demyelinating disorder; multiple sclerosis; migraines; rapid heartbeat; loss of appetite; extreme weight loss; This initial spontaneous report was received from a lawyer and the consumer regarding a case in litigation and refers to a 18 years-old female patient. The patient's medical history, concurrent conditions and concomitant medications were not reported.   On unspecified date, the patient was vaccinated with the first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) strength, lot #, expiry date, and route of administration were not provided) administered for for preventing cervical cancer, then on unspecified date too, the patient received the second dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). It was confirmed that the health care professional through and informed to the patient that the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccine was safe and effective vaccine for preventing cervical cancer.   On an unknown date, following her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccinations, the patient developed rapid heartbeat, loss of appetite, extreme weight loss, migraines and signs and symptoms of demyelination and multiple sclerosis such as: loss of control of her bladder, facial paralysis, weakness of limbs, slurred speech, loss of vision, mood swings, trouble focusing, and loss of balance. The patient  was seen by multiple physicians and specialists for her complaints.  As a result of her post quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, the patient had been unable to engage in activities that a young person her age would normally enjoy. Her college performance suffered because of her symptoms and she had to take a leave from school.  Patient contends that her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections caused her to develop serious and debilitating autoimmune and neurological injuries, including but not limited to, multiple sclerosis, loss of bladder control, slurred speech, staggered steps, paralysis on right side of the body, loss of vision, trouble concentrating, loss of motor skills, facial paralysis, rapid heartbeat, trouble swallowing, and trouble sleeping, as well as a constellation of adverse symptoms, complications, injuries, and other adverse events, many of which were alleged herein and all of which were caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) or otherwise linked to her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) induced autoimmune disorder.   The patient has suffered and continued to suffer severe and permanent physical injuries, and associated symptomatology and has suffered severe and permanent emotional injuries, including pain and suffering. The outcome of all the events was reported as not recovered.  The causality between quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) and all the aforementioned events was reported as related and were also considered as disability events.   Upon internal review, demyelination and multiple sclerosis were determined to be medically significant events.