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This is VAERS ID 279174

Case Details

VAERS ID: 279174 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: New Jersey  
   Days after vaccination:28
Submitted: 2007-05-14
   Days after onset:132
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Basilar migraine, Dizziness, Electroencephalogram normal, Fall, Gait disturbance, Haematology test normal, Nausea, Nuclear magnetic resonance imaging normal, Syncope vasovagal, Visual disturbance
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Headache
Preexisting Conditions:
Diagnostic Lab Data: electroencephalography - negative magnetic resonance - negative hematology - negative
CDC Split Type: WAES0704USA01346

Write-up: Information has been received from a physician concerning a 17 year old female patient with headache who on 09-OCT-2006 was vaccinated with a first dose 0.5 mL of Gardasil and on 04-DEC-2006 with a second dose 0.5 mL of Gardasil. In last week of January 2007, patient was dizzy, felt paralyzed, fell and needed to hold onto something to walk. This lasted for 5 minutes. This was immediately followed with nausea and a "wavy like vision that looked like a kaleidoscope." This lasted for 30 minutes, possible vasovagal reaction. On 04-DEC-2004 she also had her ears pierced. She was seen by her internist and then a neurologist. She had blood tests, magnetic resonance imaging (MRI) and electroencephalography (EEG), all were negative. Patient''s diagnosis was basal artery migraine. She was treated with Periactin. The patient was reported as recovering. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. No additional information is expected.

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