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Is Your Leg Weakness, Numbness and Tingling Related to Your Recent Vaccine (Flu Shot)?

Unexplained sensations of tingling in the feet or hands, lower back pain, leg weakness, loss of balance, dizziness, fatigue, and numbness in the body or even new onsets of nerve pain can be scary and unsettling when they initially present. The cause of these symptoms can vary from routine pinched nerves, to irregularities with blood work, to more catastrophic autoimmune diseases. If you have a new onset of these symptoms, take a closer look as to whether you are suffering from an autoimmune disease related to a recent vaccination (flu shot or covid vaccine.) **Guillain-Barré Syndrome (GBS)** Guillain-Barré syndrome (GBS) is a rare neurological disorder in which the body's immune system attacks part of the peripheral nervous system, which is the network of nerves located outside of the brain and spinal cord. GBS can range from a very mild case with brief weakness to nearly devastating paralysis, leaving the person unable to breathe independently. While most people eventually recover from even the most severe cases of GBS, permanent catastrophic outcomes and death can result. After recovery, some people will continue to have some degree of weakness, numbness, tingling, neuropathic pain and fatigue. (cite: Rodríguez, Y., Rojas, M., Pacheco, Y. et al. Guillain–Barré syndrome, transverse myelitis and infectious diseases. Cell Mol Immunol 15, 547–562 (2018)). Guillain-Barré syndrome can affect anyone at any age. It is more frequent in adults and older people, and both genders are equally susceptible to the disorder (despite some studies indicating that GBS is more prevalent in men than women). GBS is estimated to affect about one person in 100,000 each year. **Symptoms** Weakness usually begins in the feet and progresses up the body to the trunk and arms. Sometimes it spreads to the breathing muscles, face and throat. In 25% of people, the breathing muscles become so weak that individuals will require intubation and breathing machines in order to breathe. In addition, other common symptoms of GBS include feelings of tingling, pins and needles (paresthesias) and numbness. (cite: Principi, N., Esposito, S., Vaccine-preventable diseases, vaccines and Guillain-Barre’ syndrome. Vaccine. Volume 37, Issue 37, 3 September 2019, Pages 5544-5550). **Causes** GBS is caused by inflammation of the peripheral nerves, which take messages to and from the skin and muscles to the brain and spinal cord. GBS is triggered by an autoimmune mechanism where the immune system produces an immune response to an infection which cross-reacts with the nerves. This, in turn, causes damage to the outer coating sheath (or, myelin sheath) of the nerve fibers. In more severely affected people, this damage also affects the central conducting core of the nerve, called the axon. In some people, the axon is itself the main target of the autoimmune response. Scientific literature and studies have found the following causes of GBS: - Bacteria: Campylobacter jejuni which causes diarrhea; - Viruses such as cytomegalovirus, Epstein-Barr virus, Hepatitis E, Zika virus; - Upper respiratory infections; and - Vaccines: mainly the influenza vaccine (flu shot) and tetanus (Tdap) vaccine. Vaccines, often only thought of as safe and necessary for society, can be a distinct cause of GBS, especially if the symptoms of GBS began within six (6) weeks of getting a vaccination. (Cite: Vellozzi, C., S. Iqbal, and K. Broder, Guillain-Barre syndrome, influenza, and influenza vaccination: the epidemiologic evidence. Clin Infect Dis, 2014. 58(8): p. 1149–55; Schonberger, L.B., et al., Guillain-Barre syndrome following vaccination in the National Influenza Immunization Program, United States, 1976–1977. Am J Epidemiol, 1979. 