chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Vaccination site pruritus
Clinical narrative: she got extremely sick; couldn't walk; became weak; cold symptoms; dizzy; severe sweating; muscle ache/pain; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) for a Pfizer sponsored program. The reporter is the patient.  A female patient received bnt162b2 (BNT162B2), administration date 22Mar2021 (Batch/Lot number: unknown) as dose 1, single for covid-19 immunisation. Relevant medical history included: "Fibromyalgia" (unspecified if ongoing); "she's allergic to coconut and rabbits" (unspecified if ongoing); "she's allergic to coconut and rabbits" (unspecified if ongoing). The patient's concomitant medications were not reported. The following information was reported: ILLNESS (non-serious) with onset 23Mar2021, outcome "recovering", described as "she got extremely sick"; GAIT INABILITY (non-serious) with onset 23Mar2021, outcome "recovering", described as "couldn't walk"; ASTHENIA (non-serious) with onset 23Mar2021, outcome "recovering", described as "became weak"; NASOPHARYNGITIS (non-serious) with onset Mar2021, outcome "recovering", described as "cold symptoms"; DIZZINESS (non-serious) with onset Mar2021, outcome "unknown", described as "dizzy"; HYPERHIDROSIS (non-serious) with onset Mar2021, outcome "unknown", described as "severe sweating"; MYALGIA (non-serious) with onset Mar2021, outcome "unknown", described as "muscle ache/pain". No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.  Addition information : Patient had severe dizziness, severe sweating, severe muscle ache/pain. On a scale of 1 to 10, it's a 20 (that's how terrible she felt). Patient was scheduled to get the second shot on12Apr2021.
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, Dizziness, Gait inability, Hyperhidrosis, Illness
Clinical narrative: she got extremely sick; couldn't walk; became weak; cold symptoms; dizzy; severe sweating; muscle ache/pain; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) for a Pfizer sponsored program. The reporter is the patient.  A female patient received bnt162b2 (BNT162B2), administration date 22Mar2021 (Batch/Lot number: unknown) as dose 1, single for covid-19 immunisation. Relevant medical history included: "Fibromyalgia" (unspecified if ongoing); "she's allergic to coconut and rabbits" (unspecified if ongoing); "she's allergic to coconut and rabbits" (unspecified if ongoing). The patient's concomitant medications were not reported. The following information was reported: ILLNESS (non-serious) with onset 23Mar2021, outcome "recovering", described as "she got extremely sick"; GAIT INABILITY (non-serious) with onset 23Mar2021, outcome "recovering", described as "couldn't walk"; ASTHENIA (non-serious) with onset 23Mar2021, outcome "recovering", described as "became weak"; NASOPHARYNGITIS (non-serious) with onset Mar2021, outcome "recovering", described as "cold symptoms"; DIZZINESS (non-serious) with onset Mar2021, outcome "unknown", described as "dizzy"; HYPERHIDROSIS (non-serious) with onset Mar2021, outcome "unknown", described as "severe sweating"; MYALGIA (non-serious) with onset Mar2021, outcome "unknown", described as "muscle ache/pain". No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.  Addition information : Patient had severe dizziness, severe sweating, severe muscle ache/pain. On a scale of 1 to 10, it's a 20 (that's how terrible she felt). Patient was scheduled to get the second shot on12Apr2021.
