Age: 66.0
Sex: F
Vaccine: FLU3, FLU3, FLU3
Symptoms: Neuralgic amyotrophy, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pain, Paralysis
Clinical narrative: Initial unsolicited report received from a consumer on 13 June 2016. This case involves a 66-year-old female patient who was vaccinated with a dose of FLUZONE SV (batch number: U1836AA, expiry date, dose, site of administration were not reported) in the left deltoid on 21 October 2005. Patient's medical history included morphine allergy, disc herniation, syncope, dizziness, breast cyst reaction, scapular pain, hypothyroidism, parsonage turner syndrome, Hereditary brachial neuritis or neuralgic amyotrophy,chronic back pain and medical history included severe arm pain. Concomitant medications included lisinopril, Hydrochlorothiazide, thyroid supplements and aspirin. On an unspecified date in November 2005, following the vaccination after carpal tunnel syndrome, severe pain in left shoulder (intermittent pain in the left upper extremity and left scapular pain). On an unknown date following vaccination, the patient experienced numbness, tingling, muscle weakness, twitches, slurred speech, weakness of the left hand, Hereditary brachial neuritis or neuralgic amyotrophy, neuralgias, headache and dizziness, syncope and lost function of her left hand. Laboratory data included No acute intracranial abnormality, small vessel ischemic disease, tiny old lacunar infarct versus prominent perivascular space right basal ganglia region, blood pressure: 108/74. Cardiovascular: S1, S2 heard no gallops or murmur no bruits. Lungs: clear to Auscultation, no rhonchi and no rales. Abdomen: benign, no organomegaly. Extremities: no clubbing and no edema, pulse present. Neurological examination: Mental state: orientation, attention, comprehension and language are intact. Motor system: strength was 5/5 in all muscle group except for left wrist extensors which are 3/5, left finger extensor which 0/5, left wrist flexor which are 3 plus/5, left finger flexors which are 0/5, left grip which is 2/5 and left dorsal interossei which is 1/5. One was normal except for the left hand, which is decreased. No adventitious movements noted. Sensory system; sensation was intact to higher and lower sensory modalities bilaterally. Cerebellar: Limited on the left because of the weakness, but intact on the right side. Gait: Steady without any ataxia, good tandem walking, good heel walking and toe walking. Muscle stretch reflexes: 1 plus in left upper extremity, 2 plus in all the rest, equivocal plantar responses bilaterally. Patient's corrective treatment included aspirin, carisoprodol, naproxen, aspirin and hydrocodone. The outcome of the events was reported as not yet recovered. Numbness and pain in left shoulder were resolved on unspecified date. The outcome of event syncope was not reported. List of documents held by sender: none. Sender's Comments: Carpal tunnel syndrome, Monoparesis, Dysarthria, and Neuralgia unlisted for INFLUENZA USP TRIVAL A-B SUBVIRION VACCINE. Time to onset is compatible with the role of the vaccine. Further information for e.g investigative details. Patient has disability and hospitalized due to mentioned events. This document is not fully eligible. However, investigation results ruling out a concurrent infection and other etiologies would be helpful to further assess this case.