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Neurology (Expert Forum)
Any suggestions?
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Any suggestions?
by macui, Jun 20, 2003 12:00AM
Thank you for your help. 2.5 years & too many docs I remain w/persistent symptoms & no diagnosis.What began w/ mild tingling sensations has developed into constant burning sensations in my legs, primarly below the knees & my hands-recent; flu + feelings, tightness around the lft side of face, occ blurring of lft vision & lft mid calf numbing-no weakness.Persistant left sided chest pain has developed over the last 3 mos.The longest respite from the burning symptoms has been 2 mos. Symptoms worse at nite & present all over body accompanied with nite sweats.I am 47,female,NEVER been ill. W/in the past 2 yrs i've had mris of brain 6/02 (normal),cervical& thoracic-moderate spondylosis & dicogenic change, scoliosis involving thoracic, covexity to rt, min extrincic compression on thecal sac, post on T11-12. Blood:basic metabolic, hepatatic function, cbc,sed rt,b12,lyme,adolase,ana,tsh-all normal.Normal brain stem somatosensory upper & lower& visual evps, normal nerve conduction study. Neuro "clearly the patient is getting migraine accompaniments without headaches" Aside from the above I now find myself dealing w/issues never before encountered, constipation, indigestion, gerd, pneumonia.I've made major lifestyle changes re diet,exercise & stress. Something is causing these symptoms yet what i hear form the doc's is that all tests are normal - i feel as though i'm not fitting into anyones's box of readily recognizable symptoms so everything must be ok. I've done my best to remain positive & proactive about this but ... Any insight and/or suggestions are greatly appreciated. Thanks
Doctor's Answer
by CCF-Neuro-M.D.-JT, Jun 23, 2003 12:00AM
The symptoms you describe do not localize to or fit one particular region of the nervous system. However, some of the symptoms such as the burning sensations may represent a small fiber neuropathy while others like the bowel changes may represent an autonomic neuropathy. A simple way of thinking about sensory nerves is that there are large fiber and small fiber nerves. Most of the tests we have out there like EMG and evoked potentials test the large fibers. However, small fiber nerves which are responsible for modalities such as pain and autonomic functions (like sweating) require more specialized testing. Unfortunately, even if the diagnosis is established, the cause is never found in quite a number of cases. Diabetes is certainly a big cause and formal testing with a glucose tolerance test should be considered. If you are in the area or willing to travel, Dr. Robert Shields heads our small fiber/autonomic lab and would be happy to see in consultation. Good luck.
I am a female age 56, who has been afflicted with unexplained pain, numbness, pins and needles feelings, body twitches and electrical sensations in the head, that sound like elastic bands snapping. The other night I had about ten body twitches and it was very disturbing. They seem to happen just before I fall asleep, when I am in the first stages of sleep, but still partly consious.
I had foot drop in the fall of 2001 and then I started having periods of dizziness, vibrations and painful, sensitive eyes. I couldn not stand any bright light, nor could I drive in the car, without jumping at any little thing and practically had to cover my eyes, as the approaching cars made me dizzy. The dizziness and vibrations have calmed down but some days I will notice my legs are quivering or see the muscles moving under the skin.
The arch on my left foot was affected by the foot drop and it is now higher than my right foot. That affects my walking as I am down on one side. I can walk about five steps and then I have to stop as I go sideways. I have left sided weakness, which affects my balance and coordination. The numbness in my fingers and hands affects my fine motor skills. I go to the Pool and Joint Works run by the Arthritis Foundation twice a week and I really give my legs and arms a good workout. I can't walk any distance as my legs tire and it is not too safe as I can easily lose my balance. I am OK on level surfaces but have never been able to regain my normal walking gait and don't do well on stairs or slopes.
I have an exagerated startle reflex and my knee reflexes are hyper. At first my neuro thought I had a Central Nervous System disorder and that my neurons were misfiring. They also suspected MS, but since the MRI and other reports were clean, that has been ruled out for now. I have a second cousin and a grandaunt who had MS and both came down with it in their 40's and 50's. I also had a grandfather and two aunts who had Pernicious Anemia, but they tell me my B12 levels are OK. My brother was suspected of having Charcot Marie Tooth, but now they think his footdrop and leg problems are because of a bulging disk in his back. He had scoliosis as a child and has Harrington Rods in his back. He does not have burning pain like I do with my foot. The sole of my left foot is very tender and I find myself walking on the side of my foot or my toes to keep from aggravating the pain.
I also have speech problems that came on in the last year. I either stutter by repeating the first word about five times, or else I can't seem to get the right word out, or say them backwards. It doesn't happen all the time, but I can never predict when.
My cognitive reasoning abilities have not been affected and I do not suffer from clinical depression. I did go see a mental health therapist for six sessions and she verified that I was not clinically depressed, but was just reacting to this the same way anybody would, whose lifestyle has completely changed and there is no medical explanation for it.
I have a history of allergies, had Bell's Palsey in my thirties, chickenpox as an infant, convulsions as a toddler and my mother died of a brain hemmorhage at age 48.
I am managing as best as I can and am awaiting a referral to a major neurology centre where they will begin testing all over again, and hopefully find the reason for these sypmtoms. Primarly the pain and numbness affects my left leg from the knee down to the foot and toes. My right arm from the elbow down to the fingers and toes and my right hand and fingers. It feels like I slammed my elbow down on something hard, yet it do