110(2): p. 105–23) **Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)** Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease characterized by neurological symptoms and signs of progressive weakness, paresthesias, and sensory dysfunction. It is often considered to be the chronic form of Guillain-Barre Syndrome. Other symptoms include reduced or absent tendon reflexes, cranial nerve involvement, autonomic symptoms, ataxia, and neuropathic pain. Unlike other autoimmune diseases, CIDP generally affects older individuals and has a male predominance. The onset is generally insidious and can take up to 8 weeks with a relapsing-recovery pattern. Similar to GBS, the causes of CIDP can be bacterial, viral, and vaccines, such as the flu shot or tetanus vaccine. (cite: Rodriguez, Y., et al. Chronic inflammatory demyelinating polyneuropathy as an autoimmune disease. Journal of Autoimmunity. Volume 102, August 2019, Pages 8-37). **Transverse Myelitis** Transverse Myelitis (TM) is a disorder characterized by inflammation of the spinal cord that presents with symptoms and signs of neurologic dysfunction in motor and sensory tracts on both sides of the spinal cord. The involvement of motor and sensory control pathways frequently trigger altered sensations, weakness, and urinary or bowel dysfunction. **Symptoms** The classic symptoms of transverse myelitis are weakness in the arms/legs, sensory symptoms such as numbness or tingling, pain and discomfort, and bladder dysfunction and/or bowel movement problems. The symptoms can present in either legs or arms, or both. **Causes** Transverse myelitis can be caused by autoimmune disorders such as multiple sclerosis, neuromyelitis optica, systemic lupus erythematous, Sjogren’s syndrome and sarcoidosis among others. However, it may also be caused by vaccinations such as the influenza vaccine (flu shot), tetanus vaccine, MMR, varicella, and Hepatitis vaccines. Although vaccines harbor a major contribution to public health in the modern era, in rare cases they may be associated with autoimmune phenomena such as transverse myelitis. Based on the associations of different vaccines with transverse myelitis, there is a common denominator of these vaccines, such as an adjuvant, might trigger this syndrome. (Cite: Development of Transverse Myelitis after Vaccination, A CDC/FDA Vaccine Adverse Event Reporting System (VAERS) Study, 1985–2017. (P5.099). Shreya Shah, Janaki Patel, Abdul Rahman Alchaki, Moamina Fakher Eddin, Nizar Souayah. Neurology Apr 2018, 90 (15 Supplement) P5.099). **Acute disseminated encephalomyelitis (ADEM)** Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disorder of the central nervous system and is characterized by a widespread demyelination that predominantly involves the white matter of the brain and spinal cord. The presenting features include an acute encephalopathy with multifocal neurologic signs and deficits that affect children more so than adults. **Symptoms** The symptoms of ADEM appear rapidly, beginning with encephalitis-like symptoms such as fever, fatigue, headache, nausea and vomiting, and in the most severe cases, seizures and coma. Due to the damage of the white matter (brain tissue that takes its name from the white color of myelin), a patient will often experience neurological symptoms such as visual loss (due to inflammation of the optic nerve) in one or both eyes, weakness, paralysis, weak muscles, muscle incoordination, and imbalance when walking. **Causes** Vaccination-associated ADEM is most frequently observed after measles, mumps, or rubella (MMR) vaccinations. However, it has also been reported after polio and European tick-borne encephalitis vaccinations as well. ADEM has also been reported in the medical literature to occur after influenza vaccinations. (cite: Shoamanesh, A., et al. Acute disseminated encephalomyelitis following influenza vaccination. Vaccine. Volume 29, Issue 46, 26 October 2011, Pages 8182-8185). Typically, there is a latency of 7 to 14 days between a febrile illness and the onset of neurological symptoms. In the case of vaccination-associated ADEM, this latency period may be longer and not occur for several weeks following a vaccination. (cite: Menge T, Hemmer B, Nessler S, et al. Acute Disseminated Encephalomyelitis: An Update. Arch Neurol. 2005;62(11):1673–1680). **Legal Recourse** If you or a loved one received a vaccine or flu shot in the weeks before the onset of GBS, CIDP, ADEM, or transverse myelitis, please contact our vaccine attorney who can discuss how you would be eligible for vaccine compensation settlements for pain and suffering, medical expenses, future medical care and lost wages. [Click here to see if you are eligible for compensation][1] [1]:

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