Initial unsolicited report received from a Nurse on 08-Dec-2017. This case involves a patient (age and gender was not reported at the time of reaction) who was vaccinated with a dose of FLUZONE QUADRIVALENT (Batch number, expiration date, dose, dose in series and route of administration were not reported) in left deltoid on 26-Oct-2017 at the end of our clinic work day. Patient's medical history and Concomitant medications were not reported. On 27-Oct-2017, reported as (about 12-13 hours) following the vaccination, the patient felt like possibly have a toothache and had a slightly sore shoulder, as the day progressed patient started having numbness on the left side of face in the jaw area and the muscle soreness in shoulder started to spread to left arm, left side of chest and abdomen. By the early afternoon, the whole left side of face was numb and had muscle soreness from the left side of my neck (just below my jawline) down to left knee. By later in the afternoon, patient was having difficulty taking a full inspiration because the patient felt like being squeezed on the left side of my chest and abdomen. It was reported that the patient had continued to have left-sided facial numbness for about one month. The patient had been to the dentist and it was confirmed that there were no issues with the teeth, despite this being the place where the pain typically settles. Currently, I have some days where there was no pain or numbness but continued to had episodes of either pain or numbness. At times, the pain was so severe that cannot eat or drink anything. As a matter of fact, the patient can no longer eat or drink anything unless it was approximately room temperature or it will induce excruciating pain that limits the patient's ability to tolerate any mouth movement. The patient also cannot tolerate cold air on face because it induces facial pain that radiates to the upper face and around left eye. It was also reported that the patient continued taking the Gabapentin and continue following up with occupational health clinic. The patient required emergency room (ER)/ doctor visit. The patient had been receiving the influenza vaccine for approximately 15 years without a problem until last year when had an excessive swelling at the injection site Laboratory investigations were not reported. Patient received Benadryl, Ibuprofen every 2 hours when got home from work and also received Gabapentin 100 mg three times daily and a five day course of prednisone 10 mg twice daily as a corrective treatment and was diagnosed through occupational health clinic with Trigeminal neuralgia. On an unknown date, patient was recovered from possibly have a toothache and had a slightly sore Shoulder and numbness on the left side of the face in jaw area and the muscle soreness in shoulder started to spread to left arm, left side of chest and abdomen and muscle soreness from the left side of the neck (just  below the jawline) down to the left knee. The patient was not yet recovered from tolerate cold air on face because it induces facial pain that radiates to upper face and around left eye at the time of reporting. Outcome of the event trigeminal neuralgia, numbness replaced by pain and the pain was so severe that cannot eat or drink anything and difficulty taking a full inspiration because I felt like I being squeezed on the left side of the chest and abdomen was not reported. List of documents held by sender: none