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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Nueralgia due from injuryForum: Neurology Forum
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On 6/14/98 a cart struck my left heel and then ran over my foot in the emergency room where I work as a RN. I had immediate burning pain up the back of my calf from the heel--ER doctor thought I might have an achilles tendon tear and put me in an OCL splint for 2 days until I saw the Ortho Dr. who put me in a walking boot. One week later I started having severe burning pain in my knee along with the similiar pain I had all along in my foot and ankle. He thought the knee pain was from the boot and had me wear a high top tennis shoe after the MRI showed no achilles tear, but the burning pain kept continuing these past weeks and now in the thigh. Ortho Dr. consulted a neurologist and put me on Neurontin 100 mg. TID, but this did not help. When this continued I insisted on seeing a nerologist who increased the Neurontin to 200 mg TID, but this made me very sleepy. He said that my left foot was weak and that is why I have had a limp and put a TENS unit on my leg to help the pain and d/c the Physical therapy that the Ortho Dr. had ordered and stated that I should have been resting the leg instead of exercising it. Should mention that I am 108 lbs and 4ft 11inches tall and very active--walk 3 miles per day and exercise reg.The Neuro Dr. is calling my problem Neuralgia, but my Ortho Dr. and other Drs. I discuss my sx with call it possibly RSDS. Anyway, the burning pain(worse at noc and no sleep) has moved up my buttock on the left side and then one day this week it moved suddenly up my back causing severe SOB and I had to seek help in ER. Saw my Neuro Dr. yest and he increased the Neurontin to 3oo mg in am and afternoon and 400mg. at hs--unable to tolerate this doseage--can't function--like I am high on something--so spacy!!! I have a EMG and MRI of my lumbar area scheduled this week and have to be off work for 10 days--I have only been able to in and sit for 4 hrs/day the past 2 wks, other wise I have been unable to work. Is it common for such an injury to cause perm. pain? I have diff sx from the burning pain to numbness, tingling--each day has been diff and my left leg feels like it is half dead. Is there a specialist in the USA who deals with neuro problems such as mine. I couldn't go to Mayo's because this is a work.comp case.
= Thanks for your question. It appears you had an adequate neurological evaluation so far. Another diagnostic possibility to consider in your case is Neuralgic Amyotrophy, which can result in the severe pain, and weakness symptoms that you have been experiencing. However, in this pathology your EMG studies would be abnormal. If you would consider a referral to the Cleveland Clinic, the Department If you wish an appointment at the Department of Neurology at the Cleveland I hope this information is helpful. Best of luck. This information is provided for general medical education purposes only.
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