Age: 61.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Lumbar puncture normal, Monoplegia, Muscle contractions involuntary, Muscular weakness, Neuropathy peripheral
Clinical narrative: Information has been received from a 61 year old female consumer with a history of Cytomegalovirus (CMV) 30 years ago who on 01-May-2009 was vaccinated with a dose of ZOSTAVAX (Merck), "injected at the arm". Concomitant therapy included EFFEXOR. On 14-MAY-2009 the consumer had shingles, had a rash, had a tingling sensation before the rash and the skin was extra sensitive in the right torso. The consumer might have a possible reactivation of CMV after receiving ZOSTAVAX (Merck). The consumer reported that she was partially paralyzed had peripheral neuropathy and left leg was partially paralyzed. "Both of the consumer's legs were weak from muscular weakness and "neurological stuff going on." The consumer also experienced fasciculation and sensory loss. The consumer reported that she was "very disabled". The consumer had been tested by a neurologist and about to go to a clinic. MRI of whole brain and spine, lumbar puncture, blood test, lyme disease test, heavy metal test, EMG were performed and the results were not reported. At the time of report, the patient had not recovered. Partially paralyze, peripheral neuropathy, muscular weakness of both legs, "neurological stuff going on", sensory loss, fasciculation were considered to be disabling by the consumer. Additional information has been received on 14-DEC-2009 from a neurologist who stated that the patient was first seen on 01-AUG-2009, after the patient's shingles had occurred. The patient had developed weakness in the left leg and ataxia. The patient had been seen by multiple physicians and the patient was thought to have radiculo myelitis (inflammation affecting the spinal cord and peripheral nerves). One of the physicians thought the patient might have Amyotrophic lateral sclerosis (ALS). Radiculo myelitis and ALS had not been confirmed. The physician stated that the cause of the patient's symptoms was unknown at that time. The patient was to be seen at the clinic in the second week of December. The patient was to receive a series of tests at that time. The patient received the ZOSTAVAX (Merck) vaccination from another physician. The neurologist felt the patient's symptoms were disabling and life-threatening. Additional information has been requested.  12/31/09 Medical records received for date 12/14/09. DX: progressive limb weakness, amyotrophic lateral sclerosis. Chief c/o progressive upper and lower extremity weakness. Pt says received varicella vax and 2wks later developed shingles after that developed dizziness, slurred speech, imbalance. At this time pt states still having problems w/ gait worsening now weakness. Weakness started in left foot/toe progressed to upper extremity. Pt states fatigue. Assessment: (+)bilat foot droop, extremity weakness, (+)babinski and chaddock response  12/31/09 Medical records received for date 7/28/09 to 8/26/09. DX: ataxia, left side weakness. SX: eval for left side weakness s/p shingles, fatigue, gait disturbance, sweats, chills. Assessment: (+)slurred speech, slowed coordination. Multiple OV Pt states left sided weakness is worsening. 1/4/09 Medical records received for date 5/18/09 DX: shingles.