrative: 01/26/11 - 0.1 cc tetanus toxoid administered (L) Volar forearm intradermally instead of PPD 01/28/11 - 15 mm area of erythema with smaller central area of induration 01/31/11 - Erythema & induration markedly reduced.
Age: 54.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Wrong drug administered
Clinical narrative: 01/26/11 - 0.1 cc tetanus toxoid given instead of PPD 01/26/11 - developed itching at site of injection 01/27/11 - itchy and red - 01/28/11 - same 01/31/11 - less erythema, 2mm induration.
Age: 46.0
Sex: F
Vaccine: TD
Symptoms: Discomfort, Erythema, Hyperaesthesia, Induration, Pruritus
Clinical narrative: 01/28/11 - small area erythema and induration with some discomfort 01/31/11 - erythema significantly reduced, 2mm induration, no pain or discomfort 02/02/11 - itchy & sensitive but exam without change from 01/31.
Age: 43.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Induration, Pain in extremity
Clinical narrative: 01/28/11 - slight erythema, no tenderness 01/31/11 - erythema unchanged, no induration to minimal, c/o sore forearm. Erythema 1cm 02/02/11 - 1/2cm mild induration, 1cm surrounding erythema.
Age: 50.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: 01/28/11 - area on (L) forearm with very slight induration & erythema, no complaint of discomfort 01/31/11 - induration/erythema resolved, no residual.
Age: 44.0
Sex: F
Vaccine: TTOX
Symptoms: Erythema, Incorrect route of drug administration, Injection site induration
Clinical narrative: 01/26/11 - 0.1cc tetanus toxoid administered intradermally (L) volar forearm instead of PPD. 01/28/11 - large area erythema from several cms. below antecubital fossa to midway down forearm almost entire width of forearm, central induration at injection site 01/31/11 decreased erythema.
Age: 1.07
Sex: M
Vaccine: DTAPIPVHIB, FLU3, HEP, HEPA, PNC13
Symptoms: Body temperature increased, Convulsion, Ear infection, Respiratory tract congestion
Clinical narrative: Parent reported on 12/15/10 at 10:00AM that pt. was transported via ambulance around 2:30AM due to seizure activity to Medical Center. Pt. had a temperature of 101.6. Followed up with Dr.: pt. pediatrician on 12/15/10 afternoon. Parent states pt. Dx. with ear infection and congestion. Parent states pediatrician feels like seizure activity was related to fever and not the vaccines.
Age: 43.0
Sex: F
Vaccine: TDAP
Symptoms: Hypoaesthesia facial, VIIth nerve paralysis
Clinical narrative: TDAP given 10/25/10 without incident - no increased pain, redness per client. Sx facial numbness began 11/02/10 to Dr 11/03/10 with dx Bells Palsy & put on Prednisone dose pak - to have MRI if sx persist. 12/14/10 phone call to client reports sx resolved within 2 wks. No lasting effects.
Age: 24.0
Sex: F
Vaccine: HPV4, MMR
Symptoms: Drug exposure during pregnancy, Pregnancy test positive
Clinical narrative: None - Phone from client 1 1/2 wks later stating she had a blood test & is early pregnant.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Abasia, Abdominal discomfort, Back pain, Balance disorder, Catheter placement
Clinical narrative: Client received Flu shot at work. States she had a back ache a week to week and 1/2 after she received the vaccine states back felt worse than usual. Client states she took ALEVE - went to work and felt good on Oct 8, 2011. On Oct 9, 2010 she got up at 5:00AM to go to the bathroom and her left leg was numb and tingly. She states her right leg also became numb and tingly - 1 hour later she was unable to walk and went to the ER by ambulance. Client states the ER doctor thought it was GUILLAIN-BARRE. Client was hospitalized for 3 weeks. She had 3 MRI's and Cat scan and ultrasound of her leg. Her neurologist said it was transverse myelitis from the flu shot. She is still using a walker now and has a lot of pain. Her right leg is still numb. Client states she can't stand long without hurting. States the (R side of her) abdomen and buttox is numb, her groin area is painful. She states her skin is sensitive to hot and cold and she is in therapy. She states she is very unsteady and unbalanced. She states she had a catheter for 1 month now that is out - states her bowel is effected.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Computerised tomogram, Dysstasia, Groin pain, Hyperaesthesia, Hypoaesthesia
