Age: 1.03
Sex: M
Vaccine: HBHEPB, MMR, PNC
Symptoms: Listless, Muscle twitching, Retching
Clinical narrative: At pt's 1 year well visit on Feb 7, 2005 he received his first MMR vaccine. Dr stated not to be surprised that if in 10 days he broke out in a rash and ran a fever. He said if that happened, it's no big deal. Give him Tylenol for the fever and send him to daycare as it was not contagious but only a side effect of the vaccine. On Tuesday, Feb 15, 2005 (8 days after pt's shots) at approx 9AM, I received a call at work from my daycare provider. I could tell by her voice she was alarmed and panicked. She said when pt first arrived he was acting normal and was on the floor playing with the other children. She then put him in the highchair to feed him breakfast, but he was not interested in eating. He did take one bite and then acted like he was going to vomit. She took him out of the highchair and said that wherever she put him and whatever position she put him in, that's where he stayed. She was very concerned as he was listless and unresponsive. His eyes were open, but he would only look to the right. She could not get him to turn his head straight and focus on her. He was not running a temp. We called Dr's office and had a conference call with the nurse. The daycare provider explained the symptoms to nurse and then nurse consulted with Dr. They told us there was a lot of flu going around and kids act differently when coming down with it, so just monitor him and let them know if anything changed. About a half hour later, I received another phone call from daycare provider. This time she stated pt's right arm and right leg were twitching/jerking. She said if this were her kid she would be taking him to the doctor. I called Dr's office back again and was informed they had no openings for pt to be seen until 2:40 that afternoon. They told me if I felt that situation was truly an emergency, I should take pt to the emergency room. I called daycare provider back to let her know I would be by to get pt to take him to ER. At that point, daycare provider indicated that pt had fallen asleep and the jerking of his arm and leg had stopped. She stated that she would call me in a little while after pt woke up. At approx 10AM, daycare provider called back and said that pt woke up, drank a 9 oz bottle, and was on the floor playing with the other kids like nothing had ever happened. He was acting totally normal. The entire episode lasted approx 1 hr.  On Sat, Feb 19, 2005 (12 days after shots), at approx 8:30AM I was in Pt's room putting his laundry away. Pt was sitting on the bedroom floor playing with is toys. I happened to look over at him and he was sitting on the floor looking up towards the ceiling to the right. I wondered what was so interesting on the ceiling that had caught his attention so intensely. I then noticed that both of his eyes/pupils were to the far right. I said his name but I received no response. He just continued to stare up to the ceiling to his right. I then said his name a second time a little more stern. Still no response. I snapped my fingers and still no response. He then tried to crawl over to me. While crawling his head remained up and to the right. He did not look straight ahead while he was crawling to see where he was going. His crawl was very slow and off balance. When looking into his eyes, it was almost as if he was in some sort of a trance and he had the look of "no one was home", so to speak. It was at this point I realized something was wrong. I picked him up and ran downstairs. I called daycare provider to tell her what was happening and she confirmed that the symptoms I described closely mimicked what pt did with her the previous Tuesday. We took pt to the ER. I held him in my arms the entire time over there and he remained in the same position (head and eyes up and to the right) until he fell asleep. When we arrived at the hospital and I got out of the car with him, the cold air woke him up and he was then once again acting normal. This episode lasted approx 30-45 minutes and did not seem as severe as the episode he had at daycare provider the previous Tuesday. Saturday's episode he was able to somewhat crawl to me and he did not have any jerking of his limbs like he did the previous Tuesday. The ER doctor ran some blood tests and everything came back normal. He was not running a fever. Since pt was acting okay at this point, the only thing the ER doctor had to go off of was our description of his behavior. They diagnosed the incident as a seizure and told us to contact our pediatrician the following Monday to have them set up an EEG and CAT scan for patient. Both instances patient fell asleep and then woke up fine. The EEG was done at hospital on Thurs Feb 24th, and the CAT scan was performed at the same hospital on Friday Feb 25th. All tests came back normal. In doing research online regarding the MMR vaccine, I found that one of the moderate side effects of the shot is the possibility of febrile seizures (fever induced seizures) which could occur between the 8th and 14th day after the shot. Even though Pt did not run a fever during either episode, I found it quite interesting that these episodes occurred between the 8 and 14 day time period that they refer to when possible side effects could occur. Our pediatrician's office denies there is any connection between these seizures and the MMR vaccine, he has these problems and none since. He had a total of three shots at his one year well visit; two of which he had before with no adverse affects and the only new vaccine being the MMR. One other side note: Pt is adopted. He does have a half brother (same birth mother), but I have no idea if that child ever had a MMR vaccine or any similar problems with the vaccine.