Age: 28.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Fall, Fatigue, Hypokinesia, Influenza like illness, Irritability
Clinical narrative: Since coming home in March of 2004 I have been irritabile, forgetful, fatigue, sleep disorders. I was forced to get the Anthrax Vac and I had to get the Small Pox Vac to also include the long list of military shot we are requied to get annually and for travel.  I do not know all the shot I have recieved at this time.  In June of 2006 I came down with flu like conditions.  I had initally seen a Dr with the Clinic, the initial thought was it was just the flu.  This was on a Tuesday. I was given 48 hours off.  I felt alright other than having a low grade fever, throughout the next 48 hours I developed sores in my mouth, I went back to the Clinic on Friday that same week.  I was given magic mouth wash for my mouth and was told I just had the flu.  Friday night my vision started to get blurry.  Saturday I went to a cookout while I was at the cookout I started to see perfect double vision. (perfect!)  I had to shut one eye to drive home.  I feel asleep early that night about 6:30pm and sleep until 1000am the next day. (My wife had to wake me up) Sunday morning I felt a little better but I was still seeing perfect double vision.  I tried to pour a glass of water and broke the glass and then I dropped the water pitcher breaking that also.  My wife took me to Emergency RM.  While at the ER my condition got bad.  I started to lose movement on my right side.  My face drooped on the right side and I was slurring my speech.  The DR did a spinal tap and a MRI.  The initial feedback was I just came down with a severe case of MS and I was to follow up with the Neurologist in 4 days.  I was discharged from the hospital.  This brings us into Sunday night and Monday morning.  Sunday was horrible!! I felt like I had vertigo and was throwing up everywhere.  I told my wife where my will was (I do not remeber telling her anything or the events after) and proceeded down my hallway were I collapsed on the right side of the wall and lay motionless.  My wife called 911 and I was taken by ambulance to ER.  While in the ER I remember throwing up, seeing double and not being able to move any part of my body.  (the medical staff all around were outstanding) Monday I was diagnosed Acute Disseminated Encephalomyelitis commonly refered to as ADEM.  ADEM is a neurological disorder characterized by inlammation of the brain and spinal cord caused by damage to the myelin sheath.  The myelin sheath is the fatty covering, which acts as an insulator, on the nerve fibers in the brain.  ADEM may occur in association with a viral or bacterial infection as a complication of inoculation or vaccination without a preceding cause.  Onset of the disorder is sudden.  Symptoms, which vary among individuals may include headache, delirium, lethargy, coma, seizures, stiff neck, fever, ataxia, optic neuritis, transverse myelitis, vomiting and weight loss.  Other symptoms may include monoparesis (paralysis of a single limb) or hemiplegia (paralysis on one side of the body)  (I went paralyzed from the neck down.)  It has been a little more than a year since the events have happened.  I still suffer from memory loss (more short term) fatigue is a big problem.  I am currently taken a medication call PROVIGIL 200mg.  If I miss the medication it is a process for me to acomplish anything and or to stay focused on something.  I do not want to use it as a excuse.  I have to push myself everyday! Today was the first time since the recovery time that I could not even get out of bed.  I went to the DR and he gave me this contact infomation.  I have recieved so many shots since I have been in the military I cannot remember them all.  If needed I will request my shot records. 9/21/07-records received from neurology office for DOS 8/10/06-11/8/06-Impression:probably acute disseminated encephalomyelitis, improved. excessive fatigue either due to ADEM or viral in origin. In early June developed diplopia followed by nausea, vomting, confusion, numbness and weakness. Admitted to hospital on July 3, 2006.   9/21/07-records received from neurology office for DOS 8/10/06-11/8/06-Impression:probably acute disseminated encephalomyelitis, improved. excessive fatigue either due to ADEM or viral in origin. In early June developed diplopia followed by nausea, vomting, confusion, numbness and weakness. Admitted to hospital on July 3, 2006. MRI brain showed a midlin T2 hyperintensity in posterior pons in region of medial longitudinal fasiculus. Several small punctate hyperintensities were also seen in left frontal white matter. HX notable for febrile illness of temperature 102 for 3 days two weeks prior to onset of symptoms. Multiple ulcerations in buccal mucosa during febrile illness. CSF negative for oligoclonal bands and IGG index, 4 WBCs and 2 RBCs in spinal fluid and 100% lymphs. Repeat MRI of brain on 7/24/06 normal. 10/01-07-records received for DOS 7/3-7/5/06-DC DX: Disseminated encephalomyelitis, acute. Rule out Multiple sclerosis. HX of syncope. Presented with diploplia approximately 2 weeks previous when he had been on a training camp mission and had an insect bite, one week previous a febrile illness of some kind with blisters in mouth. Developed mild cough. MRI of brain showed lesions compatilble with demyelinating plaques and he was relased from ER but returned in 24 hours with persistent diplopia nausea and vomiting and some confusion and numbness.