Clinical narrative: Client received Flu shot at work. States she had a back ache a week to week and 1/2 after she received the vaccine states back felt worse than usual. Client states she took ALEVE - went to work and felt good on Oct 8, 2011. On Oct 9, 2010 she got up at 5:00AM to go to the bathroom and her left leg was numb and tingly. She states her right leg also became numb and tingly - 1 hour later she was unable to walk and went to the ER by ambulance. Client states the ER doctor thought it was GUILLAIN-BARRE. Client was hospitalized for 3 weeks. She had 3 MRI's and Cat scan and ultrasound of her leg. Her neurologist said it was transverse myelitis from the flu shot. She is still using a walker now and has a lot of pain. Her right leg is still numb. Client states she can't stand long without hurting. States the (R side of her) abdomen and buttox is numb, her groin area is painful. She states her skin is sensitive to hot and cold and she is in therapy. She states she is very unsteady and unbalanced. She states she had a catheter for 1 month now that is out - states her bowel is effected.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Myelitis transverse, Nuclear magnetic resonance imaging, Pain, Paraesthesia, Temperature intolerance
Clinical narrative: Client received Flu shot at work. States she had a back ache a week to week and 1/2 after she received the vaccine states back felt worse than usual. Client states she took ALEVE - went to work and felt good on Oct 8, 2011. On Oct 9, 2010 she got up at 5:00AM to go to the bathroom and her left leg was numb and tingly. She states her right leg also became numb and tingly - 1 hour later she was unable to walk and went to the ER by ambulance. Client states the ER doctor thought it was GUILLAIN-BARRE. Client was hospitalized for 3 weeks. She had 3 MRI's and Cat scan and ultrasound of her leg. Her neurologist said it was transverse myelitis from the flu shot. She is still using a walker now and has a lot of pain. Her right leg is still numb. Client states she can't stand long without hurting. States the (R side of her) abdomen and buttox is numb, her groin area is painful. She states her skin is sensitive to hot and cold and she is in therapy. She states she is very unsteady and unbalanced. She states she had a catheter for 1 month now that is out - states her bowel is effected.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Ultrasound scan, Walking aid user
Clinical narrative: Client received Flu shot at work. States she had a back ache a week to week and 1/2 after she received the vaccine states back felt worse than usual. Client states she took ALEVE - went to work and felt good on Oct 8, 2011. On Oct 9, 2010 she got up at 5:00AM to go to the bathroom and her left leg was numb and tingly. She states her right leg also became numb and tingly - 1 hour later she was unable to walk and went to the ER by ambulance. Client states the ER doctor thought it was GUILLAIN-BARRE. Client was hospitalized for 3 weeks. She had 3 MRI's and Cat scan and ultrasound of her leg. Her neurologist said it was transverse myelitis from the flu shot. She is still using a walker now and has a lot of pain. Her right leg is still numb. Client states she can't stand long without hurting. States the (R side of her) abdomen and buttox is numb, her groin area is painful. She states her skin is sensitive to hot and cold and she is in therapy. She states she is very unsteady and unbalanced. She states she had a catheter for 1 month now that is out - states her bowel is effected.
Age: 48.0
Sex: F
Vaccine: MMR
Symptoms: Joint swelling
Clinical narrative: Swollen knees swollen joints in hands and wrists bilaterally.
Age: 25.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Contraception, Drug exposure before pregnancy
Clinical narrative: Information has been received from a Registered Nurse concerning a 25 year old female who was vaccinated with the first and second 0.5ml dose of GARDASIL (route unspecified) on 28-OCT-2009 (Lot number was unknown) and on 17-SEP-2010 respectively. Concomitant therapy included ethinyl estradiol (+) etonogestrel (MSD) (duration, dose and indication not reported). The patient did not receive any concomitant vaccination at that time. The nurse stated that patient found out she was pregnant after receiving the second dose of GARDASIL on 17-SEP-2010 and while on ethinyl estradiol (+) etonogestrel (MSD). Last menstrual period (LMP) and the estimated delivery date (EDD) were unspecified. On 19-NOV-2010, the patient had a visit with the physician. On 10-JAN-2011, the patient reported via a phone conversation with the physician that she had terminated the pregnancy, and it was reported that this was not due to vaccination with GARDASIL. The patient did not have a follow up visit with the physician. It was reported that, the patient had cancelled the appointment to receive the third dose. Action taken with ethinyl estradiol (+) etonogestrel (MSD) was not reported. At the time of the report the patient's outcome was unknown. Upon internal review, patient had terminated the pregnancy was determined to be an other important medical event. Additional information has been requested.
