Age: 50.0
Sex: F
Vaccine: FLU3
Symptoms: Retching, Tremor
Clinical narrative: Uncontrollable muscle twitching in entire body, extreme and debilitating weakness, uncoordination, ataxia, numbness, tremors, occasional slurred speech, difficulty performing daily living tasks, mental/mood problems, dizziness, insomnia, loss of appetite.  3/19/08 Reeiewed ER medical records of 2/28/2008. FINAL ER DX: dysarthria & left arm weakness of unclear etiology Records reveal patient experienced left arm weakness & hand/finger contractions since 12/2007 w/intermittent slurring of speech.   3/24/08 Reviewed additional ER records & labs from hospital: ER 1/18/08: muscle twitching & uncoordination left arm & hand, left leg twitching & weakness, right side twitching, tingling fingers & toes, constipation, urinary retention. ER 3/4/08: increased muscle contractions all over  body, decreased appetite.  3/25/08 Reviewed neuro note of 3/10/2008. FINAL DX: anonopathy/motor neuronopathy w/upper extremity predominance. Records reveal patient w/tinnitus, night sweats, dysphagia, palpitations, IBS, urinary urgency, easy bruising, fatigue & faintness.  Exam revealed prominent thoracis kyphoscoliosis, deformed right toes, livedo reticularis, increased skin & joint elasticity, tone increased w/left side spasticity, slow coordination left hand & leg, gait left hemiparesis.  Labs, x-rays & MRIs were reviewed. Additional labs were ordered & she was instructed to apply for disability.  Depending on labs, was to be followed in ALS clinic.   5/23/08 Reviewed additional hospital & neurologist medical records for 1/18/08-4/7/2008. FINAL DX: muscle spasms, left CTS, neuropathy, glossalgia, intermittent dysarthria Records reveal patient seen in ER for muscle twitching, uncoordination & weakness.  Unable to work.  Exam 2/6/08 revealed trophic changes to right side of tongue w/white spots.  Referred to ENT. Follow-up: The family, including patient, feel her physical condition is directly related to the vaccine. The neurologist diagnosed patient with ALS but did not commit to a "yes" or "no" if this resulted from the vaccine. Her symptoms began shortly after being vaccinated. She can no longer raised her hands and arms, unable to walk, cannot feed herself, etc. She now is losing her ability to talk. The neurologist now admits that some of her symptoms are not typical of ALS.  I am the mother of patient responding to your inquiry. I am enclosing a copy of patient's journal as her physical problems have progressively gotten worse. She has been seen by two neurologist and after a battery of tests, MRIs of her whole body, EEG, EMG, CAT scans, blood work etc they have ruled out anything else and have come up with the diagnosis of ALS, aka Lou Gehrigs disease. We have pointedly asked the doctors if it could have resulted from her flu vaccine they were uncommitted. She had never had flu shot before as she has had a very active immune system since childhood and could not tolerance many meds. She is an RN and worked and was in an urgent care clinic. At the urging of her manager she conceded to get the progressed at an alarming rate. She has been unable to work since January and is now on Social Security disability. We definitely feel this is the result of the flu shot which was resulted in her immune system going into overdrive. We are not looking for any monetary compensation but would like this reaction to be explored further and see if there is some medical solution that would result in her getting better. She can no longer care for herself and needs 24 hour care. The prognosis is not good. Although most ALS patients are given 2-6 years of life and many live to 20 years after diagnosis patient has deteriorated this much in 4 months. Thanks for your continued interest in this matter. We would be thankful for anything you could offer in medical advice as to a solution or relief in her situation. We being a faith family are praying for a miracle as we don't want to lose our daughter/sister at this young age. Symptoms - Uncontrollable muscle twitching in entire body; location vary; mostly in arms, legs; also in chest, abdomen, buttox. - Uncontrollable finger movements; fingers "twitch." - Impaired fine motor skills; difficulty writing, brushing teeth, buttoning, zippering, cannot play piano, etc. - Difficulty raising arms to shower, wash hair; very jerky movements. - Legs weak, uncoordinated; feel "loose" at the hips. - Tingling in fingers, legs, toes; occasional burning feeling in legs, spine. - Occasional difficulty speaking - speech slurred, heavy; worse when talking a lot. - Occasional feeling of all over tremors, extreme shakiness. - Periods of uncontrollable yawning; inappropriate laughter; - Occasional lightheadedness, dizziness; feeling I may pass out. Above symptoms worse with increased movement, activity. Onset : ~ 12/17/07- L side only - L arm, L leg; twitching only. 1/2/08- Finger twitching - L side. 1/4/08- Loss of L hand and leg coordination. 1/18/08 - R arm twitching. 1/22/08- Loss of R hand, leg coordination. 3/2/08- Symptoms worse; ? seizure-like activity, loss of emotions; no appetite; severe insomnia, muscle "convulsions." 3/17/08- All muscles twitches and contracting- neck, back, chest, arms, legs, hands, feet; no sensation in toes, finger tips; no coordination; fingers seize up and curl into a ball; unable to lift light objects; loss of function - cannot shower (unable to lift arms, hold onto objects); cannot pull a zipper, open a button, brush teeth, wash dishes, etc: hands stiff, tight. Legs shaky, uncoordinated; very tipsy; passed out once outside- fell face down into mud; numb toes and fingers, spreads up forearms and calves (numbness). Speech problem ongoing; extreme slurred speech the more I talk or after walking to exercise. Still lack of emotions - unable to cry, laugh, feel anxiety; feel in constant state of frustration; easily frustrated with simple tasks; cannot sit still or relax; severe insomnia; constantly break out in sweats; very hot, then extremely cold on/ off throughout entire day. Gag when eating, brushing teeth. HTLV? Polymyositis? Immunoassay work-up? Flu vaccine? Steroids or immunosuppressives? Staph - Unhealing sores in face. Physical and message therapy. Tongue burning, leukoplakia, swelling. Muscle biopsy; PET scan. Severe hip pain at night; L elbow. Old Teflon, moth balls. Menopause? Other CA? Uterine, bladder, colon? Need Soc. Security benefits; unable to work. Lorazepam addiction. Copy of records, esp. EMG. Increase CK. Tay-Sachs -what is this? Increase ESR.