Sex: F
Vaccine: VARZOS
Symptoms: Decreased vibratory sense, Electromyogram normal, Facet joint syndrome, Hyperaesthesia, Hypoaesthesia
Clinical narrative: Lower left extrimiy/numbness in her entire leg/decreased sensation of lower extremitydiminished reflexes in the lower extremities/Numbness foot/numbness ascended under her breast/Left leg numbness; transverse myelitis; Stroke; hyperesthesia; uncovertebral joint spondylosis; Diminished reflexes; Pain in toe; flattening of the spinal cord; disc osteophyte complex; Mild degenerative changes are seen at the interphalangeal joint; pins and needles; facet joint arthropathy; Degeneration of cervical intervertebral disc; central spinal stenosis/neural foraminal and narrowing; Sensory loss/ decreased vibratory temperature; This case was reported by a lawyer and described the occurrence of numbness of lower extremities in a 81-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Initial information was received on 26 February 2020 via Medical record. As per medical record the patient had historical condition included spin problems and alcohol use. The patient administered shingrix vaccine on 8 May 2018. She said 1 week after getting a single sought on 19 May 2018 she developed numbness in her entire leg. On 29 May 2018 the patient visited for follow up on 29 May 23018 and patient had decreased sensation of lower extremity. The patient had numbness in her entire leg. The patient had hyperesthesia. The patient was hospitalized for Lower left extremity Numbness patient was admitted on 19 May 2018 and discharged on 21 May 2018 with diagnosis of hyperesthesia, along with decreased vibratory temperature and pinprick sensation anteriorly to T8 and posteriorly lo L3 with mildly symmetrically diminished reflexes in the lower extremities but without weakness. The patient ha d left leg numbness on 26 October 2018. Also the patient had spine problems.This was felt to represent a possible mild transverse myelitis, albeit atypical. The patient states that it started as numbness, pins and needles in her left foot and then ascended to just under her left breast. The patient does have some decreased sensation in the left lower extremity anteriorly and posteriorly. Other physician suggested that the numbness was from a shingles shot because that would be more of a peripheral nerve and there are 3 nerves that supply sensation to the leg.More likely she had a small stroke that is just not showing up on imaging studies While hopping the patient had little bit of difficulty as per discharge summery of 12 June 2018. X-ray LT toe or toes on 26 June 2019 for pain in left toe and it revealed Mild degenerative changes are seen at the interphalangeal joint with mild to moderate degeneration at the first MTP.MRI of cervical spine W/O contrast done on 13 December 2018 and it revealed Disc osteophyte complex and ligamentous buckling results in moderate central spinal stenosis and flattening of the spinal cord. Disc degeneration is moderate at C4-C5 and C5-C6 and mild in the remaining cervical spine. At C5-C6, moderate central spinal stenosis. Moderate-to-severe bilateral neural foraminal and narrowing. At C6-C7, mild right and moderate to severe left neural foraminal narrowing. At C7-Tl, mild bilateral neural foraminal narrowing. C2-C3: Shallow disc osteophyte complex. C3-C4: Disc osteophyte complex and ligamentous buckling results in mild central spinal stenosis and flattening of the dorsal spinal cord. Left-sided uncovertebral joint spondylosis and facet joint arthropathy. Mild to moderate left neural foraminal narrowing.EMG done on 13 November 2018 was normal.      Lab Comments: Xray LT toe or toes on 26 June 2019 for pain in left toe and it revealed Mild degenerative changes are seen at the interphalangeal joint with mild to moderate degeneration at the first MTP.MRI of cervical spine W/O contrast done on 13 December 2018 and it revealed Disc osteophyte complex and ligamentous buckling results in moderate central spinal stenosis and flattening of the spinal cord. Disc degeneration is moderate at C4-C5 and C5-C6 and mild in the remaining cervical spine. At C5-C6, moderate central spinal stenosis. Moderate-to-severe bilateral neural foraminal and narrowing. At C6-C7, mild right and moderate to severe left neural foraminal narrowing. At C7-Tl, mild bilateral neural foraminal narrowing. C2-C3: Shallow disc osteophyte complex. C3-C4: Disc osteophyte complex and ligamentous buckling results in mild central spinal stenosis and flattening of the dorsal spinal cord. Left-sided uncovertebral joint spondylosis and facet joint arthropathy. Mild to moderate left neural foraminal narrowing. EMG done on 13 November 2018 was normal.