Age: 15.0
Sex: F
Vaccine: HPV4, MNQ
Symptoms: Arnold-Chiari malformation, Arthralgia, Disturbance in attention, Dysgeusia, Electroencephalogram normal
Clinical narrative: This case was received from another manufacturer on 22 January under the reference number WAES 0711USA03218. The following narrative is verbatim from that report: "Information has been received from a pharmacist concerning his 15 year old daughter who in September 2007, was vaccinated GARDASIL. Concomitant suspect therapy included meningococcal vaccine (unspecified). A couple minutes after getting the vaccination, the patient suffered a grand mal seizure and fell on the ground in the office. She recovered from the grand mal seizure and was sent home. The pharmacist's wife reported that a couple weeks after the vaccination, her daughter could not focus and would forget things. The symptoms caused problems in school, and her grades dropped. It was also reported that the patient had bad headaches, a lack of concentration, a change in personality, nausea and tasted blood in her mouth. In the last two weeks, the symptoms worsened. The patient is having daily headaches and petit mal seizures. She is going to be seen by a neurologist. At the time of this report, the symptoms persisted." "Follow-up information received  from the pharmacist indicated that, as of 19-NOV-2007, his daughter had not recovered. The patient will see a neurologist in January and is being tutored to assist in her school work. The reporter did not know the lot number or any additional information." Follow up information received from the physician's medical records, confirmed that on 17-Aug-2007, at 1:45 p.m. (previously reported by the pharmacist as September 2007), the patient (a Caucasian student) was vaccinated IM in the left anterior deltoid with the first dose of GARDASIL (lot  #658556/1060U) and in the right anterior deltoid with first dose of MENACTRA (lot # U2394BA)." Additional follow up information received from the physician mentioned that at age 1 year, the patient had a fever after she received an MMR vaccination. The events on 17-AUG-2007 were described as an "episode of altered consciousness," after both of the vaccines were administered. Medical records from the physician, indicated that on 06-NOV-2007, the patient had a normal magnetic resonance imaging MRI) of her pituitary, and an MRI of the brain that revealed a possible Chiari I malformation. On 21-NOV-2007, she had a normal electroencephalogram (EEG)." "On 26-NOV-2007, the patient was evaluated by a neurologist, who indicated that the patient was in "excellent general medical health," though at the time of the visit was being treated with cephalexin (KEFLEX) for a urinary tract infection with blood in th urine. The neurologist stated that the patient's mother 9 a previous EEG technician) reported that on 17-AUG-2007, her daughter had a generalized tonic clonic seizure that lasted for "about a minute," with no tongue biting or incontinence, and she was post ictal following the  seizure. The patient has continued to have episodes of "staring spells," with no recollection afterwards. She was previously a straight A student, and currently is "flunking everything" with noted personality and behavior changes, constant fatigue, some nausea, headaches and blurred vision in her left eye, described as "objects in view of Left eye may shake." The patient also reported her hands occasionally numb. In addition, she has joint and muscle pain and muscular weakness. A Folstein mini-mental state examination (MMSE) evaluation result was 25/30, and the neurologist indicated that the patient is "intellectually impaired at this time." He recommended that she should not return to school, but she "needs a 72 EEG, ambulatory." The neurologist's impression was that "she may indeed have a post vaccination encephalopathy," and that she may be having absent seizures. Further neuropsychological testing was being planned. " The pharmacist considered his daughter's symptoms to be disabling." "Additional informational has been requested." "All available medical records will be provided upon request."