Age: 1.28
Sex: F
Vaccine: MMR
Symptoms: Convulsion, Erythema, Muscle spasms, Oral intake reduced, Pyrexia
Clinical narrative: Received the MMR shot on May 2, 2006.  At the time of the shot she had some fluid in her ears but they did not appear infected.  When she woke up from her nap on the after noon of May 5, 2006 she had a fever (101.5o F).  I gave her Tylenol.  Shortly there after she began to have spasms in her right arm.  I noticed the first one when she reached for a pack of diapers next to her on the couch and her arm snapped back like her fingers had slipped off the package as she tried to pull it toward her.  It seemed like and odd movement to me.  I had never seen her move like that.  I then picked her up and held her.  As I did so she had more spasms.  They seemed to be more in her right arm than the rest of the body.  The episode lasted a few minutes and I took her to her pediatrician's office.    The conclusion of thew doctor was that she had a reaction to the MMR shot.  (She received the vaccine in her right arm).  He said it was unusual but didn't concern either of us much at the time.  Her ears were slightly more red so he prescribed amoxicillin for the ear infection.  We began giving her the antibiotic the evening of May 5, 2006.  She continued to have a low fever all day Saturday, May 6 (approx. 100o F).  That evening we had dinner with my parents and forgot to bring Tylenol with us but were not concerned since she was feeling better and her fever was low.  She ate very little dinner which was unusual because she is a good eater.  We put her to bed at approximately 8pm.  We got ready for bed at approximately 11pm and she fussed which is not unusual.  I checked on her and she felt warm but not hot.  After soothing her she when back to sleep.  An hour later she was awake, which was also unusual and we decided to bring her into our room for the night.  When I picked her up all her limbs were spasming. She was frightened by the movements and cried when they occurred.  They were not rhythmic or constant but they were ongoing.  We decided to bring her to the ER after a short delay.  Her fever was 103o F.   In the ER they gave her Tylenol.  The conclusion was that she had an atypical seizure.  The pediatric residents were in contact with the doctor and in agreement that it was safe to go home.  We kept her on fever reducers and saw the doctorthe next day.  He prescribed a second antibiotic. We gave her the full 10 day course and she stopped having a fever after several days.  She redeveloped a fever (100o F) on approximately May 12th.  The fever continued and the morning of May 14, 2006 she awoke with spasms again.  These spasms were primarily in her right arm again.  Her father stated that when he took her from her crib, he saw only her arm spasming.  When I held her, after administering Tylenol, she had fainter spasms in all extremities.  Her temperature was 101o F.    We saw the doctor the next day.   Her recommended we see a pediatric neurologist.     She has had a fever and woken from a nap and overnight sleep with a fever since this happened (an ear infection a week and a half later that was treated with Augmentin).  In neither instance did she have a spasm.    In all instances, the spasm stopped when the fever was controlled.  The first spasm which occurred immediately after the administration of Tylenol lasted approx. 5-10 minutes.  The other episodes lasted 15-20 minutes.