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Neurology (Expert Forum)
Question about Guillain Barre
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Question about Guillain Barre
by caroland, Nov 15, 2006 12:00AM
Hi There,
I am a 34 year old female and have some problems with tingling and muscle weakness(& twitching). For background, it started in 2001 with buring in both legs. This lasted a couple of days and went away.
Months later I noticed some tingling in feet and calves, this lasted for a few weeks and went away. This went on until sept 2005. I then had really strong tingling in lower legs and feet
accompanied by muscle twitching and weakness. I started to feel some weakness in my arms as well and then my entire left side started to feel funny.
All of the weaknees eventually subsided but I still have tingling in my feet, mostly the left, and legs(sometimes arrm too). I haven't had the muscle weakness since.
I was to see a neurologist who gave me an EMG and Evoked Potentials test, all negative. I didn't have an MRI yet as I am now pregnant.
Since becoming pregnant I have a lot of palpitations(ekg said PVC's) and heavy breathing(am 4 months pregnant). Do you have any suggestions as to
what these symptoms point to. They were ruling out MS but not all testing is complete yet.
Thanks for your help.
I am a 34 year old female and have some problems with tingling and muscle weakness(& twitching). For background, it started in 2001 with buring in both legs. This lasted a couple of days and went away.
Months later I noticed some tingling in feet and calves, this lasted for a few weeks and went away. This went on until sept 2005. I then had really strong tingling in lower legs and feet
accompanied by muscle twitching and weakness. I started to feel some weakness in my arms as well and then my entire left side started to feel funny.
All of the weaknees eventually subsided but I still have tingling in my feet, mostly the left, and legs(sometimes arrm too). I haven't had the muscle weakness since.
I was to see a neurologist who gave me an EMG and Evoked Potentials test, all negative. I didn't have an MRI yet as I am now pregnant.
Since becoming pregnant I have a lot of palpitations(ekg said PVC's) and heavy breathing(am 4 months pregnant). Do you have any suggestions as to
what these symptoms point to. They were ruling out MS but not all testing is complete yet.
Thanks for your help.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Dec 01, 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 you describe are not specific for any single disorder, but are most concerning for multiple sclerosis (MS). The symptoms of MS are transient and in the begining often will resolve fully. However, the typical MS attack lasts for several weeks instead of days (although there is variation). I agree with holding off on the evaluation until after your pregnancy is complete. You have had this since 2001, and you can likley wait for 5 more months to avoid possible exposure of the baby to the testing (although MRI is thought to be generally safe in pregnancy-there is not enough information to say). When you are ready I would suggest an MRI of the brain and cervical spine with contrast (the cervical spine[neck] is often affected in MS). If the MRI is not diagnostic and more information is needed then I would recommend a lumbar puncture (to look for inflammation in the CSF, IgG index-tourtelotte, oligoclonal bands). I would also suggest some screen blood work to evaluate for other inflammatory conditions, etc including ESR, CRP, Lyme, ANA, lactacte/pyruvate and CBC/CMP. I would also recommend that you have an echocardiogram at some point, pregnancy can cause cahnges in the heart due to the increased blood volume and work during pregnancy.
I hope this has been helpful.
The symptoms you describe are not specific for any single disorder, but are most concerning for multiple sclerosis (MS). The symptoms of MS are transient and in the begining often will resolve fully. However, the typical MS attack lasts for several weeks instead of days (although there is variation). I agree with holding off on the evaluation until after your pregnancy is complete. You have had this since 2001, and you can likley wait for 5 more months to avoid possible exposure of the baby to the testing (although MRI is thought to be generally safe in pregnancy-there is not enough information to say). When you are ready I would suggest an MRI of the brain and cervical spine with contrast (the cervical spine[neck] is often affected in MS). If the MRI is not diagnostic and more information is needed then I would recommend a lumbar puncture (to look for inflammation in the CSF, IgG index-tourtelotte, oligoclonal bands). I would also suggest some screen blood work to evaluate for other inflammatory conditions, etc including ESR, CRP, Lyme, ANA, lactacte/pyruvate and CBC/CMP. I would also recommend that you have an echocardiogram at some point, pregnancy can cause cahnges in the heart due to the increased blood volume and work during pregnancy.
I hope this has been helpful.
Be your own advocate during your pregnancy, sometimes you have to push for testing esp non routine type blood work. I delivered our third child last november and the OB missed a serious heart condition (pregnancy related cardiomyopathy) that was definitely present in the third trimester. I had symptoms that were objective and also reported breathlessness and the picture was just not put together.\, even during delivery when I was monitored, they all thought it was thyroid related even though the thyroid workup was negative.
I hope your neuro work up comes up negative. Its a scary time when pg and you cannot complete all the testing, but honestly its not worth concerning yourself with possibilities, it is what it is and cannot be changed right now. Do not let this ruin the joy of your pg, its tough but take it one day at a time and enjoy the wee babe.
Fiona, Mom to three 6y, 3y and 1y