Re: Ultram and neurological reactions, a lengthy and dramatic tale with questions

Posted By Lori L. on December 26, 1998 at 13:05:57:

In Reply to: Re: Ultram and neurological reactions, a lengthy and dramatic tale with questions posted by CCF Neurology W6 MD on December 24, 1998 at 05:52:41:







Dear Lori,
your posting as well as the others who have experienced similar symptoms as a result of taking Ultram again brings up the issue of underreporting of these adverse events. Only through reporting and a good epidemiologic data can we decide if a new WARNING label is indicated or maybe the drug should be withdrawn altogether.
I can't comment any further as I have not had bad experience with patients on Ultram (knock on wood, I will be very careful though).
Regarding you other question, toxicity due to medications, metabolic imbalances, etc. USUALLY causes a generalized symptoms and findings, NOT a focal one. So the fact that you have a somewhat focal exam finding does raise the suspicion that you may have had a focal insult, be it from a stroke, or other lesion. Depending on the size and the location, it may or may not be visualized on imaging, and it may or may not cause symptoms. But a good neurological examination by a neurologist should be able to pinpoint the problem (that is what system is affected, and where in the neuroaxis).
I hope this helps and good luck to you.
I was examined by a neurologist approximately three months after the fact, and my MRI and CAT were negative.  He did note the exagerated deep tendon reflexes and balance disorder, and concurred with the other md that
I was probably having seisures, but he did not persue it any further.  He also made no comment about it being a local or focal reaction.  He also stated, like the other physician that the reaction would abate eventually since it had already improved significantly by the time he saw me.  It has been a full year now since I saw that neurologist, and I am still having problems...though by and large my motor function has returned to normal.
I have wondered if I should consult with another neurologist, and if there are other tests that could determine what and where the problem is or was.
Is it too late for another consult to be beneficial in that respect?
Lori L.