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Neurology (Expert Forum)
Neuropathy?
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Neuropathy?
by meikman, Jan 09, 2007 12:00AM
I was put on Neurontin because of the burning pain in my upper legs and tingling in the balls of my feet on toes. It had gotten to the point where I couldn't hardly walk. I had to hold onto something if I didn't then I could hardly lift my legs. I am very heat sensitive. Which is still the case since on the meds. When I get hot it seems to make it harder for me to get around or just do about anything. The meds have help especially with the tingling-it is pretty much gone and it has help a lot with the pain but it is returning now. Also the fatique that I feel is debilating and my brain doesn't as fast as it use to.
15 months ago I gave birth to a 32 weeker due to severe pre-eclampsia and HEELP. I was on vent for 4 days and was given 2 transfussion. When I got home I had a problem with staying warm and at the same time would sweat badly.
My question are; Could my current problems be contribute to the blood transfussion? I realize that my body has already rid itself of it.
Could I be demostrating signs of Ms? I have had an EMG which was normal.
15 months ago I gave birth to a 32 weeker due to severe pre-eclampsia and HEELP. I was on vent for 4 days and was given 2 transfussion. When I got home I had a problem with staying warm and at the same time would sweat badly.
My question are; Could my current problems be contribute to the blood transfussion? I realize that my body has already rid itself of it.
Could I be demostrating signs of Ms? I have had an EMG which was normal.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jan 28, 2007 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 that you describe are consistent with a peripheral neuropathy, probably of the small fiber type (causes sensory problems without weakness, does not show up on EMG). There are many potential causes of this condition. The most common cause is diabetes, but other causes include vitamin deficiencies, heavy metal toxicity, to much vitamin B6, multiple myeloma, metabolic/mitochondrial disorders, and paraneoplastic disorders (related to cancer). As far as blood transfusions are concerned, I think it is unlikely to be related, but there is one case where it could possibly be related. Hepatitis C infection (sometimes obtained from blood transfusion, but blood is supposed to be screened for this now) causes a condition called cryoglobunemia, which can lead to a peripheral neuropathy. I would suggest that you get tested for hepatitis C, liver function tests, cryoglobulins, a glucose tolerance test (for diabetes), heavy metal screen, B12 level, B6 level, Serum/urine protein electrophoresis (for multiple myeloma). I would also suggest a QSART test (a test for small fiber neuropathy) and a skin biopsy (to look for loss of small myelinated nerve fiber in the skin, also a sign of small fiber neuropathy). The fatigue and mental slowness may be a side effect of the neurontin and you may consider trying a different drug such as cymbalta, elavil or lyrica, which also treat this disorder. I do not think you are having symptoms of MS (multiple sclerosis).
I hope this has been helpful.
The symptoms that you describe are consistent with a peripheral neuropathy, probably of the small fiber type (causes sensory problems without weakness, does not show up on EMG). There are many potential causes of this condition. The most common cause is diabetes, but other causes include vitamin deficiencies, heavy metal toxicity, to much vitamin B6, multiple myeloma, metabolic/mitochondrial disorders, and paraneoplastic disorders (related to cancer). As far as blood transfusions are concerned, I think it is unlikely to be related, but there is one case where it could possibly be related. Hepatitis C infection (sometimes obtained from blood transfusion, but blood is supposed to be screened for this now) causes a condition called cryoglobunemia, which can lead to a peripheral neuropathy. I would suggest that you get tested for hepatitis C, liver function tests, cryoglobulins, a glucose tolerance test (for diabetes), heavy metal screen, B12 level, B6 level, Serum/urine protein electrophoresis (for multiple myeloma). I would also suggest a QSART test (a test for small fiber neuropathy) and a skin biopsy (to look for loss of small myelinated nerve fiber in the skin, also a sign of small fiber neuropathy). The fatigue and mental slowness may be a side effect of the neurontin and you may consider trying a different drug such as cymbalta, elavil or lyrica, which also treat this disorder. I do not think you are having symptoms of MS (multiple sclerosis).
I hope this has been helpful.
I have been having different things go on for the past 3 years, its just this pain and the difficultly walking that has me so bother. It really has effected my quality of life. Before my last pregnancy I had this dizzy spell. It was as if my brain wasn't keeping up with my head movement. It got so bad that I couldn't walk. I had no balance. This has gone away and not returned. Then about 2 months after giving birth I started having this painful pin ***** feeling in my hands. It was difficult to drive because it was most painful when driving. I believe it must of been the way I had to hold onto the wheel plus I had just bought a minivan trading in my car and at the time thought that might have had something to do with it. Since then I have other things going on. I just not sure if previous problems have anything to do with what I am feeling now.
The thing is I don't have ins. and was wanting to go back to work after RSV season. I am really worried that I can't work a full day. I think that when I do go back that the fatigue that I feel will get better if that makes since. At my last job I did quite a bit of walking but believe that I can find a job where I would stay at my desk all day. I am serious thinking of using a cane to help me walk at this point. I just want an answer as to why my body is doing what it is doing and a definite answer as to why I need a cane and not just that I have difficulty walking. Anyways the EMG was done by a neurologist but no exam or history taken. I want a answer so bad but if this is something like ms I think it to best to wait until I have ins to be dx. I go back to my GP for a follow up but unsure if I should voice my thoughts to him so that my records will be clean when ins company request them.