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Brachial Plexus Neuritis and Flu Shots
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Brachial Plexus Neuritis and Flu Shots

I am a 51 year old male.  About 6 years ago, I experienced what appears to have been a bout of brachial plexus neuritis (BPN).  I had all the classic symptoms of this condition and, fortunately, it resolved without treatment.  I am aware that some BPN cases are associated with receipt of a vaccination.  This was not the case for me – I had received no vaccination in the months preceding the onset of this condition.  However, I did have some kind of infection a few weeks before the condition appeared.  I have received tetanus shots and perhaps one or two flu shots in the past with no problems of any kind.

My question is this:  Should I be concerned about receiving the H1N1 vaccination, or even the regular flu vaccine?  In other words, is there any reason to think, whether based on empirical evidence or for other reasons, that I would be at increased risk for a recurrence of BPN if I am vaccinated?  In other words, if one has already had BPN, is one at increased risk of a recurrence, even one from a trigger event not associated with the first occurrence?

Furthermore, should I be concerned about Guillan-Barre syndrome? - Is a person with a history of BPN at any increased risk for this serious condition in the specific context of receiving a flu shot?

I am well aware that there is no such thing as a zero-risk option.  I have asthma (associated with pet and dust allergies) and, of course, this is a factor in favour of taking the shot.  I am also aware that if I do not get the shot, getting H1N1 itself could conceivably trigger BPN.  It may also be relevant that I did indeed receive the 1976 swine flu vaccine.

Finally, I certainly want to be a responsible citizen – in other words, my personal health is not the only consideration here.  Any comment would be appreciated.
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the risks of BPN occuring if you are vaccinated with H1N1 vaccine. However I will try to provide you with some useful information.

As you may know, the hereditary form of BPN (that which runs in families) is very likely to recur: 75% of patients with the hereditary form have recurrent attacks. However, even in people without the hereditary form, BPN can reccur in 25% of patients.

As you mention, vaccination can trigger an attack of BPN, though recurrent attacks (i.e. a second attack) of BPN are rare in the setting of vaccination in general, so there is not robust research data on this. To my knowledge, BPN following vacciation has been reported with hepatitis B vaccination, HPV vaccination, and in the 1970s, there is a reported case with the swine flu vaccination. This is again overall rare, but the H1N1 vaccination is relatively new, and cases may be under-reported in the general medication literature.

However, it can be said that the risks of recurrent BPN from an infection are higher than risks of recurrent BPN from a vaccination (statistically speaking).

To my knowledge, a prior history of BPN does not particularly predispose a person to Guillain-Barre.

As you mention, nothing is zero risk. While the risk of BPN is theoretically present in someone in general who takes the influenza vaccine, and perhaps you in particular since you have had BPN before, the risk is statistically low, but still present. It is a matter of weighing risks and benefits of taking the vaccine vs. not. Discussion with your physicians is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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