Age: 13.0
Sex: M
Vaccine: FLUN(H1N1)
Symptoms: Contraindication to vaccination, Dry eye, Eyelid function disorder, Hypoaesthesia facial, Hypoaesthesia oral
Clinical narrative: A spontaneous report of serious event of Bell's palsy presented with symptoms of tongue felt strange within mouth, strange feeling of the left-side of face, the child's left eyelid would not close all the way, left nasal fold, the left cheek and the left-side of lips did not move when he tried to smile, could not move left cheek, could not blow air out from mouth and had difficulty feeling tongue, dry feeling in the eye, neck discomfort and non-serious events of H1N1 LAIV administered to the patient having asthma and difficult for him to sleep was received from a physician, concerning her 13-year-old son, subsequent to H1N1, Intranasal. The patient has medical history of sports related injuries (fracture wrist, avulsion rectus femoris tendon of the right leg), chicken pox, herpetic whitlow of his fingers (twice) and asthma. The patient did not receive any other vaccinations or medications within four weeks prior to MedImmune Vaccine. The patient was not on any concomitant medications. On 18-Nov-2009, the patient received H1N1, Intranasal for an unknown indication. On approximately 02-Dec-2009, the patient complained of neck discomfort. His mother thought this was a sports injury and she iced his neck. The following night, on approximately 03-Dec-2009, the child noted that his tongue was beginning to bother him; this was described later by the patient as his tongue felt strange within his mouth and this made it difficult for him to sleep that night. On 04-Dec-2009, the patient complained to school nurse about strange feeling of his tongue and a strange feeling of the left-side of his face. The school nurse reported that the patient could not move his left cheek, could not blow air out from his mouth and had difficulty feeling his tongue. At the physician's office, the child's left eyelid was not closing all the way, his left nasal fold and the left cheek and the left-side of his lips did not move when he tried to smile. On 04-Dec-2009, the patient's pediatrician made a definitive diagnosis of Bell's palsy. At that time, the mother reported that she realized that her son's neck discomfort from two days prior was a prodromal stage for the Bell's Palsy. On 04-Dec-2009, the pediatrician started the treatment with an oral methylprednisolone 5 mg once daily in morning for five days and oral doxycycline 100 mg once daily for five days. At that time, there were no antiviral drugs prescribed nor any testing was done. The child started having dry feeling in his eye for which an ophthalmologist prescribed eye gels and artificial tears at night, but no taping was required or prescribed. At the time of report on 11-Jan-2010, the child's Bell's Palsy was 95% resolved and this was described as the child can smile, his tongue no longer has a strange feeling and the left eye can almost close fully. At the time of report on 29-Jan-2010, the patient continued to improve everyday, he was not 100% recovered, but he was very-very close to it. The event of sleeping difficulty was resolved within one week of its onset. The patient was doing very well, and had no current or new problems. The outcome of the Bell's palsy was resolving while that of vaccination error and difficulty in sleep was resolved at the time of report. Additional information was received on 11-Jan-2010 and incorporated into the narrative: past medical history, concomitant medication, non-serious adverse events of 'H1N1 LAIV administered to the patient having asthma' and 'difficulty for him to sleep' were added, outcome of the reported adverse event and treatment given. Additional information was received on 29-Jan-2010 and incorporated into the narrative: the outcome of the event.