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What Cause Weakness In Left Side Of Body After Yellow Fever Vaccination?
Question: My father-in-law is a very healthy and active 72 year old man. He was in the process of planning a trip to Brazil. Roughly 15 days ago he had the yellow fever vaccination. Approximately 1 week after the immunization he began to experience weakening of his left side (where the injection was given) of his leg and arm. His right side is absolutely perfect. He is completely coherent. Mentally he is clear, and sharp. His appetite is normal. His mood is normal. But, his left side is weak and he feels hesitate to walk. Before he was walking several miles a day.
Will this pass with time?
What should be done? We have taken a CT scan, but will not know results for 2 days. We don't want the delay in getting CT Scan to affect him. Over the last couple of days he is not degrading, but he is also not improving. How can we help him?
Also, because the neurologist did not admit him to the hospital - what does this mean? Rather had him go home to come back in 2 days for the results, and then has said we may follow up with MRI, but first need the CT scan.
Is this the result of the vaccine? Or, how to know if this is encephalitis etc. etc.?
Obviously, as a family we are trying to dispassionately read his symptoms:
So, in our observations of him and questioning of him - he is absolutely normal - except the weakness in his left side leg (especially) and slight weakness of the left arm.
Based on this - what is his prognosis? What can we do while the slow medical system makes us sit and wait. What medications? What vitamins? What food? What rehabilitation?
Will this pass with time?
What should be done? We have taken a CT scan, but will not know results for 2 days. We don't want the delay in getting CT Scan to affect him. Over the last couple of days he is not degrading, but he is also not improving. How can we help him?
Also, because the neurologist did not admit him to the hospital - what does this mean? Rather had him go home to come back in 2 days for the results, and then has said we may follow up with MRI, but first need the CT scan.
Is this the result of the vaccine? Or, how to know if this is encephalitis etc. etc.?
Obviously, as a family we are trying to dispassionately read his symptoms:
So, in our observations of him and questioning of him - he is absolutely normal - except the weakness in his left side leg (especially) and slight weakness of the left arm.
Based on this - what is his prognosis? What can we do while the slow medical system makes us sit and wait. What medications? What vitamins? What food? What rehabilitation?
Brief Answer:
This is very unlikely due to the vaccine
Detailed Answer:
Hi,
Thanks for the query,
I understand your concern
The symptoms that you have described is very typical of brain stroke. The site of the brain stroke is in the right side which causing a left side of paralysis. In this type of cases it is very important to know the CT scan findings as it will guide the treatment. In the absence of CT scan, it is extremely difficult for me to tell you the medications. In the mean time, I suggest you to find out if he has high blood pressure, diabetes or cholesterol problem. Based upon the CT result, he may need a detailed cardiac evaluation.
It is very unlikely that it is encephalitis as well as he is completely coherent. To the best of my medical knowledge, This is NOT Related to vaccine. The prognosis and long term out come and treatment will depend upon the exact site and type of stroke.
I suggest you to take him to an emergency Neurology service which will solve the issue
please feel free and let me know in case you need any help
best wishes
This is very unlikely due to the vaccine
Detailed Answer:
Hi,
Thanks for the query,
I understand your concern
The symptoms that you have described is very typical of brain stroke. The site of the brain stroke is in the right side which causing a left side of paralysis. In this type of cases it is very important to know the CT scan findings as it will guide the treatment. In the absence of CT scan, it is extremely difficult for me to tell you the medications. In the mean time, I suggest you to find out if he has high blood pressure, diabetes or cholesterol problem. Based upon the CT result, he may need a detailed cardiac evaluation.
It is very unlikely that it is encephalitis as well as he is completely coherent. To the best of my medical knowledge, This is NOT Related to vaccine. The prognosis and long term out come and treatment will depend upon the exact site and type of stroke.
I suggest you to take him to an emergency Neurology service which will solve the issue
please feel free and let me know in case you need any help
best wishes
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you Dr. Dash,
I appreciate your initial comments. Based on the patients symptoms at this time, it seems it may be brain stroke. HOWEVER, here are the specific nuances:
1. Approximately 7 days after the vaccination, people around him noticed his unsteadiness in his gate. Dragging the left foot - but still walking.
2. Then a couple of days after that he fell down in trying to adjust his left leg.
3. The following day, he felt extreme difficulty in placing his left foot in walking, and hand was still fine - so he went to an orthopedic doctor.
4. Next day, the difficulty was so much, he did not want to walk and started to notice the weakness in his left hand.
5. So, since the paralysis in the left side, came gradually - instead of sudden- does that still lead you to think it is a brain stroke?
