Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Alanine aminotransferase normal, Anion gap decreased, Anti-cyclic citrullinated peptide antibody negative, Antinuclear antibody, Antinuclear antibody negative
Clinical narrative: The first abnormal effect I experienced was numbness in my inner upper lip. This was intermittent and lasted roughly 24-48 hours after vaccine administration. Then on 3/25, I had muscle cramping/soreness in my lower leg muscles (calves). The next day (3/26), the muscle soreness continued, and my lower leg muscles began to feel tight when walking. On 3/27, I woke up with numbness and tingling in my right 5th digit, which then spread to all my fingers and toes.  That morning, the muscle soreness had also spread into my thighs and bilateral upper extremities. I also noted mild swelling in my hands and feet and could not put my rings on or wear socks or shoes. By that evening, walking became more difficult as the muscle soreness had now turned into muscle weakness. This prompted me to go the ER for evaluation. A CT scan of my head and lab work was done. I was given IV fluids and sent home with instructions to return to the ER the following day for a MRI of my brain. Overnight, the weakness and swelling in my hands and feet progressed . I became unable to walk, go to the bathroom, or feed my self without assistance. The numbness and tingling I first experienced in my inner upper lip returned, and these symptoms were also now noted in the rest of my face as well. I also began having muscle soreness in my neck, my jaw felt sore when chewing food, and I began seeing some floaters. I returned to the ER the morning of 3/28.  They did more blood work, imaging, as well as a lumbar puncture, and I was admitted to hospital. Once admitted, the hospitalist consulted with another hospital and recommended transfer by EMS there where I was admitted under a neurologist's care. When I arrived at that hospital, I began to feel somewhat better as the soreness and swelling appeared to be improving, and I could walk without assistance. They did a full neurological workup and kept me overnight for observation. Overnight, I did experience a mild headache that was relieved with Tylenol and rest.  I woke up the next morning  (3/29) with nausea and did have a few episodes of vomiting that turned into dry heaving and was given Zofran with relief. The swelling in my hand went down enough that I was able to make a fist and grasp objects with my fingers again. After the neurologist reviewed my labs and work up the morning of 3/29, I was allowed to return home to await final test results as all my tests were looking normal, my symptoms were continuing to improve, and PT had cleared me to be able to return home. Upon discharge, I was instructed  to not get my 2nd COVID vaccination as it was possible that my symptoms were an adverse reaction to the COVID vaccination as no  other diagnosis was found with testing. I was instructed to follow up with my PCP in one week. Since returning home, I have continued to be very easily fatigued and have had some headaches, nausea, and dizziness. I continue to feel weak when walking and have some muscle stiffness when first waking from sleep. I also continue to have some intermittent episodes of numbness and tingling.