Age: 37.0
Sex: M
Vaccine: ANTH
Symptoms: Paralysis
Clinical narrative: Bells Palsy after 3rd AVA shot in 2003. Chest pain/palpitations after SMPX vaccination 2/20/2003. Immunization: Anthrax #3 Smallpox revac  Vaccine Date: 2/13/2003  2/20/03 Onset date: 6/30/2003  9/8/03 Symptoms: This 40 year old began the Anthrax series on 15 Jan 2003 with his second AVA given on 31 Jan 2003 without any reported adverse events. He received his third AVA vaccination on 13 Feb 2003 prior to being deployed 12 March 2003 for 88 days again with no reported adverse events.  He returned on June 18, 2003. On 20 Jun 2003 after a fun filled day with his family, his wife playfully "popped" him on the right side of the head prior to retiring that night. He reported awakening several hours later unable to move the right side of his face.  He stated his smile drooped; he could not raise his eyebrow or fully close his right eye with increased tear production. This tearing had begun 12-24 hours prior to the muscle paralysis.  He complained of a 6-7/10 dull headache from his right ear to forehead that lasted for an hour. He was able to return to sleep with resolution of the headache only. No medication was taken. He reported a history of chronic sinus problems and migraine-like headaches for "years"; however, this headache was not like any of his previous sinus or migraine-like headaches. He denied any visual disturbance, nausea, vomiting, paresthesia, weakness or loss of function to extremities, cervical pain, current illness, injury or trauma.  He reported removing a tick the day before with no known bite or visible rash. He was seen 20 Jun 03 and 30 Jun 03 by Family Practice with a diagnosis of Bells Palsy.  Laboratory tests included a normal CBC and negative Lyme's titer.  He was placed on tapering dose of prednisone (80/80/60/60/40/30/20) and acyclovir 1000 mg daily for 5 days without resolution. He stated the Bells Palsy lasted for approximately 60 days before resolving without reoccurrence. He was evaluated for "hirsuitism and back skin tag removal" by Dr July-Aug 03 with no mention of Bells Palsy. His PRT screening 26 Aug 03 reported no active problems while completing lipid panel evaluation for hypertriglyceridemia. While deployed (Mar-Jun 03) he complained of "skipping sensations" with reoccurrence approximately 08 Sept 2004. (There are no medical records available for review; however 05 Oct 2004 eval by Dr noted c/o 3-4 month of palpitations while deployed.) He felt as if his heart was skipping with associated shortness of breath and lightheadedness during the "skipping".  He described the feeling as a fullness then a thud followed by rapid skipping for 10 beats lasting 2 minutes to 4 hours.  Position and activity did not affect his discomfort. He stated running actually made him feel better yet he could not climb stairs due to the shortness of breath and lightheadedness. He sought medical treatment at a fleet hospital where he was sent for a complete cardiac evaluation. He continued experiencing reoccurring discomfort three times a month for 5-10 minutes and followed up with Medical Center cardiology.  A holter monitor 24 Sept 04 for "fullness in the left side/chest and a pause in heartbeat with a thud" showed unifocal PVC and PACs; 9 Sept 2004 echocardiogram was normal with 60% EF. He was diagnosed with benign ventricular ectopy and placed on beta blockers. His past medical history documented "cardiac" problems on 30 October 2002 with a diagnosis of "esophagitis, esophageal spasm, r/o reflux" which was treated with Zantac. He followed up with cardiologist in Jan 2005 for a "9+ months" history of daily palpitations. A repeat stress echo was normal with 60% EF and his EKG showed sinus bradycardia-normal sinus rhythm with no evidence of cardiovascular disease. His Toprol XL was weaned and stopped. As of this interview he reports no reoccurrence of Bells palsy or palpitations. He continues treatment for hypertension and hypertriglyceridemia.