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Neurology (Expert Forum)
Could this be neuralgia?
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Could this be neuralgia?
by E D, Oct 27, 2000 12:00AM
I'm 35 with a chronic pain problem and no clear diagnosis. It began over 6 years ago. The main pain is constant burning and is triggered by pressure. It is bilateral but localized and may have begun by overuse of each effected area. All areas were not effected at the same time but manifested themselves over the course of about the first 2 years. The areas effected in order of their onset: both feet, both knees, tailbone & buttocks, chin, then both outer thighs. There does seeem to be trigger points in both my feet and tailbone when I have bad flair-ups but not in the other areas. I also have increased skin sensitivity in all these areas along with other areas in my upper body. Remission does happen at times, but it's never complete and some areas are not included. Avoidance is the best medicine but complete impossible.
My question is could this be neuralgia, and if so, what kind? One other factor I think might be related is that I've had genital herpes for the past 16 years. Could this virus have caused this, and if so, explain why? Could this make the diagnosis postherpetic neuralgia or is that diagnosis only for zoster herpes? If someone has postherpetic neuralgia do they only have symptoms in the area of the lesions? I have an appointment next month with a different neurologist and I would appreciate any information that you could give me in order to help me better prepare.
My question is could this be neuralgia, and if so, what kind? One other factor I think might be related is that I've had genital herpes for the past 16 years. Could this virus have caused this, and if so, explain why? Could this make the diagnosis postherpetic neuralgia or is that diagnosis only for zoster herpes? If someone has postherpetic neuralgia do they only have symptoms in the area of the lesions? I have an appointment next month with a different neurologist and I would appreciate any information that you could give me in order to help me better prepare.
Doctor's Answer
by CCF Neuro[P] MD, RPS, Oct 30, 2000 12:00AM
Dear ED:
Sorry to hear about your constant paresthesias. What sort of lab workup have you had? What was your sedimentation rate? If it were high, then post-viral may be a cause. This would also go along with your genital herpes (as you know, herpes is a life long disease). You might also have fibromyalgia as you have constant pain and trigger points, but you didn't seem to mention fatigue. There is a genetic disease of pressure palsies but you do not give a history of family members having your problems. Small fiber neuropathy can be a cause, but these are difficult to diagnose. I will assume that you are not an alcoholic, diabetic, have amyloidosis, tangiers, etc. (systemic illness)or trauma. I would think that some lab tests of sedimentation rate, vitamine B12, and maybe an EMG or MRI of the spine might help in giving your physician a direction to investigate.
Sorry, that I am not much help.
Sincerely,
CCF Neuro MD
Sorry to hear about your constant paresthesias. What sort of lab workup have you had? What was your sedimentation rate? If it were high, then post-viral may be a cause. This would also go along with your genital herpes (as you know, herpes is a life long disease). You might also have fibromyalgia as you have constant pain and trigger points, but you didn't seem to mention fatigue. There is a genetic disease of pressure palsies but you do not give a history of family members having your problems. Small fiber neuropathy can be a cause, but these are difficult to diagnose. I will assume that you are not an alcoholic, diabetic, have amyloidosis, tangiers, etc. (systemic illness)or trauma. I would think that some lab tests of sedimentation rate, vitamine B12, and maybe an EMG or MRI of the spine might help in giving your physician a direction to investigate.
Sorry, that I am not much help.
Sincerely,
CCF Neuro MD