Artha Timothy v. HHS - Influenza, trigeminal neuralgia (2023)

Artha Timothy, a 61-year-old woman, received an influenza vaccine on October 9, 2014. She alleged that this vaccine caused her to develop trigeminal neuralgia, a condition characterized by facial pain and spasms.

Because trigeminal neuralgia is not listed on the Vaccine Injury Table, Ms. Timothy had to prove causation-in-fact under the Althen standard.

She presented expert testimony from Dr. M.

Eric Gershwin, who theorized that the vaccine caused a localized innate immune response leading to inflammation and compression of the trigeminal nerve, drawing analogies to Bell's Palsy. Respondent presented expert testimony from Dr.

Subramaniam Sriram and Dr. Neil D.

Romberg, who argued that trigeminal neuralgia is typically caused by vascular compression, not inflammation, and that Ms. Timothy's condition was more accurately described as tic convulsif, a syndrome associated with vascular issues.

They also contended that the vaccine could not cause inflammation in the trigeminal nerve via the lymphatic system from the injection site. The court reviewed Ms.

Timothy's medical records, which showed a history of hypertension, diabetes, and migraines, all potential risk factors for trigeminal neuralgia. Her treating neurologist, Dr.

Gadipudi, had noted that the flu shot would not have any relation to her facial spasms. Ultimately, the court found that Ms.

Timothy failed to establish a medically probable theory of causation linking the flu vaccine to her trigeminal neuralgia, as the proposed mechanism was not supported by the evidence and the analogy to Bell's Palsy was unconvincing. The court also found that the medical records did not demonstrate a logical sequence of cause and effect, and that her treating neurologist had explicitly denied a link.

Therefore, the petition was dismissed for failure to prove entitlement.