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Neurology (Expert Forum)
Need Help - Results are bugging me.
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Need Help - Results are bugging me.
by jeffm5690, Jan 22, 2002 12:00AM
Please give me some guidance. Beginning in December I had several headaches behind my left eye which turned into a Trigeminal Neuralgia. This was followed by twitches throughout my body which still persist. I have had intense "bone" like or muscular spasms all over. Back pain had begun and became worse down the left side with that same neuralgic feeling down my left thigh. On xmas, my left eye shifted to the left by inself then the lid fluttered for several seconds. I have seen a Neuro and Rheumy and the results are as follows:
MRI Brain nl
MRI L-Spine nl
EEG nl
EMG shows Multilevel Radiculopathy L4-S1 paraspinal myotomes. Note: Fibs/PSW 1+ for LumbParaL3,L4,L5,S1. NCV shows that left peroneal distally was of lower amplitude than the prox stimulation.
Blood results:
ESR 5
ASO 233
ANA Negative
IGG,IGM <1.0
Rheumatoid Factor 16
Anti Dnase B Antibody 120
I cancelled a LP for a second opinion because I worry that this is just a hunt for something that may be a simple dx. Could someone give me some guidance and let me know what I should do.
Thank you.
MRI Brain nl
MRI L-Spine nl
EEG nl
EMG shows Multilevel Radiculopathy L4-S1 paraspinal myotomes. Note: Fibs/PSW 1+ for LumbParaL3,L4,L5,S1. NCV shows that left peroneal distally was of lower amplitude than the prox stimulation.
Blood results:
ESR 5
ASO 233
ANA Negative
IGG,IGM <1.0
Rheumatoid Factor 16
Anti Dnase B Antibody 120
I cancelled a LP for a second opinion because I worry that this is just a hunt for something that may be a simple dx. Could someone give me some guidance and let me know what I should do.
Thank you.
Doctor's Answer
by CCF-Neuro-M.D.-JT, Jan 23, 2002 12:00AM
Many symptoms, but not necessarily all related. Back pain with "neuralgic feeling" down thigh could be explained by the "multilevel radiculopathy" on EMG, which basically translates into pinched nerve by something like a herniated disc. If twitches and spasms started before the EMG, and it still did not show any ominous changes related to those symptoms, then probably not serious neurologic disease. (keep in mind I have not personally examined you nor have I performed your EMG) However, what concerns me most about your history is the remark about your eye moving by itself. It's hard to speculate about this as there are not many details given, but this is something you should tell your neurologist. A formal eye exam by an ophthalmologist may also need to be considered. This could be a primary problem in the eye or brain. Glad the MRI was normal, but contrast scans (given with dye)may be helpful if not already done. Based on a few lines of history, I can't say whether or not you need the LP just yet. But talk to your doc about the eye problem so that someone takes a careful look at both the motion of the eye and inside of it with a funduscope. Good luck.
A Neuro Opthamalagist would be a good person to see.
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