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Neurology (Expert Forum)
All comments appreciated (where to go from here?)
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
All comments appreciated (where to go from here?)
by EJoe, Sep 10, 2003 12:00AM
Any suggestion / guidance would be much appreciated. I'm not sure where to go from here and my doctors don't seem to be either. I haven't been to a neurologist yet and am not sure if my symptoms justify it.
I'm a 35 year old caucasian male and have been experiencing a host of symptoms - some physical and some neurological - for at least 10 years. Over the last 3 months I've had symmetric numbness in my two outer fingers, up the outer edge of my arms and in my outer toes and up my legs. I've also had some lightheadedness and some unsteadiness (I wouldn't call it vertigo as I'm not dizzy) over this period. Tingling in my two outer fingers is a fairly regular thing, though it seems to come and go. It's particularly acute in the morning.
Other neurological fun and games:
(a) when I sneeze I often get shooting pains down both my left and right arms that subside in under a minute.
(b) I often experience "spots" of pain. I would liken it most to the feeling you get when your funny bone takes a whack. They subside in 1-3 minutes. They're not symmetric and though I tend to get them into the palms of my hands most often, I've gotten them in my arms, legs, shoulders and privates. Is there a name for this?
(c) I get alot of muscle "twitching". It does not persist for very long and tends to move around.
I had an MRI of the brain two weeks ago and that came back normal. Various x-rays, bonescans, etc haven't shown anything. I don't perceive any muscle weakness. I take Celebrex for various rheumatalogical symptoms.
Thanks much.
I'm a 35 year old caucasian male and have been experiencing a host of symptoms - some physical and some neurological - for at least 10 years. Over the last 3 months I've had symmetric numbness in my two outer fingers, up the outer edge of my arms and in my outer toes and up my legs. I've also had some lightheadedness and some unsteadiness (I wouldn't call it vertigo as I'm not dizzy) over this period. Tingling in my two outer fingers is a fairly regular thing, though it seems to come and go. It's particularly acute in the morning.
Other neurological fun and games:
(a) when I sneeze I often get shooting pains down both my left and right arms that subside in under a minute.
(b) I often experience "spots" of pain. I would liken it most to the feeling you get when your funny bone takes a whack. They subside in 1-3 minutes. They're not symmetric and though I tend to get them into the palms of my hands most often, I've gotten them in my arms, legs, shoulders and privates. Is there a name for this?
(c) I get alot of muscle "twitching". It does not persist for very long and tends to move around.
I had an MRI of the brain two weeks ago and that came back normal. Various x-rays, bonescans, etc haven't shown anything. I don't perceive any muscle weakness. I take Celebrex for various rheumatalogical symptoms.
Thanks much.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Sep 11, 2003 12:00AM
Some of the symptoms you describe, particularly the sneezing and and funny bone like sensation, could be consistent with a nerve problem in your neck. Patients with bulging discs or nerve impingement within the spine typically complain of similar symptoms. Therefore an MRI of the cervical spine would be reasonable. If you have not seen a neurologist it would be advisable. They can help to further investigate your symptoms which are diffuse. Perhaps an EMG (test to measure the muscles and nerves) would be useful. Other possibilities which could be screened include vitamin B12 dysfunction, lupus, other connective tissue disorders, vitamin E dysfunction, and possibly lyme disease. Good luck
Longer term, I have been seeing a rheumatologist and am taking Celebrex for arthritic symptoms. I get the usual batch of blood tests every 6 months and nothing exceptional ever turns up. I have a tendency toward mild polycythemia. I also had the genetic test for hemochromatosis which came back negative.
Most of my physical pain is in my neck, hands and feet. It seems to me as though it is focused on my tendons (esp achilles) but I can't say for sure. It is almost always symmetric. I also have bouts of fatigue.
Aside from some unexplained episodes about 20 years ago (vision disturbance, and a separate "illness" that resulted in incredible fatigue but was never diagnosed) I've had the following history:
15 years ago I started to experience a fair amount of pain fast walking or running in my shins. If I ignored it, it would become quite bad and persist outside activity. In some cases it bothered me for months before it got better.
12 years ago, I gave up golf because I couldn't play any more without substantial pain in my hands - it felt like tendonitis and took months to heal.
6 years ago I found I could no longer use a "normal" computer keyboard without alot of pain in my hands. I had it in both hands and a neurologist gave me some tests for carpal tunnel which came back negative. I started using specialized keyboards which are much better.
5 years ago I developed a large number of small blisters on my fingers and toes. At their peak, there were as many as 50 on a single finger. They were clustered around the joints. This would subside and recurr, but each recurrence was less severe and now I only occasionally get a couple on one finger or toe.
3 years ago, I started having noticable morning stiffness and I was having some substantial joint pain (IOW it was bothering me). My GP gave me methotrexate for a couple of months and that was great. When I go to see the rheumatologist, I ended up taking celebrex which has seemed to limit the long term inflamation issues I was experiencing.
Recently I went to a research hospital for a second opinion on the rheumatology side and they said it sounded like spondylitis might be a possibility though I didn't really fit the pattern. (I don't have any lower back pain)
Other physical fun and games:
(a) Chronic sinusitis
(b) My left eye gets red and itchy in the evening. The corner of my eye twitched for a year straight - though fortunately thats subsided. I was checked by an opthamologist and he just noted persistant low level conjunctivitis.
(c) Various bowel issues for the last 15 years (esp dumping syndrome). Various tests for IBD come back negative. Had a flex sig done and the doctor said there was alot of spasming going on.
In any case, it's insidious and progressive. Any thoughts and potential new directions would be appreciated.
http://www.fmnetnews.com/pages/criteria.html
Tests like MRIs, EMGs, and standard bloodwork usually come out negative. That does *NOT* mean that this condition isn't real, or that you don't need the Celebrex or other treatment. It just means fibromyalgia is not understood yet.
The "blisters" you describe having on your fingers and toes - did you also notice any around your abdomen/upper thighs? Also, did these "blisters" look like small, dark red/black, bumps that bled when scatched? Do you experience "burning" and/or "shooting" pain in your hands and/or feet, especially when it's hot out or if you have a fever? You mentioned an opthamology exam noted conjunctivitis? Did the DO also perform a slit-lamp exam, if and so, did he/she make any mention of "corneal opacities"?
If yes to these queries, I would look up Fabry's disease. Your symptoms sound very similar to my own (except location of "blisters" - angiokeratomas and bowel symptoms), and I am being tested for this lyosomal disorder now. Your age (35) is a little off for developing these symptoms now, but it has such variable presentations, who knows?
Best of luck in nailing the problem down...