Question:
1. If it is brain stroke, could the degradation in the left side happen gradual as described. OR, doesn't it degrade everything at the same time?
2. If this is a brain stroke, are we then saying it is NOT related to the yellow fever vaccine?
3. We are in a medical system that is very slow. He will not be getting his CT scan, nor follow up with the neurologist doctor visit for another 48 hours - is this waiting without intervention doing more harm??
4. As a family - what can we do to prevent degradation?
I appreciate your initial comments. Based on the patients symptoms at this time, it seems it may be brain stroke. HOWEVER, here are the specific nuances:
1. Approximately 7 days after the vaccination, people around him noticed his unsteadiness in his gate. Dragging the left foot - but still walking.
2. Then a couple of days after that he fell down in trying to adjust his left leg.
3. The following day, he felt extreme difficulty in placing his left foot in walking, and hand was still fine - so he went to an orthopedic doctor.
4. Next day, the difficulty was so much, he did not want to walk and started to notice the weakness in his left hand.
5. So, since the paralysis in the left side, came gradually - instead of sudden- does that still lead you to think it is a brain stroke?
Question:
1. If it is brain stroke, could the degradation in the left side happen gradual as described. OR, doesn't it degrade everything at the same time?
2. If this is a brain stroke, are we then saying it is NOT related to the yellow fever vaccine?
3. We are in a medical system that is very slow. He will not be getting his CT scan, nor follow up with the neurologist doctor visit for another 48 hours - is this waiting without intervention doing more harm??
4. As a family - what can we do to prevent degradation?
Brief Answer:
His symptoms are unlikely to be due to vaccine
Detailed Answer:
Thanks for the feed back and a detailed history.
If the weakness if not that sudden and it is gradual, the other possibilities of infections, inflammation, space occupying lesion in the brain or spinal cord can cause these symptoms. A neurological re-evaluation will guide us the exact site of scan. I strongly feel that he should undergo MRI scan of the brain and Spine urgently to understand the type of problem which has resulted in left side weakness.
stroke can sometimes will have slow onset and hence without a detailed neurological examination, I am not abler to rule out a possibility of stroke in this case. To the best of my medical knowledge, I do not think that it is related to the vaccine. In any patient with brain stroke the first few hours are crucial. As there is no other options as of now I am not able to say the future course of this case. As most of the patient s with stroke may have worsening in the initial few days. Please note the limitations of not examining the case.
Please note that this case needs urgent review by a neurologist and based upon the diagnosis, we will be able to guide you further.
please get back in case you need any clarification
His symptoms are unlikely to be due to vaccine
Detailed Answer:
Thanks for the feed back and a detailed history.
If the weakness if not that sudden and it is gradual, the other possibilities of infections, inflammation, space occupying lesion in the brain or spinal cord can cause these symptoms. A neurological re-evaluation will guide us the exact site of scan. I strongly feel that he should undergo MRI scan of the brain and Spine urgently to understand the type of problem which has resulted in left side weakness.
stroke can sometimes will have slow onset and hence without a detailed neurological examination, I am not abler to rule out a possibility of stroke in this case. To the best of my medical knowledge, I do not think that it is related to the vaccine. In any patient with brain stroke the first few hours are crucial. As there is no other options as of now I am not able to say the future course of this case. As most of the patient s with stroke may have worsening in the initial few days. Please note the limitations of not examining the case.
Please note that this case needs urgent review by a neurologist and based upon the diagnosis, we will be able to guide you further.
please get back in case you need any clarification
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi Dr. Dash,
Again thank you for your time and thoughtful response. I do have additional information about my father-in-law. Please review and consider my questions.
He did have a CT Scan which showed chronic subdural haematoma. He had fallen on some slippery stairs two months earlier (April 2014). At that time, he had a CT Scan but it did NOT show any areas of concern. He also never loss consciousness, and did not complain of any issues, other than general soreness due to the fall.
Before that, and since that fall, as I stated, he has been absolutely normal, continuing on his regular schedule. It was only in the last 10 days, that this slow weakening of his left side began.
Currently, he has been admitted into the hospital, and the plan is to do surgery in 1 week. They are waiting 1 week, because he has taken ecospirin (blood thinner) since 2001 - due to a triple bypass surgery. Since 2001, he has never had any medical issues whatsoever. He has never been hospitalized for any issue whatsoever.
They want to wait 1 week, to allow the blood platelets to buildup/normalize before surgery.
