Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: Need Some Answers Please.
Forum: The Neurology and Neurosurgery Forum
Topic Area: Reflex Sympathetic
Posted by CCF Neurology MD - AY on September 15, 1998 at 06:41:42:
In Reply to: Need Some Answers Please. posted by Belinda on September 15, 1998 at 00:04:33:



Dear doctor, I am not sure if I posted in the right catagory as I do not know what is wrong with me. I have to search the internet now for answers. I will not see another 'wrong' doctor and get a script for pills without knowing what I have and why I am taking them. My pains started with dental work. I actually may have two problems. The jabs in the teeth periodically do not bother me. What bothers me is the achey, tingling and soreness in my left neck/throat/temple area that has extended to weakness in the whole body and tingling and swelling in the feet and legs. The hands are stiff and swollen now when I get up in the mornings as is the rest of the body. I can hardly move when I get up. I also wheeze when I lay down at night and sound like a fog horn. I also have irregular heart rates when I feel the worst .(heart tests were normal) I had an MRI of the brain and of the cervical. It only shows a small bulge in the C5/C6 area and the orthopod said it is nothing. There are afternoons that I have such great fatique and malaise that I go into a deep sleep for 2 hours..I never had or felt like this prior to this dental work. Someone said a possible neck injury in the chair...But I do not know. I can walk and feel pressure going up my spine and settling into my head. I feel some relief when I lay down. Saw many doctors but husband said I am seeing the wrong kind or I am not explaining myself correctly. What kind of a doctor should I see? Three neurologist do not know. Orthopod does not know. Cardiologist does not know. They gave me Mexitril, Pamelor, Neurontin, Ultrum, Stadol, Daypro and Relefen. No help. Blood work is all normal except for a bit of elevation in the white count. The alpha interferon is quite elevated and the IGG is low. The doctor did not know how to interpt these. Neither do I. Could I have RSD and how do I get tested for this? .Lyme Disease? I see where you mentioned EMG's in another post. I never had these. Would that help diagnose me?. There is also like a squeezing sensation in my left throat/neck area when I bend over and/ or turn my head. At times when I turn my head to the left I will get dizzy but this only last for a few seconds. Sorry for this being so long. I am tried of this pain. I need answers. Going on two years now. What are nerve blocks? I never had these. Thank you doctor. This is so embarrassing that I have to resort now to the internet for answers and help. Belinda.


=
Thanks for your question. It is difficult to find a single/"unifying" explanations
for all your symptoms, so I will try to address some of the issues, and start it
from there:

1. "Excessive daytime fatigue and sleepiness": it appears that you might have
a component of sleep obstruction (or apnea). It is not easy to directly
correlate that to your dental work, but did the procedure somehow extend
to the back of your oral cavity? Were you prone to snooring before? An
evaluation at a "sleep study lab", where your sleeping pattern is continuously
recorded for a night, could be helpful. A neurologist or ENT (ear/nose/throat)
surgeon specialized in sleep disorders might be helpful.

2. "Morning stiffness and aches": from the description it is difficult to
know if it is muscular or articular (joints) in nature. Blood tests
known as "acute phase reactants" (Sedimentation rate, C reactive protein)
would help clarify the hypothesis of some chronic inflammatory process -
which could, for instance, cause mildly elevated white counts.

Reflex Sympathetic Dystrophy (RSD) is mostly commonly associated with a
history of trauma, and can be evaluated by testing the sweating function
in the affected limb. An EMG (electromyogram) is not an appropriate exam
unless your physician can identify a specific/localized motor or somatosensory
deficit, or find objective evidence of muscle wastings/weakness.

I hope this information is helpful. Best of luck.

This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.


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