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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Arteriospasms of unk. etiologyForum: Neurology Forum
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My daughter is diagnosed with cerebral palsy...although she probably truly has post stroke symptoms from a bleed at/around birth (32-week preemie). Her scans show a non functioning area in the rolandic fissure area. She is 21 y.o. now..and still suffers from what was diagnosed as arterio-spasms of unk. etiology. Her right leg from about knee down will periodically show slowed circulation symptoms...cold feeling..cold to touch, mottled skin, etc. Plethsmography shows 1/4 circulation when exposed to the cold pressor test( hand put in ice water). I read the post about Neurotin (sp). Would this be a medication that might be worth investigating for her? She does not spend much time outside in the cold weather, has difficulty sleeping due to the symptoms occurring more frequently at nite, limits swimming and other activities to situations that will not expose her to large temperature differences. (The Cerebral Palsy (?) evidences itself mostly in hypertonic muscles on the right side..mostly in the leg, minimally in the arm, and not elsewhere. She is fully functional, but kinestetic sense is diminished, as well as some spasticity ( minimal ) on the affected side. Her worst problem is leg length discrepency coupled with the spasticity, causing gate problems, as well as this circulation problem. She also gets migraines on a regular basis, and has tried many of the meds designed to control them. Would they be a symptom of possible circulation changes in the brain...Given her probable neonatal bleed, and post stroke condition? WOuld the migraine meds be contraindicated given her hx? I appreciate the time and info regarding this child...and enjoy reading the forum. Thank you for the service...
There is no published experience regarding the use of Neurontin in peripheral arterial spasm, there is extensive evidence of its use in periphera neuropathy but this does not nesessarily transfer over to use in the situation you describe. Migraine is probably due to spasm of vessels in the brain, but the mechanism is different to that seen in peripheral problems. There has been no link established dbetween migraine and peripheral vascular spasm disorderds like raynauds phenomenon which is more closely realted to what you are describing. Regardless of the underlying cause the diseases characterised by vessel spam do respond to vasodilator drugs like Verapamil and Nifedepine. Some drugs used to treat midraine like propanolol would be contraindicated but the first two I mentioned Verapamil and nifedepine could theoretically help both problems.
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