Mrs. X, 40 years old, has a familial hypermobile Ehler Danlos syndrome (maternal grandfather and mother affected). She has suffered from chronic diffuse pain since the age of 12.
Her medical history includes: a vaccination for hepatitis B at the age of 11, a breast reduction, a vaginal delivery and a caesarean section.
When she was treated 10 years ago, she presented with chronic pain with signs of central sensitization (diffuse cutaneous hyperesthesia), muscle weakness of both lower limbs, bladder instability with 6 to 8 nighttime rises to urinate.
On clinical examination, there was diffuse cutaneous hyperesthesia, extensive muscle pain, examination of the different surgical areas revealed neuropathic pain located at the level of the different scars from these surgeries (electric shocks and painful paresthesias during the palpation-rolling maneuver of these scars).
Her initial management included:
- A ketamine protocol in hospital with continuous infusion of ketamine at a dose of 100 mg per 24 hours for 3 days for the purpose of central desensitization.
- The treatment of these scars (breast surgery, epidural and cesarean section scars) allows for a rapid and clear improvement in her painful situation. She has since benefited from maintenance of this treatment every 3 months in these scars and, occasionally, from ketamine treatment, when the signs of central sensitization return.
4 years ago, the patient received an injection of the Covid 19 vaccine in the left deltoid with immediate onset of severe paralysis of the left upper limb evolving into a very disabling adhesive capsulitis (10% mobility in all axes). Given the persistence of this capsulitis and the existence of neurological signs (electric shocks and paresthesias)
Given the persistence of this capsulitis and the existence of neurological signs (electrical discharges and paresthesias) when palpating the skin in the vaccination area for 2 years, treatment of the vaccination area was carried out.
Mrs. X has 2 sons. One of her sons also has hypermobile Elher Danlos syndrome. He is 9 years old. He has had severe sleep disorders since the age of 1 associated with diffuse pain.
These different disorders are accompanied by daytime hypersomnolence that has required adaptations for school.
Given these symptoms, the question of the effect of vaccines given in early childhood arises. A thorough clinical examination reveals 4 potential vaccination zones that are sites of neurological reactions during the palpate-roll maneuver (upper right and left external lateral thigh and 2 deltoids).
Treatment of these 4 areas (doctor’s information) allows complete normalization of all the child’s symptoms.
Discussion
Hypermobile Ehlers Danlos syndrome is a connective tissue disease causing different symptoms. American J of Med Genetics Pt C – 2017 – Tinkle – Hypermobile Ehlers Danlos syndrome a k a Ehlers Danlos syndrome Type. In our experience these patients very frequently present with cicatricial neuropathies.
It is likely that this reaction is found in patients who do not have this syndrome.
It seems that vaccination can be a source of local cicatricial neuropathic pain with an impact on the functioning of the nervous system.
Local treatments exist to treat these pathologies.
Please note: This clinical case describes a little-known side effect of vaccination. It in no way calls into question the importance and usefulness of vaccination in the health of patients.