Age: 70.0
Sex: M
Vaccine: VARZOS
Symptoms: Muscular weakness, Neurological examination abnormal, Nuclear magnetic resonance imaging normal, Paraesthesia, Paralysis
Clinical narrative: Information has been received from a physician concerning a 70 year old male with hypertension, alcohol use but not abusive, "reflux" and "iodine reaction (contrast dye) as an adolescent" and a history of right sided pain a few months prior, thoracic spine injury in 1993 and spinal fusion in 1993 who on approximately 05-DEC-2007 was vaccinated with a dose of ZOSTAVAX.  An orthopedic physician reported that the patient was referred to him as a second option after experiencing an adverse event following vaccination with ZOSTAVAX.  The onset date was reported as approximately 27-DEC-2007.  Initially, the patient began to experience a tingling sensation of his arms and legs.  A few days later, he became acutely paraplegic.  The patient was hospitalized and was seen by a neurosurgeon.  It was reported that a MRI was done but no hematoma was found; however, the patient's spinal implants interfered with the MRI.  He was treated with fluids and steroid protocols.  The orthopedic physician could not find anything that would explain the patient's symptoms.  At the time of the report, the patient had improved approximately 50%.  No rash was involved.  Outcome was reported as recovering.  There was no product quality complaint.  Tingling sensation of arms and legs and acutely paraplegic were considered disabling.  In follow-up information received from the physician, it was reported that he was "secondary consult".  He reported that within three weeks of receiving ZOSTAVAX, the patient became "acutely paraplegic".  He stated, "Is it related to ZOSTAVAX?  I don't know.  It is a very serious AE."  He reported that the patient has had a 50% recovery in motor/sensory loss, but "has a long way to go".  He reported that he has given a couple of potential differential diagnoses which they are working the patient up for including inflammatory dymyelinization condition or spinal cord stroke.  Further follow-up information was received from the patient's primary physician.  He reported that the patient was seen in the clinic and was still using a wheelchair.  Most of his symptoms were subsiding.  He is recovering.  The patient's symptoms included acute muscle weakness in the lower extremities, semi-paralysis.  The patient had "inability to walk", he fell down and was admitted to the hospital.  A spinal tap "did not show anything acute".  The patient had an MRI which was normal.  A complete neurological workup showed, "no specific findings but poly-neuritis".  The patient recently complained of right upper quadrant abdominal pain radiating to the back for which a CAT scan has been ordered.  That test has not yet been performed.  The physician was asked if he felt the patient's experience was related to ZOSTAVAX and he stated, "I have no idea".  He did state that the patient had "various sensitivities before the shot."  Which was not further specified.  The physician said that the patient's past medical history included chronic back pain and back fracture.  The patient had a Harrington Rod in his back.  Additional information has been requested. 3/10/08-records received-C/O severe back pain on 12/24/07-seen in ED Developed bilateral tingling and swelling with left leg weakness, fell times 3. Impression peripheral edema probably secondary to salt in diet and prolonged sitting in recliner due to back pain.