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This is VAERS ID 496426

Case Details

VAERS ID: 496426 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:17
Submitted: 2013-07-11
   Days after onset:1068
Entered: 2013-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Angiogram normal, CSF culture negative, Hypoglossal nerve paralysis, Nuclear magnetic resonance imaging brain normal, Serology normal, Tongue paralysis
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data: MRI angiography, Spinal fluid culture, MRI brain and Serology test were normal
CDC Split Type: WAES1307DNK004617

Write-up: Case received from a health care professional via the Health Authorities on 04-Jul-2013 under the references DK-DKMA-ADR 22156769 and DK-DKMA EFO6163. Case medically confirmed. A 12-year-old female patient had received the first injection of GARDASIL (batch number unknown, administration site not reported) via intramuscular route on 22-Jul-2010. On 08-Aug-2010, the patient developed right-side tongue deviation and paralysis of the hypoglossal nerve dexter. In Jun-2013, the patient had stationary function-failure of right nervus hypoglossus, localised at nerve nucleus. The patient was investigated with MRI of cerebrum and throat, MRI angiography, spinal fluid test and serological test for inflammation and neuro infection. All tests were without findings. At the time of reporting, the patient had not recovered.

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