Age: 16.0
Sex: F
Vaccine: HPV4, MNQ
Symptoms: Blepharospasm, Bronchitis, Clonus, Computerised tomogram head normal, Confusional state
Clinical narrative: This VAERS report is being sent because of parental concern with a seizure disorder. Patient's mother asked me on 3 February 2014 as to whether the patient's newly diagnosed seizure disorder from October 2013 might be related to receiving the HPV vaccines (her mother had been reading the Internet). A review of history of the patient's seizures and fainting has shown that her first fainting episode occurred in 2009 (before any HPV vaccines) and was felt to be related to her menstrual cycle. She has had at least 2 other fainting episodes reported by other family members but we do not have any specific dates for those. In October of 2013 she had a syncopal episode that is thought to have possibly have been postictal since she was not seen to actually seize. She has had many seizures since that time that were finally controlled with medication by November the 14, 2013. The patient received 3 HPV vaccines in 2010 and then got 2 extra HPV vaccines in 2013. She had no reactions to the HPV vaccines at the time they were given here at the Clinic, and there is no record of difficulty with the first 3 she was given in 2010 at the previous medical facility. The patient's seizure disorder started on October 7, 2013, which was roughly 4 months after her 4th GARDASIL immunization. When she got to the Clinic her immunizations were entered into the EHR. However, the second and third HPV immunizations were not seen on our regular immunization sheet, which made it look like she had only received 1 HPV vaccine. She therefore received a second HPV vaccination on June 12, 2013, and a third one on December 20, 2013. The meningococcal immunization that was recorded in the Clinic chart was entered as having been given on April 2, 2007 (instead of April 2, 2010). She was given a second meningitis vaccine on June 12, 2013 (most likely because the date of April 2, 2007 would have been given before she was 11 and so therefore would have possibly been considered an incorrectly given dose). The following is a chronological list (as best we have) for the evolution of this seizure disorder. October 7, 2013: The patient was at volleyball practice in the afternoon. After about 5 minutes she was coughing and had some difficulty breathing so she went to the locker room. She passed out in the locker room and was found 5 minutes later. She was in and out of consciousness for about 20 minutes and was transported by EMS to hospital. At that time it was considered a syncopal episode. EKG and head CT were reported to be negative. October 8, 2013: I saw the patient in the office and she was having more coughing. I thought she had bronchitis and gave her some ZITHROMAX and a PROAIR inhaler. I arranged for a neurology appointment. October 11, 2013: Neurology appointment with Dr. At this time it was still considered syncopal although he was also concerned that this was going to be a seizure disorder. An EEG was then scheduled at that time for 21 October 2013. October 20, 2013: The patient had 2 seizures that were witnessed by her mother. An EEG was scheduled for the 21st. Her menstrual period started on 19 October 2013. Her mother had wanted a second opinion for neurology. Her tests that had been reported to be normal within the next 2 weeks included a CT scan, a Holter monitor, and an EEG. She was started on KEPPRA. October 26, 2013: She had at least 1 seizure. October 29, 2013: She had a series of 3 seizures at school. November 2, 2013: In the evening she had been unresponsive with some eye twitching and clonic movements that lasted about 3 minutes. In between times, she would seem confused but would say she was "okay." There was one time when she had come in having urinary incontinence and temporary "lockjaw." November 4, 2013: The patient was seen at Hospital. I believe that was through the emergency room. I do not know if she did make an appointment later that week. November 13, 2013: She saw neurologist again and her medication was changed to DEPAKOTE. This was also felt to help with some headaches. November 15, 2013: I saw her in the office for recheck of the asthma symptoms, which seemed to be better although she was still having a little bit of some respiratory issues she felt. December 20, 2013: I saw her for recheck of the asthma and she still seemed a little bit winded when she would walk up the stairs but in general it seemed to be better. She was having no more seizures at that time. January 31, 2014: She had a series of 4 seizures. These were the first seizures she had had since 3 November 2013. Past Medical History: Her other medical concerns have included Depression and ADHD. She has seen Psychiatry for those and I have been monitoring those. Since she has been on the ZOLOFT and the ADDERALL, these seem to have helped those 2 concerns and she has been doing well in school. If you have questions or if you need further clarification, please contact me.