Age: 13.0
Sex: F
Vaccine: MNQ
Symptoms: Computerised tomogram normal, Convulsion, Electrocardiogram normal, Laboratory test normal, Nuclear magnetic resonance imaging normal
Clinical narrative: Information has been received from a physician concerning a female who was vaccinated with a 0.5ml dose of GARDASIL. On an unspecified date, after receiving a dose of GARDASIL, the patient experienced seizures. The patient sought unspecified medical attention. Follow-up information was received from a nurse. It was reported that the patient had not received the GARDASIL in their office, so she did not know how many vaccine the patient received. It was reported that the patient had the first dose of GARDASIL and sometime after had the first seizure on 30-MAR-2008. The patient was taken by ambulance to the emergency room. A computed axial tomography scan and labs were normal, so the patient was discharged that same night. The physician had the patient got electrocardiogram and magnetic resonance imaging which were normal. It was documented that the patient had been to an amusement park on a roller coaster and received the meningococcal vaccine the week before the seizure. The patient had another seizure in August 2008. In September 2008, she was seen by a neurologist who prescribed LAMICTAL. The nurse did not have anymore information about the patient's current status. Upon internal review, seizures were determined to be other important events. Additional information has been requested. 3/16/09-records received-office visit 3/31/08 presented with C/O syncopal/seizure episode last night. Had rode a roller coaster 4-5 times. Just received meningococcal vaccine last week. Had shaking tremors and syncopal like episode and presented to ED where CT and labs all normal . Office visit 4/29/08for sports physical exam. Office visit 1/20/09-C/O amenorrhea and began periods 2 years ago. Now having spells of not feeling well, continues with seizure activity. Dizziness some headace sore throats cough stomach ache, hot/cold spells and possible irregular heart rate night before. On Lamictal. Has not started period yet has vaginal discharge and episode with cramping. 9/10/08-neurology consult for two seizure like events with arms and legs jerking and one side of face drooling and face pale. After event was sleepy and lethargic for 1 day. No further seizure activity until 8/31/08-with left side of face droopy and she stopped breathing and lips turned purple and arms jerky movments. Presented to ED and tests WNL. C/O feeling tired all the time since first episode. Impression:new onset seizure activity consist of tonic-clonic movments and drooping to one side of face and slurring of speech with Postictal state.  3/17/09-vac rec rec'd hpv4 not received on 3/25/08 first hpv4 on 4/14/08 lot#0389U.   7/31/09 Neurology consultant records received DOS 9/10/08. Assessment: Juvenile Myoclonic Epilepsy. Patient reports two seizure-like events. The seizure activity consists of tonic-clonic movements to arms and legs lasting between 5 to 8 minutes in length. Has displayed drooping to one side of face and slurring of speech. Postictal state. Activity appears to be epileptic in nature. Neurological exam is normal. Previous CT of head and labs have all been normal.