Sex: U
Vaccine: FLUX
Symptoms: Acute motor-sensory axonal neuropathy, CSF cell count increased, CSF protein increased, Electroencephalogram normal, Electromyogram abnormal
Clinical narrative: This case was reported in a literature article and described the occurrence of acute motor-sensory axonal neuropathy in a patient who received Flu unspecified (Influenza vaccine) for prophylaxis. On an unknown date, the patient received Influenza vaccine at an unknown dose. On an unknown date, 7 days after receiving Influenza vaccine, the patient experienced acute motor-sensory axonal neuropathy (serious criteria hospitalization and GSK medically significant), guillain barre syndrome (serious criteria hospitalization and GSK medically significant) and pleocytosis (serious criteria hospitalization). The patient was treated with immunoglobulins nos (Immunoglobulin). On an unknown date, the outcome of the acute motor-sensory axonal neuropathy, guillain barre syndrome and pleocytosis were recovering/resolving. The reporter considered the acute motor-sensory axonal neuropathy, guillain barre syndrome and pleocytosis to be possibly related to Influenza vaccine. Additional information was provided. This case was reported in a literature article and described the occurrence of rapidly progressive fulminant acute motor-sensory axonal neuropathy (AMSAN) in a patient of unspecified age and gender who was vaccinated with unspecified influenza vaccine (manufacturer unknown) for prophylaxis. No information on patient's medical history or family history or concomitant medication or concurrent condition was provided. On an unspecified date, the patient had received unspecified influenza vaccine (administration route and site unspecified; dosage unknown; batch number not provided). The age of vaccination was not provided. On an unspecified date, 1 week after vaccination, the patient developed symptoms of fulminant AMS. Subsequently, within 24 hours of symptoms onset, the patient presented to hospital. On presentation, nerve conduction study and electromyogram confirmed the diagnosis of AMSAN (1 of the classification of Guillain-Barre Syndrome (GBS) based on clinical and electrophysiological findings). The patient was hospitalised. The patient required intubation and mechanical ventilation, with loss of all brain stem reflexes within 36 hours of symptoms onset, mimicking brain death. The fulminant AMSAN rapidly progressed. The patient's electroencephalogram was performed, and it consistently showed the presence of cortical brain activity and excluded brain death. Initially, the cerebrospinal fluid had a atypical presentation with polymorphonuclear pleocytosis. 2 weeks later, the repeated lumbar puncture was consistent with cytoalbumin dissociation. This case has been considered as serious due to hospitalisation. The patient was treated with 2 courses of intravenous immunoglobulin treatment.  The process of recovery was unique in terms of gaining back the head and neck movement, while the brain stem reflexes remained absent. The author stated, "This case also confronted us with a questionable correlation between the recent influenza vaccination (one week prior to onset) and developing the fulminant GBS."  Lab Comments: Lab tests were performed on an unspecified date. Nerve conduction study and electromyogram confirmed the diagnosis of rapidly progressive fulminant acute motor-sensory axonal neuropathy AMSAN (1 of the classification of Guillain-Barre Syndrome (GBS) based on clinical and electrophysiological findings). The patient's electroencephalogram was performed, and it consistently showed the presence of cortical brain activity and excluded brain death. Initially, the cerebrospinal fluid had a atypical presentation with polymorphonuclear pleocytosis. 2 weeks later, the repeated lumbar puncture was consistent with cytoalbumin dissociation.