Age: 25.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Abortion induced, Drug exposure during pregnancy
Clinical narrative: Information has been received from a Registered Nurse concerning a 25 year old female who was vaccinated with the first and second 0.5ml dose of GARDASIL (route unspecified) on 28-OCT-2009 (Lot number was unknown) and on 17-SEP-2010 respectively. Concomitant therapy included ethinyl estradiol (+) etonogestrel (MSD) (duration, dose and indication not reported). The patient did not receive any concomitant vaccination at that time. The nurse stated that patient found out she was pregnant after receiving the second dose of GARDASIL on 17-SEP-2010 and while on ethinyl estradiol (+) etonogestrel (MSD). Last menstrual period (LMP) and the estimated delivery date (EDD) were unspecified. On 19-NOV-2010, the patient had a visit with the physician. On 10-JAN-2011, the patient reported via a phone conversation with the physician that she had terminated the pregnancy, and it was reported that this was not due to vaccination with GARDASIL. The patient did not have a follow up visit with the physician. It was reported that, the patient had cancelled the appointment to receive the third dose. Action taken with ethinyl estradiol (+) etonogestrel (MSD) was not reported. At the time of the report the patient's outcome was unknown. Upon internal review, patient had terminated the pregnancy was determined to be an other important medical event. Additional information has been requested.
Age: 60.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Asthenia, Chest discomfort, Feeling abnormal
Clinical narrative: Received flu shot and left the clinic and felt a stabbing pain to the chest. She was weak and sick in bed for 4 days. Did not go to the doctor. She is ok now as far as she knows.
Age: 60.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Activities of daily living impaired, Asthenia, Chest pain, Malaise
Clinical narrative: Received flu shot and left the clinic and felt a stabbing pain to the chest. She was weak and sick in bed for 4 days. Did not go to the doctor. She is ok now as far as she knows.
Age: 36.0
Sex: M
Vaccine: FLU3, FLU3
Symptoms: Abasia, Dizziness, Guillain-Barre syndrome, Hypoaesthesia, Nausea
Clinical narrative: Time course reported on ?-04-11 received call at 8:20 pm - pt indicated he was diagnosed with Guillain-Barre syndrome on or about 11-23-10.
Age: 36.0
Sex: M
Vaccine: FLU3, FLU3
Symptoms: Paraesthesia, Paralysis, Wheelchair user
Clinical narrative: Time course reported on ?-04-11 received call at 8:20 pm - pt indicated he was diagnosed with Guillain-Barre syndrome on or about 11-23-10.
Age: 36.0
Sex: M
Vaccine: FLU3, FLU3
Symptoms: Guillain-Barre syndrome
Clinical narrative: Time course reported on ?-04-11 received call at 8:20 pm - pt indicated he was diagnosed with Guillain-Barre syndrome on or about 11-23-10.
Age: 36.0
Sex: F
Vaccine: DTAP, DTAP
Symptoms: Lymphadenopathy
Clinical narrative: Vaccine administered on 2/5/11 Left deltoid. On 2/6/11 noted half dollar size enlarge lymph gland left axilla.
Age: 73.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Headache, Herpes zoster, Injection site pruritus, Nausea
Clinical narrative: 1/8/11 - 12:30 P.M. Headache, nausea, chills, rash itching - at vaccine site, 2:30 PM shingles started breaking out different sites on my body - mild case - for 3 to 4 weeks. No treatment.
Age: 73.0
Sex: F
Vaccine: VARZOS
Symptoms: Vaccination site rash
Clinical narrative: 1/8/11 - 12:30 P.M. Headache, nausea, chills, rash itching - at vaccine site, 2:30 PM shingles started breaking out different sites on my body - mild case - for 3 to 4 weeks. No treatment.
