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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: pain, numbness partial paralyiasForum: Neurology Forum
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Hi My 17 year old son had his tonsils and adneoids removed oj 10-28-98 He was told he would be up and at it with 7 days. He ended up being out of school almost week. Went back to school on Nov 16. still did not feel the greatest stayed all day came home at 3:00 and was exhausted, so he took over a 2 hour nap. then as he started to work on his homework he was complaining of severe chest pains and pain going dowan the right arm. We waited a little while then took of for the ER they said that he had sevee chest wall syndrome and sent home with a presp. for ibpuferon 500 mg. In two days still no inproement in fact worse so I called our family doctor and took him in. he felt at the time Brad had chest wall syndrome. As each day goes by Brad is getting worse not better and on Nov.28, 1998 we go back to ER Brad had lost the use of his right arm. He has no muscle control, cannot lift his arm up on its own has no strength and grip whole arm hurts but from elbow down it is asleep. He now has extreme pain in both shoulders, both sides of his neck and it is starting down left arm. We have had MRI SPINE MRI BRAIN EEG EMG COUNTLESS BLOODWORK spinal tap. First we had a diagnoizes of Guillian Barre, possible reaction from anethestic, fibromyagilia and parsonage turner syndrome. All test were negative but spinal tap showed white cellcount of 38. After doing emg the neurologist it was negative and so that rules out personage turne exam. During this time he was give Solomedral 60 mg every 6 hours and given Neurontin for pain. Did pretty well until the day Dr uped it to 2 pills 3 x the next day Brad begin to get ral light headed, dizzy falling and staggering like a drunk, his eyes were moving back an forth like crazy. So after 4 days of letting the body adjust to new medicine I called doctor he said to to stop the neurontin right now.ANd start tegretol after 1 dose of the tegretol Brad not only had all the other symptons plus now he was having some type of seizure. They started as his left arm, feet, moving up and down eyes moving vey fast. Then the next day he started having the jerking and talking and acting like he was a 2year old. Was told to pull him off tegretol. Again just yanked him off without working him off. The doctor said he didn't know what was causing the seizures and really isn't sure what they are. Also he is not sure what could be causing his other problems. So I said thank you very much but I need Brad's records and we are going to another doctor. So we did and he is in the process of doing theat and having more tests. DO YOU HAVE ANY SUGGESTIONS AS TO WHAT IT MIGHT BE!!bRAD HAS MISSED ALMOST 6 WEEKS OF SCHOOL AND HAS A TUTOR COMING TO THE HOUSE HE IS TOO WEAK hAS ANYONE EVER HEARD OR HAD ANYTHING LIKE THIS ANY HELP WOULD BE GREATLY APPRECIATED thanks Brad had been loratab exl for pain from tonsilectomy
Dear Brenda: Difficult and challenging diagnostic problem. The course and symptoms are indeed quite suspicious of the Parsonage Turner syndrome ("neuralgic amytrophy"). The EMG, however, should be abnormal in that situation, although it is possible that an extensive enough survey was not performed. In addition, the cells in the CSF point to an inflammation of the nerve roots or spinal cord. CSF pleocytosis is unusual with the Parsonage Turner syndrome, but would be seen with disorders such as multiple sclerosis, lyme disease, and some other rare infections and inflammations. Neuromuscular specialists (Dr. Hiroshi Mitsumoto, Dr. Kerry Levin, and Dr. Robert Shields) at the Cleveland Clinic would be most happy to address your son's problem. In case a detailed EMG re-evaluation is felt necessary, Dr. Asa Wilbourn, the director of the EMG laboratory at the Cleveland Clinic, is one of the world's leading experts on the Parsonage Turner syndrome. Appointments can be made by calling (800)223-2273, or (216)444-5559 locally.
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