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Neurology (Expert Forum)
Neuralgia
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
Neuralgia
by Bits, Aug 07, 2004 12:00AM
I am a healthy 58 year old female and told I have neuralgia. Problem began 07/03/03 with severe sharp pains in upper left flank radiating into breast. CT Chest & Abdomen with contrast - no significant inter-abdominal adenopaty identified. MN Bone 3 Phase scan - no abnormalities in left ribs - mild degenerative changes in lower thoracic spine. MR thoracic spine without contrast - minor hypertrophy of articular facet on left side at T10-11 without stenosis. MRA abdomen - no vascular anomaly noted. EKG normal. Chest x-ray normal. Colonoscopy - biopsy negative. Endoscopy - biopsy negative, medium hiatal hernia. All blood and urine work within normal limits. Facet injection at T10-11 at Pain Clinic successful on first injection. All pain disappears as result of injection on 08/14/03. Severe pain returns 04/29/04. Referred to Pain Clinic and received 2 facet injections which are unsuccessful. Referred to neurologist who states I have neuralgia, usually associated with shingles - never had shingles. Currently taking Prempro, Protonix, Vioxx, Trileptal, Flexeril, Percocet, Actiq & using Lioderm patches. Never know when attack of pain will manifest itself or how severe. Pain can be totally debilitating and at times would be willing to donate left breast to anyone willing to take it. Never experiences such pain in my life. I have been told that I will likely have this the rest of my life. I am seeking any information & literature available regarding this problem. Any input would be greatly appreciated.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Aug 11, 2004 12:00AM
Without examining you I cannot be sure, but it does sound like this is isolated to one nerve area, and could be consistent with neuralgia. Causes of neuralgia could include: shingles, diabetes, lyme infection, non-specific inflammation, and idiopathic (meaning the doctors do not know). To evaluate this a MRI of the thoracic spine, consider markers of inflammation , and lastly a spinal tap, for fluid analysis (look for inflamation and signs of Lyme disease). Regarding treatment, I would typically use a anti-seizure medication such as neurontin, carbamazepine, and trileptal to name a few or elavil (an anti-depressant). If Trileptal is not working the dose can be increased, or you could try a need medication. You can discuss this with your neurologist, and seek a second opinion if you have any other concerns. Good luck.
I have had three MRI's, EMG and an EEG, all of which were normal, yet my symptoms have progressed to involve all my extremities, except my right foot and leg. I had footdrop in the fall of 2001 and the sole of my foot is always tender and sore. I also have a history of allergies, had Bell's Palsy, chickenpox as an infant and prior neuralgia like pain most of my adult life. I was just wondering if you may also have had a similar medical background and if a virus may be responsible for these symptoms. I have read up on MS and they now suspect a virus may be responsible for trigguring that Immune Disorder.
Take care,
The Canadian
Best of luck with your situation.
Bits
It seems that until we are afflicted with our own personal pain filled journey, that we tend to take good health for granted. Pain changes who you are and it rules your life, your body responds to this assault with stiffness, numbness, soreness and fatique. If they offered me the lottery or two weeks of relief from pain and restful sleep, I think I would chose the pain relief.
Thanks for your comments and hang in there. I am much better emotionally then I was when this all started. You just have to learn to make the most of it and keep on hoping that something will show up to explain it sometime in the future. I think not having a diagnosis or label to rationalize it all is the worse. People who have MS or Cancer, etc. at least know what they are dealing with and they now have newer meds to help out in these diseases, not that I would want to have either.
God Bless,
The Canadian