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This is VAERS ID 497496

Case Details

VAERS ID: 497496 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Illinois  
   Days after vaccination:1
Submitted: 2013-07-23
   Days after onset:462
Entered: 2013-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Private
Symptoms: Abasia, Amnesia, Anti-NMDA antibody negative, Antinuclear antibody positive, CSF test normal, Dizziness, Dystonia, Electroencephalogram normal, Headache, Laboratory test normal, Nuclear magnetic resonance imaging brain normal, Psychogenic seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Respiridone 0.5 mg, Sertraline 75 mg
Current Illness: Potentially had dizziness and vomiting
Preexisting Conditions: Bipolar disorder, developmental delays
Diagnostic Lab Data: CSF studies were normal; NMDA testing was normal; MRI of brain was normal; multiple EEGs were normal; unremarkable serum chemistries; child did have positive ribonucleoprotein antibody
CDC Split Type:

Write-up: Child had vomiting, dizziness, that proceeded to headaches, over ensuing weeks, child developed amnesia, dystonia, and lost ability to walk; child had multiple pseudoseizures.

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