This case was reported by a healthcare professional and described the occurrence of burning sensation injection site in a 44 year old female subject who was vaccinated with hepatitis B vaccine recombinant Engerix B, plus a separate injection of tetanus and diphtheria toxoids absorbed. Medical history included sulfa allergy. The reporter stated that in 2003, the subject had a reaction to Septocaine where she had burning, pain and swelling in her face and on the right side of her body. She has a history of complex regional pain syndrome that they believe is a result of this reaction. Concurrent medications included Vicodin, Gabapentin Neurotin, and Amitriptyline. On 8/30/2005 the subject received 1st dose of Engerix B in the right deltoid and a separate injection of tetanus diphtheria toxoids absorbed lot U1208CA in the left deltoid. On 8/30/2005, the subject also received a tuberculin TB skin test, unknown manufacturer, at an unspecified site of administration. On 8/30/2005, immediately after vaccination with Engerix B and tetanus diphtheria toxoids absorbed, the subject experienced burning sensation at an unspecified injection site. The reporter stated that, the burning sensation slowly progressed into limited mobility, pain and weakness of the right side of the body. She is wheelchair bound. The subject was seen at a physicians office. The healthcare professional stated that the physician considered the vaccine to cause the subjects complex regional pain syndrome to worsen. The healthcare professional considered the events were disabling. At the time of initial reporting, 5/3/2006, the outcome of the burning sensation at injection site was not reported, the mobility had improved, the pain, and weakness of the right side of the body and the worsening complex regional pain syndrome were ongoing. The healthcare professional considered the events were probably related to vaccination with Engerix B and tetanus diphtheria vaccine. Follow-up: On 10/4/2004, a pre-existing condition of-Trigeminal Neuralgia definitely a neuritis- was diagnosed. The trigeminal nerve is a facial nerve. I've had chronic facial mouth pain since a Septocaine reaction dental procedure on 12/9/03. I'm allergic to sulfurs and its compounds. The bone still has not healed properly. After the immunizations, this condition was aggravated and symptoms spread immediately to head, neck and right arm. AFTER THE VACCINES: Symptoms began with headaches that increased in severity. Also, sore arm with scab rash at injection site, fatigue, etc. The tetanus shot hurt, but the Hep B shot burned badly while the nurse injected it. I told her 3x how much it hurt. I had to sit for 5-10 min after the vaccines b/c I was lightheaded. I went home and lay down during lunch. When I went back to work I wasn't able to perform my regular duties and another teacher covered for me. That was just the beginning of the conditions continuing to worsen. Lab tests also show impaired liver function and other body function impairments. I also have photophobia and sensitivity to sound. Doctors document nerve damage down right side of body after the vaccines. I'm in constant chronic pain, bedridden and must use a wheelchair with leg elevator, etc. for anything more than very brief walking in house with cane. There are more symptoms, etc. AFTER THE VACCINES, CRPS WAS DIAGNOSED. Please see the attached medical reports from treating physician that clearly show the pre-existing condition and the NEW DIAGNOSIS AFTER VACCINES OF COMPLEX REGIONAL PAIN SYNDROME. Again, hospital incorrectly records that ...history of crps... and that the vaccines caused patient worsening symptoms of crps and the overall worsening of the crps. NO MATTER HOW MANY TIMES THEY SAY IT, THE FACTS ARE THAT THERE WAS NO CRPS PRIOR TO THE VACCINES. THE VACCINE RESULTED IN CRPS. It states a test report could be obtained from another provider. I am enclosing the results and information on this test with the government fact sheet explaining what the lab test is for. The test is for sulfide exposure and checks for exposure to Hydrogen Sulfide, a toxic gas. Within 12 hours prior to receiving the test. This test shows I was not exposed to Hydrogen Sulfide within 12 hours. The doctor had ordered a sulfide allergy test, but there isn't one. The lab incorrectly tested me for sulfide exposure. The test is irrelevant to the SULFATE exposures in the vaccines. And she had burning pain during the injection... I was swollen 9 days (FACE ONLY) and could not open my mouth 1/4". I've had chronic facial and mouth pain ever since. I was in a period of recovery when I received the vaccinations that aggravated the diagnosed pre-exiting trigeminal neuralgia condition. There was no right side body involvement after the Septocaine. Proof of this are the physical exams given my hospital that show full range of motion and also my grip strength. There are also lab tests which show body functions were within normal range before receiving the vaccinations. The nerve damage down the right side of body was a direct result of the vaccines received on 8/3/05 from hospital. CORRECT DIAGNOSIS: Pre-existing: Trigeminal Neuralgia (facial only) was diagnosed 2004 before vaccines. Current: Complex Regional Pain Syndrome was diagnosed 9/12/09 after vaccines. Allergy to sulfurs and its compounds diagnosed 2006.