Currently he has not degraded, and is maintaining as I have described.
Questions:
1. Is 1 week long enough to wait for his blood platelets to build up.We do want to have the surgery as fast as possible, but need to manage his safety.
2. After the surgery, do the symptoms of the weakness on the left side go away on their own - or does it require physical therapy?
2. What should we monitor/watch for during this 1 week waiting period to ensure his healthy recover? And that his life is not in danger.
3. Are there any issues we should mention to our neurologist surgeon, again to ensure his successful outcome.
4. Is this considered a standard surgery or is it a risky life threatening surgery?
My father-in-law is still a very active semi-retired Professor. And, is loved by many students, as well as family. I am trying to manage his wellness from afar, so I appreciate your comments and responses.
Again thank you for your time and thoughtful response. I do have additional information about my father-in-law. Please review and consider my questions.
He did have a CT Scan which showed chronic subdural haematoma. He had fallen on some slippery stairs two months earlier (April 2014). At that time, he had a CT Scan but it did NOT show any areas of concern. He also never loss consciousness, and did not complain of any issues, other than general soreness due to the fall.
Before that, and since that fall, as I stated, he has been absolutely normal, continuing on his regular schedule. It was only in the last 10 days, that this slow weakening of his left side began.
Currently, he has been admitted into the hospital, and the plan is to do surgery in 1 week. They are waiting 1 week, because he has taken ecospirin (blood thinner) since 2001 - due to a triple bypass surgery. Since 2001, he has never had any medical issues whatsoever. He has never been hospitalized for any issue whatsoever.
They want to wait 1 week, to allow the blood platelets to buildup/normalize before surgery.
Currently he has not degraded, and is maintaining as I have described.
Questions:
1. Is 1 week long enough to wait for his blood platelets to build up.We do want to have the surgery as fast as possible, but need to manage his safety.
2. After the surgery, do the symptoms of the weakness on the left side go away on their own - or does it require physical therapy?
2. What should we monitor/watch for during this 1 week waiting period to ensure his healthy recover? And that his life is not in danger.
3. Are there any issues we should mention to our neurologist surgeon, again to ensure his successful outcome.
4. Is this considered a standard surgery or is it a risky life threatening surgery?
My father-in-law is still a very active semi-retired Professor. And, is loved by many students, as well as family. I am trying to manage his wellness from afar, so I appreciate your comments and responses.
Brief Answer:
Please find below a point- by point response to your questions
Detailed Answer:
1. Is 1 week long enough to wait for his blood platelets to build up.We do want to have the surgery as fast as possible, but need to manage his safety.
Answer: 1 week is the average time hat is recommended and there is no point in waiting for more duration. 10 days should be the maximum.
2. After the surgery, do the symptoms of the weakness on the left side go away on their own - or does it require physical therapy?
Answer: The left sided weakness will not improve with surgery. He needs physical therapy and rehabilitation.
2. What should we monitor/watch for during this 1 week waiting period to ensure his healthy recover? And that his life is not in danger.
Answer: Doctors should note his level of sensorium and if there is any worsening of weakness.
3. Are there any issues we should mention to our neurologist surgeon, again to ensure his successful outcome.
Answer: As I mentioned earlier, I do not know the exact cause of his weakness. As a neurologist I do not have recommendations to the surgeon.
4. Is this considered a standard surgery or is it a risky life threatening surgery?
Answer: This is a standard surgery, nothing to worry.
Hope I am clear.
Regards
Please find below a point- by point response to your questions
Detailed Answer:
1. Is 1 week long enough to wait for his blood platelets to build up.We do want to have the surgery as fast as possible, but need to manage his safety.
Answer: 1 week is the average time hat is recommended and there is no point in waiting for more duration. 10 days should be the maximum.
2. After the surgery, do the symptoms of the weakness on the left side go away on their own - or does it require physical therapy?
Answer: The left sided weakness will not improve with surgery. He needs physical therapy and rehabilitation.
2. What should we monitor/watch for during this 1 week waiting period to ensure his healthy recover? And that his life is not in danger.
Answer: Doctors should note his level of sensorium and if there is any worsening of weakness.
3. Are there any issues we should mention to our neurologist surgeon, again to ensure his successful outcome.
Answer: As I mentioned earlier, I do not know the exact cause of his weakness. As a neurologist I do not have recommendations to the surgeon.
4. Is this considered a standard surgery or is it a risky life threatening surgery?
Answer: This is a standard surgery, nothing to worry.
Hope I am clear.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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