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Neurology (Expert Forum)
Periphereal neuropathy and Dysphagia
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Periphereal neuropathy and Dysphagia
by Mel38, Nov 07, 2006 12:00AM
I am a 29 y/o female who has been having trouble with oral phase dysphagia since July. I am also hypothyroid and have been having trouble regulating my tsh and T3/4 levels (they have been high, then low throughout the summer with all the usual accompanying symptoms of fatigue, coldness, loss of hair). A few weeks ago I started to have numbness and weakness on the right side of my face, migrating to my arm. It usually only lasted a few hours, then disapperaed. Last week I had it for a few days in my right leg and when it left, I could no longer flex my foot up. The doctor told me I have drop foot and although the numbness is gone I have shooting pain in my right hip and soreness in the whole leg. He said that all of these problems are a periphereal neuropathy of some kind and I ahve been referred to a neurologist and an endocrinologist.
Please could you offer me any indication of what these symptoms may indicate? The GP said that the neuropathy can strike anywhere and I'm worried about not being able to work or drive anymore. I have already lost in excess of 30 pounds and am finding day to day things a bit difficult now. Any assistance you can offer would be very appreciated! Thank you in advance.
Please could you offer me any indication of what these symptoms may indicate? The GP said that the neuropathy can strike anywhere and I'm worried about not being able to work or drive anymore. I have already lost in excess of 30 pounds and am finding day to day things a bit difficult now. Any assistance you can offer would be very appreciated! Thank you in advance.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Nov 22, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms of focal numbness and weakness in the face arm and leg is unusual for a peripheral neuropathy. In your age group the most common cause of these type of symtoms is multiple sclerosis. There is other rare conditions that are associated with thyroid disease that could cause your symptoms called a paraneoplastic disorder. This occurs when the body makes antibodies (immune reaction) against your thyroid gland causing a hyperthyroidism often followed by a hypothyroidism that is difficult to control. This immune reaction that affects your thyroid can also affect the nerves in your brain and around your body.
I would reccomend that your get an MRI of the brain and cervical spine with Gadolinium contrast. This will evaluate for signs of multiple sclerosis and/or the paraneoplastic thyroid condition. There are also specific antibody tests (blood work) that can be sent to test for this condition (that your neurologist or endocrinologist can send). An EMG (nerve muscle test) can be conducted to evaluate the health of your peripheral nerves. I would also recommend starting a medication that is effective for neuropathic pain such as neurontin, elavil, lyrica, topamax, cymbalta, etc.
I hope this has been helpful.
The symptoms of focal numbness and weakness in the face arm and leg is unusual for a peripheral neuropathy. In your age group the most common cause of these type of symtoms is multiple sclerosis. There is other rare conditions that are associated with thyroid disease that could cause your symptoms called a paraneoplastic disorder. This occurs when the body makes antibodies (immune reaction) against your thyroid gland causing a hyperthyroidism often followed by a hypothyroidism that is difficult to control. This immune reaction that affects your thyroid can also affect the nerves in your brain and around your body.
I would reccomend that your get an MRI of the brain and cervical spine with Gadolinium contrast. This will evaluate for signs of multiple sclerosis and/or the paraneoplastic thyroid condition. There are also specific antibody tests (blood work) that can be sent to test for this condition (that your neurologist or endocrinologist can send). An EMG (nerve muscle test) can be conducted to evaluate the health of your peripheral nerves. I would also recommend starting a medication that is effective for neuropathic pain such as neurontin, elavil, lyrica, topamax, cymbalta, etc.
I hope this has been helpful.
Member Comments (3)
by vega1318, Nov 08, 2006 12:00AM
why did you lose 30lbs? I think it is worrisome, you should have your doctors check you out completely for a possible malignancy. Sorry, to be so blunt, but neuropathies can sometimes precede malignancies. You should have a mammogram and other testing just to make sure.
by Joface, Nov 12, 2006 12:00AM
It's good that you've been referred to a neurologist, but I might request and MRI with and w/out contrast of both your cervical and lumbar spine...depending on results of that, you may need to see a neurosurgeon - I think there's more going on there than a simple case of peripheral neuropathy. I am quite a bit older than you are, but I had similar kinds of symptoms and the MRI revealed a compression of my spinal column, causing the nerves in that area to be compromised. I needed to have surgery to relieve the compression - it had absolutely nothing to do with peripheral neuropathy. I think the dysphagia (difficulty swallowing) that you have may also be be related to a possibly compromised cervical problem. Be your own advocate and demand testing to resolve this. Good luck!