Age: 41.0
Sex: F
Vaccine: FLU3
Symptoms: Nausea, Neurological symptom, Nuclear magnetic resonance imaging brain abnormal, Pain, Pain in extremity
Clinical narrative: On 12-12-12 at approximately 4:15pm, flu vaccination administered. Within the 1/2 hour, I started experiencing numbness and tingling in hands and feet, mostly on the right side and temporal lobe headaches bilateral, but stronger on the right side. I had experienced similar headaches (and general weakness with malaise) previous years since the 2009 H1N1 vaccination and each year since after getting the influenza vaccination. In 2011, my physician correlated the headaches (temporal lobe and severe occipital headache with an over active immune response and felt that taking BENADRYL before and then a few days after receiving the injection would reduce the symptoms. So, I followed through with this, by taking BENADRYL before and then for a few days after the 2012 vaccination. The headache this year initially seemed to be less severe than previous year, but was still feeling "out of sorts". On Saturday 12-15-12, headaches worsened and feeling very weak. On Monday evening, headache occipital to temporal area, very severe and could not lay still to sleep. Neck very tight. Feeling very agitated, restless with the headaches. Took BENADRYL and muscle relaxant, FLEXERIL, to relieve symptoms. Light sensitivity and tingling headaches in temporal lobes bilateral noted too. On Tuesday, continued having headaches, and tingling in hands and feet, more so on right than left, but present both sides. Flashing LED lights aggravated headaches and headaches worse as day progressed. On Wednesday, 12-19-12, went to urgent care and they treated headache with TORADOL injection to break the cycle in case it was a migraine. On 12-20-12, went to see Dr. and he completed myofascial treatment to loosen tight muscles in neck/back and administered another TORADOL injection to relieve the headache that had returned. On 12-21-12, I saw my PCP. She felt that I was having an inflammatory response causing headaches and started me on a MEDROL dose pack and prescription for TRAMADOL for pain. While on the dose pack continued to experience the temporal lobe headaches with snap crackle pop sensation or tingling sensation, but less frequent. Also experienced some nausea, poor balance and hearing changes bilateral, but this improved by the end of the dose pack. Pack ended 12-26-12. Late in day 12-27-12 noted increased headaches and numbness tingling in hands and feet, light sensitivity, sound sensitivity and word searching noted more frequently. On 12-28-12, had follow up visit with Dr. Discussed symptoms and she feels I may be having migraines. Discussed the possibility of a variant of GBS or an acute inflammatory response to flu vaccination. Will send to a neurologist if symptoms continue. Wants to hold on doing anything else at this point since symptoms improved with steroids. 12-29-12: I have been off steroids for a few days. Headaches continue and some blurriness of vision, changes in taste noted. On 12-30-12, note numbness and tingling which has been more prominent on right side, is also occurring on left side severely extending up arms and legs from hands and feet. Right side of body with burning pain, especially to touch or with showering...Feel a definite split in the left side and right side of head. Tingling right side face around eye and temporal area and decreased sensation to tongue and mandible area into lips. Tingling also noted in cheek and lips on right side. Headache on right side worse than left. 12-31-12: Gait more ataxic and more weakness. Feet with the feeling of being bruised. Right side and left side temporal headaches with tingling continue and ringing in ears bilateral. Symptoms affecting both sides and nausea noted. Now that it is Monday, Dr. notified. She ordered for an MRI to be completed. This completed 1-2-13. Results indicated an acute inflammatory process such as ADEM, and a mass was also noted in skull base. Symptoms continued with general weakness. On 1-4-13, Dr started me on prednisone (decreasing doses). She also referred me to neurosurgeon and neurologist. Also given Rx for ZOFRAN to treat nausea. On 1-15-13, saw neurosurgeon. He recommended a surgery for biopsy and tumor removal. Prednisone completed that AM. Only symptoms that still reside are mild bilateral headaches with tingling in temporal areas and mild tingling into right cheek an face. On 1-18-13, right. This also noted in biopsy (pathology) report indicating he removed cancer and chronologically inflamed sensory ganglion and spindle cells during my craniotomy. He wants me to follow-up with neurologist. On 2/28/13, after had healed some from craniotomy I saw neurologist and his resident physician and we discussed neurological symptoms after influenza vaccination and symptoms experienced since surgery. Initially discussed possibly doing a spinal tap, but then decided that since current symptoms primarily related to surgery and cancer, he wanted to hold on this. He did write a note to my PCP and my employer, recommending that I be exempt from the influenza vaccination since all the symptoms I experienced after flu shot, could not be tied to the chondrosarcoma. His plan is to follow up with me in 6 months and test further if symptoms should reoccur. For now he states that the influenza vaccination contributed nerve inflammation. He wants me to focus my energy on getting through the cancer treatments. Treatment, besides removal of the tumor, has been proton radiation. My oncologist is also recommending exemption from taking the flu shot in the future as my symptoms are not all correlated to the cancer. I have been undergoing proton radiation to control growth of cancer. This started May 5, 2013. Even though chondrosarcoma has not been tied directly to the influenza vaccination, Drs recommended that I share this with CDC since the only time I experienced any neurological symptoms, and trigeminal nerve headaches was after being vaccinated with the 2009 H1N1 and then the 2010, 2011 and 2012 influenza vaccination. I had talked to Drs previous years about my symptoms, but headaches and weakness initially not as severe and so initially Drs were unsure whether the influenza vaccination was a causative factor.