Age: 58.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site discolouration, Injection site pain
Clinical narrative: Tender in left upper arm. Can still see where the shot was given; and discolored where it was red.
Age: 0.51
Sex: F
Vaccine: DTAPIPVHIB, HEP, PNC13, RV5
Symptoms: Urticaria
Clinical narrative: Developed urticaria (diffuse) late on 2/5/11, received immunizations 2/4/11.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Adenoidal hypertrophy, Adenoidectomy, Allergy test negative, Antibody test positive, Antinuclear antibody negative
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Anxiety disorder, Arteriogram coronary normal, Blood 25-hydroxycholecalciferol, Blood immunoglobulin A, Blood thyroid stimulating hormone
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Borrelia test negative, Bradycardia, Bronchitis, Chest X-ray normal, Chest discomfort
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Chest pain, Chills, Computerised tomogram abnormal, Computerised tomogram head, Computerised tomogram thorax normal
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Cough, Cytomegalovirus test negative, Dermatitis contact, Dizziness postural, Drug screen negative
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Dyskinesia, Dyspnoea, Echocardiogram normal, Electrocardiogram ambulatory abnormal, Electrocardiogram normal
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Electroencephalogram abnormal, Electrophoresis protein normal, Epstein-Barr virus test negative, Exercise electrocardiogram, Fatigue
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Full blood count normal, Glycosylated haemoglobin, HIV test negative, Headache, Heart rate irregular
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Helicobacter test negative, Injection site erythema, Injection site pustule, Injection site swelling, Injection site warmth
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Intervertebral disc degeneration, Intervertebral disc protrusion, Lipids normal, Lymphadenopathy, Metabolic function test normal
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Migraine, Muscular weakness, Nasal septal operation, Nasal turbinate hypertrophy, Nuclear magnetic resonance imaging brain abnormal
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Nuclear magnetic resonance imaging spinal cord abnormal, Oropharyngeal pain, Palpitations, Poor quality sleep, Pulmonary function test normal
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.
Age: 26.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Pyrexia, Radioallergosorbent test negative, Rash, Red blood cell sedimentation rate normal, Renal function test normal
Clinical narrative: SM with multiple complaints following receipt AVA, typhoid, men 8/11/09, spv 8/12/09, & ava-flumist 9/29/2009. Over next few days he described a robust takt to spv site (red pustular near, site swelling, left axillary tenderness and nodal swelling). 1-2 weeks later c/o sob on inspiration with squeezing sharp midsternal stab "something pushing inside trying to get out vs sitting on chest" 6/8/10 pain scale; not affected w/position. Duration 4 days unrelieved with MOTRIN. Resolved 9/1/2009. 10/8 to 10/22/09 dx contact dermatitis on steroid therapy. 10/22/09 (day 70 spv, day 23 AVA2) f/u contact derm/rash, 3 day hx fever, chills, congestion, ST, HA, cough, wheez...dx bronchitis-resolved 2 weeks later. 11/13/09 H1N1 IM given and deployed Dec 2009. 1/18/2010 c/o diff breathing and wheezing with exertion. Strong hx cardiac disease family...sent for cardiac eval then pulm...wnl. 2/17/2010 c/o unwitness syncopal like episodes with no LOC but legs buckling with fatigue walking/standing > 10 min. Muscles want to collapse. No paresthesia, incontinence or visual disturbances. March-April 2010 c/o dizziness standing, chest pain, palp, knees buckling, bradycardia, headaches. Comprehensive cardiac eval, advised chest pains "unrelated to presyncopal symptoms". 4/2010 neuro eval dx vasovagal syncope with possible hyperventilation syndrome w/o overbreathing. He was also dx migraine headaches secondary to poor sleep. Sleep studies consistent for sleep deprivation. ENT treated with septo-turbo-adenoidectomy for turbinate hypertrophy with improvement breathing and smell...no change to fatigue. May 2010 episodic bouts UE weakness including difficulty w/ fine motor control hands with repetitive actions or holding/carrying > 10 lbs. Still with LE weakness. Psych dx anxiety disorder. Comprehensive eval in progress.