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Write-up: Information has been received from a licensed practical nurse concerning her 17 year old daughter with a history of grand mal seizures as a child aged 10 months to the age of 7 years who in November 2007 was vaccinated with a first dose of Gardasil. There was no concomitant medication. The nurse reported her daughter was experiencing severe neurological adverse events after receiving Gardasil. On an unspecified date two weeks later the patient began experiencing daily severe headaches. The patient sought medical attention. The patient then began experiencing what was described as "brain shaking". An EEG showed signs of seizure activity and a repeat EEG is scheduled to confirm these results as the patient is changing neurologists. MRI, lab values, eyes and cardiac tests were normal. Despite the headaches the patient received a second dose of Gardasil on an unspecified date with the headaches and "brain shakes" continuing and possible intensifying after the second dose. The patient was prescribed LAMICTAL and RELPAK but has not had any relief from the headaches. The headaches were currently reported to be getting worse instead of better. At the time of reporting the patient has not recovered. The mother considers the event to be disabling because the debilitating headaches interferes with her classes (where she was a straight A student) and her cheerleading (where she was one of the top cheerleaders in the state). No further information was available. Additional information has been requested. 4/15/09 Incomplete records received from reporter. Sent for stress echo to eval seizures, neurocardiogenic syncope, H/A, black outs, hypotension. Pt recd HPV 11/6/07 1061U. 5/1/09 PCP records recd from 11/6/07 to 3/2009. WCC 11/6/07 with reported shoulder and aknle discomfort 2'' to gymnastics. Vax given. Returned 12/7 with c/o sore throat, H/A, body aches and runny nose. Dx: pharyngitis. Multiple visits with the following c/o: H/A, blank-out periods. DX: H/A. Seizure d/o. Neuro eval 1/11/08. pt reports vibrating sensation in head with H/A, light-headedness and dizziness. Exam WNL. Dx:Hx of epilepsy. Vasc H/A. Possible neurocardiogenic syncope/presyncope. Sent for EEG and MRI brain-normal. F/U 1/21/08 with Dx: Migraines. Epilepsy. Malaise noted 2/29/08. H/A worsening 4/1/08. Dx: Reactive depression. 5/4/09 neuro consults received dated 4/2/08-4/7/09. Pt reports onset of headaches (frontal/temporal) since 12/2007-throbbing and pressure in nature. Constant with (+) phono and photophobia as well as difficulty concentrating. Feels like "brain shaking" with no LOC. ROS (+) for depression, blurred vision, muscle pain. PE WNL. 2 ER visits for seizures in 4/2008 with dx: non-epileptic seizures. Out of school 10 days. Brain shakes eveolve into crying, screaming, shaking and feeling wierd. No incont. Meds not helping. suggest psych eval. Worsening H/A 5/08 with some improvement by 6/08. Dx with Crohn''s 11/08. Brain shakes 3x/week noted 4/7/09. by 9/9/2008 reporting RLQ abdominal pain, diarrhea, nausea and wt loss.
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