Age: 63.0
Sex: F
Vaccine: FLU3
Symptoms: Asthenia, Computerised tomogram normal, Dysphagia, Guillain-Barre syndrome, Paraesthesia
Clinical narrative: Generalized symmetrical weakness with peripheral paresthesia leading to dysphagia and compromised respiratory status. DX Guillain Barre, acute.  02/15/07-Records received with VAERS report for a 2 day hospital stay for pt. c/o progressive weakness, numbness and tingling in fingers and feet.  She progressed to being unable to feed herself, transfer in  bed or ambulate.  PE: WNL except Muscle strength decreased. Grip stength decreased. Unable to lift arms greater than 45'. Discharge DX: Generalized symmetrical weakness with peripheral paresthesias presumed to be due to acute Guillain Barre Syndrome.  Transfered to another facility for management and neuro. consult. 3/31/2010 Follow up: Making steady slow progess. I am writing to you regarding patient, who has previousl been a patient. By way of summary, I saw patient at hospital as an inpatient in December of 2006, she was suffereing from progressive weakness of muscles. I diagnosed her as having Guillian Barre syndrome and she was subsequently transferred for continued care. She had a rather stormy and difficult course while she was there, but ultimately was transferred back for nursing home rehabilitation with, as I understanding it, the plan to return to the move aggressive inpatient physical therapy program. Patient has made really quite significant progress since returning to care center. I know that she was evaluated perhaps a month or six weeks ago and felt to not have made enough progress at that time to participate in the comprehensive inpatient program. I do feel that she has now continued to make excellent progress. She has reached the point now where she can be in a regular wheelchair all day, she can position herself independently from side-to-side, iss able to do forward, backward movements independently. She can get her feet on and off the foot pedals independently, can move the foot rest out of the way on her ownn. She has independent wheelchair mobility throughout the nursing home facility. She has now full active range of motion in all lower extremity motions except for straight leg raises and diminished dorsiflexor strength. She transfers via an EZ-stand and can transfer in physical therapy with moderate assistance of one and uses her platform front wheeled walker. She can sit and stand with just mild assistance. She tolerates intensive physical therapy for 60-90 minutes and the physical therapist feels she could tolerate more, but staffing limits at the home limits her to shorter sessions twice a day. She walk with a platform front wheeled walker, minimal assistance of two. She has bilateral ankle/foot orthotics. She can cover distances of 20-30 feet before resting. She ahs some problems with foot control and decreased proprioception. She has some difficulty with knee hyperextension, but is making steady progress. The patient's speech has made significant progress, she is now easy to understand with a fairly normal speech pattern. This contrasts to January when she could only tolerate a reclining Geri-chair for short periods of time, she got dizzy when she sat up, she had very little active movement in any joints. She was totally dependent on transfers and was generally extremely fatigued. She was unable to do any weight bearing. We are very interested in getting her involved in a more aggressive and complete therapy setting and would very much like to see her admitted to your comprehensive inpatient therapy program. At this point, the patient is very highly motivated and is very anxious to become more involved in rehabilitative therapy. We feel she has made excellent progress and will continue to make super progress.