Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging head abnormal, Magnetic resonance imaging neck normal, Malaise, Memory impairment, Metamorphopsia
Clinical narrative: Immediately had the  worst headache of my entire life  shortly after receiving the vaccine that morning- mimicked migraine on the left side but I had never had a migraine before.  Felt very ill the day of the vaccine and days after with head pain, lightheaded, chills, fatigue, nausea Over the next few months began having frequent  migraines  (now we believe could have also been trigeminal neuralgia) Saw PCP 11/9/2021 to address last months of migraines that have been happening every week and lasting for a few days. Left eye will droop and pupil dilates, nausea, emesis 2x during the worst of it. No apparent triggers. No previous history of headaches/migraines Dermatology 4/5/2022 for unexplainable hive/blistery rashes (never had have rashes before in my history) Over few months I began having more  migraines  that would last weeks on end and only resolve for a few days at a time and was having vision changes and gastrointestinal problems 9/22/2022 Saw PCP for dizziness, vertigo, vomiting, tinnitus, blurry vision, cranial nerve pain and  migraine  for > 1 month 9/27/2022 Audiology evaluation for positive nystagmus with PCP ER 9/28/2022 - Presented for severe neurological pain, stroke-like symptoms on left-side, dizziness, SOB, chest pain, faint MRI revealed no changes, Troponin was high for several hours but lowered, no etiology found at this time Audiology/Vestibular Testing 10/21/2022 - Right vestibular hypofunction and acute damage Neurology 11/2/2022 ENT 11/8/2022 - No etiology noted PCP Clinic 12/22/2022 Neuro-otology 1/23/2023 Neuro-optometry Jan 2024, July 2023, Jan 2024 Neurology Clinic 2/8/2023 Dermatology 2/20/2023 - Telogen effluvium Spinal Tap 2/24/2023 Saw functional medicine providers from 3/23 to 8/23 consistently because no clear answers for etiology or treatment were provided Rheumatology 7/13/2023 - referred for positive ANA PT 11/15/2023 - followed for 5 weeks but could not tolerate exercises as needed Neurology 1/9/2024 Speech-language Pathologist eval 1/29/2024 OT Eval 2/2/2024 - currently following for vestibular/neuro rehab Currently also following vision therapy with neuro-optometrist I haven t worked or been able to function normally since September of 2022.  My nervous system has not worked properly since I started having neurological issues.  The consensus is I had some sort of brain damage but there is no clear etiology.  I live with chronic severe pain, inability to complete daily activities as normal, dizziness, neuropathies, and more.  This has never resolved since hitting it s peak in Sep 2022.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Current Problem list  Hair loss - Telogen effluvium Headache, chronic daily   Imbalance Autoimmune Thyroiditis Binocular Vision disorder   Vestibular dysfunction of right ear   Visual distortions   New onset headache   Paresthesias   Chronic pain  Dysautonomia  Neuropathic pain   Hemisensory deficit   Trigeminal neuralgia   Positive Romberg test   Tremor       Positive ANA (antinuclear antibody)   Intermittent upper abdominal pain   Decreased appetite   Daily nausea     Shortness of breath on exertion   Arachnoid cyst   Face pain   Ear pain   Dizziness   Pressure in head   Multiple neurological symptoms    Neck pain   Hyperosmia   Cognitive communication deficit   Coordination problem   Unsteady gait   Diplopia   Visual disturbance, subjective   Abnormal visual perception   Altered olfactory perception   Tinnitus   Poor concentration   Poor memory   Executive function deficit   Palpitations   Lightheadedness