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Neurology (Expert Forum)
Sensory disturbances, muscle pain
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Sensory disturbances, muscle pain
by Nutricia, Jul 04, 2005 12:00AM
Dear Neuro,
I,m 39yo female, had my third baby in May 2004, very traumatic experience - 7 days on NICU, continous problems after, months of anxity and worry. Came back to work in September, Flu shot, two weeks later muscle tweeches in my legs started. Chest pains, squeezing, went to Cardio in December - Stress Echo-normal, Chest X-ray suspicious area (a lot of stress), clarified in January by Chest CT-completly normal.Occasinal dizziess and nausia. Begining of March went to chiropractor, next day severe dizziness,strange hearing, nausea started continously, went to Neuro, dx Vestibulatis or Anxiety, prescribed Meclesine. ENT visit - some lost of hearing higher frequences, had that for years- stoped Meclesine, started on Prednisone 6 days, ANA, ESR, RPR, RF, Lyme - normal. A week after bizzare sensations started: muscle tweeches, could feel muscles getting into spasms, knobs all over the body, stabbing pains, "buzzing", pareasthesies everywhere,one morning could't move arms. Third Neuro exam normal, brain MRI pre, post contrast normal, C-spine MRI " multiple posterior central dics herniations C3/4, C4/5, C5/6, C6/7 with correspondingindentionof the adjacent ventral CSFspace withoutcord contact or neural foraminal inpingement. Straightening of cervical lordosis". April parestheasies, muscle, joints pains-limbs Advil wouldn't help, 4th neuro exam normal,CBC, metabolic, liver,thyroid,RF,ANA,HGB A1C,Homocysteine,HS CRP,CPK,RPR,Aldolase,Esr-all normal. Tried Effexor-more anxity, PR120, coulnt sleep-stopped, occasinal 0.25 Clonasepan. Stopped DR visits.
I,m 39yo female, had my third baby in May 2004, very traumatic experience - 7 days on NICU, continous problems after, months of anxity and worry. Came back to work in September, Flu shot, two weeks later muscle tweeches in my legs started. Chest pains, squeezing, went to Cardio in December - Stress Echo-normal, Chest X-ray suspicious area (a lot of stress), clarified in January by Chest CT-completly normal.Occasinal dizziess and nausia. Begining of March went to chiropractor, next day severe dizziness,strange hearing, nausea started continously, went to Neuro, dx Vestibulatis or Anxiety, prescribed Meclesine. ENT visit - some lost of hearing higher frequences, had that for years- stoped Meclesine, started on Prednisone 6 days, ANA, ESR, RPR, RF, Lyme - normal. A week after bizzare sensations started: muscle tweeches, could feel muscles getting into spasms, knobs all over the body, stabbing pains, "buzzing", pareasthesies everywhere,one morning could't move arms. Third Neuro exam normal, brain MRI pre, post contrast normal, C-spine MRI " multiple posterior central dics herniations C3/4, C4/5, C5/6, C6/7 with correspondingindentionof the adjacent ventral CSFspace withoutcord contact or neural foraminal inpingement. Straightening of cervical lordosis". April parestheasies, muscle, joints pains-limbs Advil wouldn't help, 4th neuro exam normal,CBC, metabolic, liver,thyroid,RF,ANA,HGB A1C,Homocysteine,HS CRP,CPK,RPR,Aldolase,Esr-all normal. Tried Effexor-more anxity, PR120, coulnt sleep-stopped, occasinal 0.25 Clonasepan. Stopped DR visits.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jul 09, 2005 12:00AM
Its encouraging that your neuro exams are normal, and (although limited by not seeing the MRI) your MR scan are ok. The cervical spine findings are probably not causing any symptoms
It is difficult to localize your symptoms to one area of the nervous system. Widespread paresthesias and muscle/joint may be a more systemic disorder such as B12 defiency or calcium/phosphate disorder or other electrolyte disorder. Some potassium channel disorders can cause 'periodic paralysis', a transient inability to move, especially after a cardohyfrate load. It is difficult to diagnose - havign blood drawn during an episode for example. An EMG can sometimes also be helpful in picking it up, and it may be helpful to have the sensory nerve conduction study as well to look for a sensory neuropathy. POsterior tibial and median nerve evoked potential studies can sometimes be helpful in picking up spinal cord abnormalities not seen on MRI. Less likely are seizures, and a normal EEG would be reassuring in this regard.
Good luck
It is difficult to localize your symptoms to one area of the nervous system. Widespread paresthesias and muscle/joint may be a more systemic disorder such as B12 defiency or calcium/phosphate disorder or other electrolyte disorder. Some potassium channel disorders can cause 'periodic paralysis', a transient inability to move, especially after a cardohyfrate load. It is difficult to diagnose - havign blood drawn during an episode for example. An EMG can sometimes also be helpful in picking it up, and it may be helpful to have the sensory nerve conduction study as well to look for a sensory neuropathy. POsterior tibial and median nerve evoked potential studies can sometimes be helpful in picking up spinal cord abnormalities not seen on MRI. Less likely are seizures, and a normal EEG would be reassuring in this regard.
Good luck
What it all can be? anxiety, paraneopalstic syndrom, ALS, ... Forgot to Mention that Since June 2003(migraine and tension headaches) to April 2005, I had 3 brain MRI all normal. Thank you for your attention.