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Neurology (Expert Forum)
Hyperexcitable peripheral nerve disorder
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Hyperexcitable peripheral nerve disorder
by Lee, Dec 11, 1999 12:00AM
I have just been diagnosed as having a hyperexcitable peripheral nerve disorder and cannot find any information about this. My EMG showed "channel abnormalities" that can result in problems such as Isaacs syndrome. I am confused as to the the direction these syndromes lead. Do they progress? Do they lead to more serious neurological diseases? Can they disappear? I am a 40 year old female and have led a very active life and would like to continue this lifestyle. My symtoms consist of facsciculations ,facial pain, vibrating sensations numbness in my hands and feet. In addition to these symtoms I also have pain and stiffness in my knees which make walking difficult at times. My doctor does not believe the knee problem is a condition of this nerve disorder. What information can you give me concerning this syndrome?
Doctor's Answer
by CCF Neuro[P] MD, RPS, Dec 12, 1999 12:00AM
Dear Lee:
I am not sure how your physician decided that you had a channel disorder by EMG? The EMG wuold only tell you that you had widspread myokymia with delayed muscle relatation (excessive and spontaneious muscle activity). Twitching spasms, and rippling of muscles are evident. THere can be stiffness and slowness of movement but severe muscle aching is not found. This condition is sometimes found with a type of inherited ataxia that is responsive to diamox, and sometimes this disorder remits on its own. If you have had the genetic test that looks at the potassium channel on chromosome 12, then you might have the genetic type, and not the inherited ataxia or spontaneous type. Interesting, there is a psychiatric form associated with psychosis.
Anyway the treatment is phenytoin or carbamazepine which usually abolishes the muscle activity.
I can not tell you whether your knee problem is part of your disorder.
Sincerely,
CCF Neuro MD
I am not sure how your physician decided that you had a channel disorder by EMG? The EMG wuold only tell you that you had widspread myokymia with delayed muscle relatation (excessive and spontaneious muscle activity). Twitching spasms, and rippling of muscles are evident. THere can be stiffness and slowness of movement but severe muscle aching is not found. This condition is sometimes found with a type of inherited ataxia that is responsive to diamox, and sometimes this disorder remits on its own. If you have had the genetic test that looks at the potassium channel on chromosome 12, then you might have the genetic type, and not the inherited ataxia or spontaneous type. Interesting, there is a psychiatric form associated with psychosis.
Anyway the treatment is phenytoin or carbamazepine which usually abolishes the muscle activity.
I can not tell you whether your knee problem is part of your disorder.
Sincerely,
CCF Neuro MD
CCF Neuro MD
I am not sure what to expect from this diagnosis. I am afraid my symptoms will get worse. Is there anywhere I can find more information about Isaacs Syndrome? Does it ever progress? I've never heard of psychosis causing such symptoms. What is the possibility of this? I have never experienced any mental health problems.
Please read my posting. There is a form of myokymia that is associated with psychosis, not that you have psychosis. This is just a variant type. Look in all the neurology texts, I assure you that it will be present. Your symptoms do not indicate that you have a mental problem. Sorry I even brought up the subject.
CCF Neuro MD
You mentioned Dilantin and Tegratol as possible treatments for this condidion. If you have had little or no success with one( tegratol ) is it worth trying the other?
Thanks for your help.
DJ
Only if the fasciculations are due to myokymia.
CCF Neuro MD
Did you find any more information regarding hyperexcitable peripheral nerve disorder? I have almost the same symptoms as you, and my neurologist tells me to "wait and see". He put me on Neurontin. I don't like not having an answer for my problems. Do you also have fatigue?
I stopped taking Neurontin and lowered my Klonopin to .25 mg. I have been feeling alot better. I still have some knee pain and some twitching, but my legs feel great! I had a spinal MRI today and hopefully will find out next week if they see anything. Do your arms and legs fall asleep alot? Does your Doctor think you could have MS or a spinal problem? If my MRI comes out fine, I think I will go to Mayo Clinic and have them diagnose me!!
CCF Neuro MD