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Neurology (Expert Forum)
Chronic Chest Pain and Hyperhidrosis
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Chronic Chest Pain and Hyperhidrosis
by celowe, Sep 29, 2005 12:00AM
Hi Doc. I’m a 32 year old male with asthma and no family history of neurological disorders, heart disease or other medical problems besides asthma. I have never smoked, did drugs or drank. I take Theophylline(22 years) and Singulair(6months) for my asthma.
Just a little over a year ago, my hands starting sweating, I started to have right side chest discomfort/pain just to the right of the breast bone and into the lower neck, I started to have a very fine tremor in my hands. These symptoms/conditions have continued everyday for the past year. I have had quite a few procedures to rule out any known cause.
For Chest Pain:Echograms to eliminate chest pain of cardiac origin. Ct and bone scan of my chest(normal)and my stomach has been ruled out as the cause. My chest pain does not respond to tylenol, NSAIDS or narcotic analgesics.
For sweaty hands: Thyroid has been checked twice and normal and a 24hr VMA to rule out adernal gland tumors.
Tremors: My doctor took me off theophylline, she thought this was problem but it did not solve the problem. I seen a neurologist, he prescribed Depakote which did not help.
I've also had a CT scan of brain and it came back normal.
As you can see I'm at loss for what could be causing this. I know that hyperhidrosis in mostly genetic and starts during puberty not when you're in your 30's. I could see a connection between the tremors and sweaty hands which could be an Autonomic disfunction, but I'm not sure how the chest pain plays in the big picture. Any suggestions on procedures for diagnosis or cause or am I pretty much SOL.
Just a little over a year ago, my hands starting sweating, I started to have right side chest discomfort/pain just to the right of the breast bone and into the lower neck, I started to have a very fine tremor in my hands. These symptoms/conditions have continued everyday for the past year. I have had quite a few procedures to rule out any known cause.
For Chest Pain:Echograms to eliminate chest pain of cardiac origin. Ct and bone scan of my chest(normal)and my stomach has been ruled out as the cause. My chest pain does not respond to tylenol, NSAIDS or narcotic analgesics.
For sweaty hands: Thyroid has been checked twice and normal and a 24hr VMA to rule out adernal gland tumors.
Tremors: My doctor took me off theophylline, she thought this was problem but it did not solve the problem. I seen a neurologist, he prescribed Depakote which did not help.
I've also had a CT scan of brain and it came back normal.
As you can see I'm at loss for what could be causing this. I know that hyperhidrosis in mostly genetic and starts during puberty not when you're in your 30's. I could see a connection between the tremors and sweaty hands which could be an Autonomic disfunction, but I'm not sure how the chest pain plays in the big picture. Any suggestions on procedures for diagnosis or cause or am I pretty much SOL.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Oct 02, 2005 12:00AM
I'm not sure if I can connect the chest pain with the tremor or another neurological cause
A fine tremor occurring at your age, with no other neurological abnormalities is usually benign essential tremor. This is especially likely if someone else in the family has it. Depakote will make it worse, as it is also a cause of fine tremor.
Tests for thyroid function are important as well as a few tests to ruleout some rare but treatable disorders like Wilsons disease. Treamtent is with medications such as beta blockers or primidone. The hyperhidrosis is less clear, but it would be interesting to see if it diminished when, for example, a beta blocker was succesful in treating the tremor. If not, more specialized testing may need to be done in an autonomic center such as the Cleveland Clinic Autonomic laboratory.
Good luck
A fine tremor occurring at your age, with no other neurological abnormalities is usually benign essential tremor. This is especially likely if someone else in the family has it. Depakote will make it worse, as it is also a cause of fine tremor.
Tests for thyroid function are important as well as a few tests to ruleout some rare but treatable disorders like Wilsons disease. Treamtent is with medications such as beta blockers or primidone. The hyperhidrosis is less clear, but it would be interesting to see if it diminished when, for example, a beta blocker was succesful in treating the tremor. If not, more specialized testing may need to be done in an autonomic center such as the Cleveland Clinic Autonomic laboratory.
Good luck
