Received Feb 12, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HPV9 | HPV (GARDASIL 9) | MERCK & CO. INC. | 1 | — | RA |
| MNQ | MENINGOCOCCAL CONJUGATE (MENACTRA) | SANOFI PASTEUR | UNK | — | LA |
| TDAP | TDAP (ADACEL) | SANOFI PASTEUR | UNK | — | LA |
Patient had unusual pain in her right arm following the HPV vaccine along with decreased mobility. This lasted for approximately 4-6 weeks. I thought it was just vaccine soreness and as we were getting ready to follow up to check on this, the pain and mobility issues began to subside so we did not schedule. She did continue to complain of a muscle spasm in her neck with discomfort. We mentioned this at her 2023 well child visit, but the doctor said it was probably just from her looking down at her phone or something. Late fall (2023), we noticed drooping in her shoulder. Unaware of what it was from or what was wrong, we started off with a chiropractor (2 visits). This was of zero benefit so we started OMT in January 2024. After a few sessions, the doctor determined it was in fact her trap muscle vs an alignment issue. We were referred to a local orthopedic doctor (Dr) who then referred us for the first of 2 EMGs. This concluded her spinal accessory nerve was not functioning. We attempted physical therapy with nerve stimulation, but nothing was helping. At this point, we were starting into summer of 2024. An MRI was ordered to confirm no tumors or masses compressing the nerve, there was not. We were then referred to an orthopedic doctor specializing in brachial plexus (Dr). We had a second EMG completed. He sent us to hospital for a neurography to check for hour glass constrictions in her nerve. The radiologist concluded it had most likely been to long to see the constrictions. Dr felt confident her diagnosis was Parsonage Turner Syndrome due to her HPV vaccine (autoimmune response), but we needed to do our due diligence and rule everything out. She had a group of vessels noted on the neurography so we were referred to a neurosurgeon and had an angiogram completed to see if that was an issue. This was determined to be nothing and not contributory at all. At this point, it was November of 2024. Dr determined she would not recover at all due to the extensive and severe muscle deterioration in her trapezius and sternocleidomastoid muscles. It was causing pronounced muscle weakness and scapular winging which in turn caused forward shoulder rotation. She was experiencing a lot of stiffness, pain, and discomfort. Since her scapula had very little support due to trap muscle deterioration, she had to have a triple muscle transfer on 1/13/25. We were informed she would never recover and this was strictly a surgery to help deal with the damage. She will have lifelong damage and complications.
None
Migraines, seasonal allergies
Cyproheptadine 4mg every night; Singulair 5mg every night
None
#1 EMG: April 2, 2024 PT started: 5/2/2024 #1 MRI: 5/31/2024 #2 EMG: 7/8/2024 MR Neurography: 8/6/2024 Angiogram: 11/1/2024 Triple Muscle Transfer: 1/13/2025