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Myalgia, Nasopharyngitis
Clinical narrative: she got extremely sick; couldn't walk; became weak; cold symptoms; dizzy; severe sweating; muscle ache/pain; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) for a Pfizer sponsored program. The reporter is the patient.  A female patient received bnt162b2 (BNT162B2), administration date 22Mar2021 (Batch/Lot number: unknown) as dose 1, single for covid-19 immunisation. Relevant medical history included: "Fibromyalgia" (unspecified if ongoing); "she's allergic to coconut and rabbits" (unspecified if ongoing); "she's allergic to coconut and rabbits" (unspecified if ongoing). The patient's concomitant medications were not reported. The following information was reported: ILLNESS (non-serious) with onset 23Mar2021, outcome "recovering", described as "she got extremely sick"; GAIT INABILITY (non-serious) with onset 23Mar2021, outcome "recovering", described as "couldn't walk"; ASTHENIA (non-serious) with onset 23Mar2021, outcome "recovering", described as "became weak"; NASOPHARYNGITIS (non-serious) with onset Mar2021, outcome "recovering", described as "cold symptoms"; DIZZINESS (non-serious) with onset Mar2021, outcome "unknown", described as "dizzy"; HYPERHIDROSIS (non-serious) with onset Mar2021, outcome "unknown", described as "severe sweating"; MYALGIA (non-serious) with onset Mar2021, outcome "unknown", described as "muscle ache/pain". No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.  Addition information : Patient had severe dizziness, severe sweating, severe muscle ache/pain. On a scale of 1 to 10, it's a 20 (that's how terrible she felt). Patient was scheduled to get the second shot on12Apr2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Back pain, Bell's palsy, Blood iron normal, Blood thyroid stimulating hormone normal, C-reactive protein normal
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Full blood count normal, Headache, Lipase normal, Metabolic function test, Pain
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Pain in extremity, Prostatic specific antigen normal, Protein total increased, Protein urine present, Red blood cell sedimentation rate normal
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test negative, Treponema test negative, Vitamin B12 normal
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Arthralgia, Back pain, Bell's palsy, Eyelid function disorder, Facial paresis
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Headache, Hypoaesthesia, Pain, Swelling face
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Ageusia, Angiogram, Arthralgia, Back pain, Bell's palsy
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Blood iron normal, Blood thyroid stimulating hormone normal, C-reactive protein normal, CSF protein increased, CSF white blood cell count increased
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Computerised tomogram spine, Cytology, Electromyogram, Eye movement disorder, Facial paresis
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Flow cytometry, Full blood count normal, Guillain-Barre syndrome, Headache, Hypoaesthesia
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Immunoglobulin therapy, Lagophthalmos, Lumbar puncture abnormal, Magnetic resonance imaging abnormal, Metabolic function test normal
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Muscle spasms, Neurological examination abnormal, Pain, Pain in extremity, Prostatic specific antigen normal
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Red blood cell sedimentation rate normal, Spinal osteoarthritis, Tenderness, Treponema test negative, Vertebral foraminal stenosis
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Arthralgia, Back pain, Bell's palsy, Blood iron normal, Blood thyroid stimulating hormone normal
Clinical narrative: Narrative: Patient was in his baseline state of health until 4/6 when he noted R hemibody numbness, which began with right-side facial numbness when brushing teeth. He was evaluated by his PCP (no exam noted) and initiated on regimen of doxycycline 100mg BID, acyclovir 800mg TID, and prednisone 40mg for 'Bells Palsy'. On 4/9, a referral to neurology was made after pt returnedd to clinic w/ burning deep low back pain that radiates up to his shoulder, and his b/l temples. Neuro exam documented at that time denote a L sided Bells Palsy only. CBC, CMP, PSA, RPR, TSH, B12, ESR, CRP, RPR, Iron lvls were all normal. MRI brain and Lumbar spine were ordered and pt was to obtain expedited LP.  Pt again re-presented to urgent care on 4/12 due to severe burning back pain that resolved w/ activity. At this time again only L sided facial weakness noted (documented as reduced ability to close eyelid, raise eyebrow, weakness puffing out cheeck, and reduced smile on L), no other weakness, drift, or sensory findings. Pt was instructed to continue doxycycline 100 mg BID 10d course (4/6-4/15), prednisone 40mg 7d course (4/6-4/12), acyclovir 800mg TID 7d course (4/6-4/12). Pt was instructed to obtain MRI and LP in expedited fashion. Telephone note Addendum on 4/14 noted improve in Bell Palsy symptoms and back/shoulder/head pain w/tylenol. Given persistent back pain and J&J COVID19 vaccine, pt was instructed to present to urgent Care. He deferred until the following day. On 4/15 pt woke up w/ worsening facial numbness. He presented to urgent care w/ b/l inability to close eyes and 'when attempting both eyes rollup into his head . He also complained of sharp pain upon extending his RUE AND RLE. Exam showed b/l inability to close eyes, description of Bells phenomenom, and palpable tenderness at base of C spine w/ mild spasms. CTH was obtained and was unremarkable. CT C spine showed multilevel degenerative cahgnes w/ neuroforaminal narrowing at C5-C7. Given inability for pt to obtain an expedited MRI and LP to r/o inflammatory or malignant process at outside hospital case was discussed and accepted for transfer on 4/15. Of note pt obtained J&J vaccine on 3/18 by outside hospital. On presentation patient confirms the timeline detailed above and additionally notes that he has lost his sense of taste. Pt underwent MRI scan on day of admission 4/15/21 which showed enhancement of the bilateral facial nerves and oculomotor nerves, and possible trigeminal nerve enhancement. He underwent LP which showed 6 WBCs and 346 protein; negative cytology and flow cytometry. Given his clinical presentation and imaging/CSF findings, high suspicion for atypical GBS/AIDP which EMG done on April 20th, 2021 was most consistent with. He underwent CT C/A/P which were all negative for malginacyny. He was treated with IVIG for presumed AIDP/GBS. Discharged on April 21st, 2021.