Age: 0.17
Sex: M
Vaccine: DTAP, RV5
Symptoms: Facial paralysis, Facial paresis, Herpes simplex test negative, Speech disorder developmental, Strabismus
Clinical narrative: Patient began showing abnormal symptoms around 10 days after vaccination. Face became swollen and asymmetrically misshapen. When swelling subsided, the left eyelid and left side of mouth revealed drooping and lack of movement compared to the right side of the face. Patient was diagnosed with cranial nerve palsy of the 7th cranial nerve at the next doctor's visit, around 30 days after vaccination. Patient was eventually referred to the following specialists: neurology, neurological ophthalmologist, allergy and immunology, infectious disease specialist, audiology, physical therapy and occupational therapy. The neurological ophthalmologist diagnosed 7th cranial nerve palsy.   Outcomes of specialists: Neurology: Neurologist identified DTaP as a possible cause of the cranial nerve palsies / facial palsy. She identified other common causes of facial palsy (specific virus) and ruled  out by lab testing (negative for current or past infection). Explained that molecular mimicry caused the body to attack itself as a protein in the myelin "looks too similar" to  some vaccine component(s). The body is having an immune response, which is what we want from vaccines, but the response is too strong and is targeting the patient's own myelin covering the nerves (6th and 7th cranial nerves). Neurologist cited around 1/3 of patients will make a full recover of facial palsy, 1/3 will not improve/recover at all, and 1/3 will recover somewhat, but not completely. Recovery can be expected within 12 months of onset of palsy, but beyond 12 months, any remaining damage can be expected to be permanent.   Neurological Ophthalmologist: Identified DTaP and possible / likely cause of eye crossing, nerve palsies. Vision is worse in the left eye than the right eye. Left eye crossing and 7th cranial nerve palsy diagnosed. Neuralgia of 7th cranial nerve and Esotropia, intermittent, monocular. Strabismus.  Allergy and Immunology: Identified DTaP as likely cause of facial/cranial nerve palsies / Bell's palsy. Explained that they could not know if it was one of the disease components (tetanus, diphtheria, or pertussis) or one of the other adjuvant components that is causing the palsies. Could not identify if other vaccines would also cause palsies if they have the same adjuvant components.   Infectious Disease Specialist: Referred  to VAERS reports to identify other similar cases. Difficulty analyzing reports or identifying trends given the many different terms associated with these conditions.   Physical Therapy: Weakness in the left cheek noted.  Occupational Therapy: Weakness in left cheek confirmed. Liquids dribbled from left side of mouth. Ongoing occupational therapy for difficulty eating.   Acupuncturist: Recently (nearly 2 years post reaction) patient has seen some positive results from a Bell's palsy specific protocol with an acupuncturist, although some damage remains.   Pediatrician recently diagnosed a speech delay.   Patient is now 2 years old and still suffers Bell's palsy visible in his mouth on the left side and has delayed speech and eating issues.   Various VAERS reports with similar conditions use the following keywords: facial nerve palsy, VII cranial nerve palsy, VI cranial nerve palsy, facial palsy, neuralgia of the 7th cranial nerve, facial paralysis, strabismus, esotropia, facial asymmetry, Bell's palsy, facial nerve disorder, facial neuralgia, facial paresis. This has made analyzing similar reports difficult.