Age: 21.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Ultrasound Doppler normal, Vaccination complication, Vasculitis cerebral, Visual evoked potentials normal, Visual impairment
Clinical narrative: Please note all dates are approximate as patient has memory issues since the administration of the HPV vaccine. Around 7/16/09 after being seen by Dr. she received the first of the series of the GARDASIL vaccine. Later that week, she reported right foot numbness to me. As she did not have health insurance, she continued to work and ignore it. Eventually about couple weeks, even though it did not subside, she learned to walk with it this way. Approximate 8/2/09 she woke up with a terrible headache and her vision was affected. She went to work on 8/3- and found it impossible, not seeing people peripherally and stumbling on things on or around the floor, as well as not seeing the cash register completely. I, as well as her boyfriend convinced her to go seek medical treatment. She went to a clinic and was seen by an eye doctor who after examination sent her immediately to emergency room. She was admitted there 8/4 to 8/11/09. They told her that her MRI showed a patchy small lesion on her left brain, possible indicating MS and that her spinal tap showed one or two Oligo bands. She was given steroids and sent home. She had to give up her apartment and move in with her boyfriend who lives in a duplex upstairs from his parents. The steroids caused a horrible reaction as well, steroid psychosis. On 10/20/09 she awoke in the middle of the night/early am with a terrible burning/screaming pain and had left hemiparesis and her vision was much worse. She was admitted from 10/20/09 to 11/17/09. Visual evoke response test, carotid Doppler, spinal tap were normal but MRI showed complete white patchy areas over her entire right hemisphere of her brain. IV steroids induced psychosis and did NOT appear to help. HIV, Lyme tests were negative. Finally, plasmapheresis was given and she was sent for acute rehab from 11/17/09 to 12/08/09. She developed right foot drop during that admission. Her vision never returned to normal. She had spasms and was eventually able to walk with a brace on her left leg. She was given COPAXONE to take every day by the drug company and was eventually able to use her left arm a bit. She suffered terribly with depression, spasms/tremors and increased pain. Her speech and thoughts were affected. She could not sequence numbers or tell the days of the week. Her speech was slurry. It was difficult, but she did show some mild improvement and eventually could walk upstairs (observed) and with much help. She was now told by the neurology chairman that this was moving way too fast to be MS. She had shown major improvements but her MRI was increasingly getting worse and now leukoencephalopathy had increased from her right brain into her left. The head of neurology had no idea was caused all this. He now felt it wasn't MS but some sort of autoimmune response. He wanted her to consider having a brain biopsy done sometime soon. Turns out the MRI was an indicating factor. On 3/3/10 she awoke with her right arm paralyzed and was again taken to hospital and admitted. She had actually been able to walk into the ER with a brace and assistance but by admission to the floor she was spasming constantly and uncontrollably on her left side. After admission, she was paralyzed completely on the right side (and basically left side except for spasms). She was in constant pain and left suffering without anything seemingly to help the spasms and pain. In addition, she was having dystonia. On 3/11/10 she underwent a brain biopsy with removal of bone flap. This was done in an ancient fashion I found out later. They were afraid she might have something contagious and therefore had to use older autoclaved items without mapping her brain. Pain meds had to be withheld as she had coded shortly after the surgery in the neuro ICU. Several weeks later, the electron microscope results from IAC were negative along with the brain biopsy. Cadasil results were negative. They did NOT replace her bone flap! She was given more treatments of high steroids, which again did not help. She was given plasmapheresis and also some IV chemotherapy. Approximately 3/31/10, she was sent for acute rehab. She was discharged home 4/10/10 but this time her progress was very, very slow. Last I heard the head of neurology now may think she may have progressive MS or cerebral vasculitis. His thoughts were for admission to hospital every other month and given chemo for up to two years along with steroids. She had lived a completely normal life until that vaccine and now her life is in shambles. I do NOT wish to return to that hospital ever again and want answers. A therapist who looked into her case AFTER she was discharged this last time asked me about the GARDASIL vaccine. That was when things started falling into place about why this may have happened to her. Now she needs answers on what to do for this condition. She didn't have health insurance for 2 more years, but did have the state medical card. Constant PT and OT are recommended but after little to no improvements are shown, they discharge her which leaves her body contracting more and more. I am disabled myself and finally had to bring her to another state and into a nursing home in order for her to go to the university and get health insurance. She now lives just a few miles by me as she has to have a constant caregiver/companion to cook, clean, help her to the bathroom, wash, etc. She requires complete care and mentally is very upset as she loved her independence and hated to move back and have mom take care of her! They still can't pinpoint a name or diagnosis but the closest seems to be cerebral vasculitis. Several physicians say the vaccine could have caused this type of reaction. We have an attorney on her vaccine case at this time. Should you need info - aka medical records etc you may contact him or me.