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Neurology (Expert Forum)
Should I be concerned?
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Should I be concerned?
by Lyn2, Apr 30, 2001 12:00AM
I had written a post recently about a possible drug interaction causing some neurological symptoms. It was amiodarone I was wondering about. My Primary Care doc. and cardiologist insisted I see a neurologist about hyperflexia, and other symptoms. I was reluctant, but finally made an apointment which is on Friday. I am so tempted to cancel, hoping that my problems will go away, or are actually nothing to worry about.
I'll tell you whats happening to see what you think. Besides the hypereflexia, I have numbness in my hands going up my arms, exactly the same on both sides at night. Numb, cold toes at same time. The last couple of weeks, I have prickly sensation in hands, but not heavy feeling, and now they itch terribly. I'm really wondering about tremors I'm getting. My hands sometimes shake quite alot on and off. Usually one or the other not both at once. My friend noticed once. My hand was just sitting on my lap and it was shaking very noticeably, also if I lift my heels off the floor, my legs shake alot. When I'm using the computer and holding my hand on the mouse, my hand sometimes jerks so hard it goes right off the mouse pad, and often my body will suddenly jerk at any time during the day, like at night when your starting to fall asleep. There is absolutely no warning to this.
So sorry about the length. I also had some T.I.As last year. I am 33yr. and am on coumadin, because I have A-fib, a pacemaker, and a patent foramen ovale. Dont know if this is relevant.
What I'd like to know is if I go into the neurologist's office on Friday, is he going to look at me like I'm crazy and say there is nothing wrong with you? Are there any diseases that could fit this profile? I have had these particular symptoms the last few months. I am not nervous, and have not thought of any trigger, other than medications. What kind of tests might they do, if they suspect a problem? And finally, could this be nothing? I am so afraid that I will end up cancelling this appointment. One thought. Is it possible this is an autonomic nervous system problem. I have had some very serious arrythmias, and problems with blood pressures rapidly lowering.
Thankyou so much!
I'll tell you whats happening to see what you think. Besides the hypereflexia, I have numbness in my hands going up my arms, exactly the same on both sides at night. Numb, cold toes at same time. The last couple of weeks, I have prickly sensation in hands, but not heavy feeling, and now they itch terribly. I'm really wondering about tremors I'm getting. My hands sometimes shake quite alot on and off. Usually one or the other not both at once. My friend noticed once. My hand was just sitting on my lap and it was shaking very noticeably, also if I lift my heels off the floor, my legs shake alot. When I'm using the computer and holding my hand on the mouse, my hand sometimes jerks so hard it goes right off the mouse pad, and often my body will suddenly jerk at any time during the day, like at night when your starting to fall asleep. There is absolutely no warning to this.
So sorry about the length. I also had some T.I.As last year. I am 33yr. and am on coumadin, because I have A-fib, a pacemaker, and a patent foramen ovale. Dont know if this is relevant.
What I'd like to know is if I go into the neurologist's office on Friday, is he going to look at me like I'm crazy and say there is nothing wrong with you? Are there any diseases that could fit this profile? I have had these particular symptoms the last few months. I am not nervous, and have not thought of any trigger, other than medications. What kind of tests might they do, if they suspect a problem? And finally, could this be nothing? I am so afraid that I will end up cancelling this appointment. One thought. Is it possible this is an autonomic nervous system problem. I have had some very serious arrythmias, and problems with blood pressures rapidly lowering.
Thankyou so much!
Doctor's Answer
by CCF Neuro[P]-M.D.-RPS, Apr 30, 2001 12:00AM
Dear CN:
I think that I suggested that amiodarone can cause a neuropathy, and we have seen it several times here at the Clevelend Clinic. I would pursue this avenue and many of the things your describing are noted to occur with amiodarone. Most commonly, there is a tremor of the extremities and not usually a whole body jerk. This would be the most logical pursuit.
The differential is large for tremor and many tests are done if that is what is thought to be occurring. Blood tests, neurological exam and depending on the results of the above, maybe some nerve conduction testing and maybe some imaging. An autonomic problem that is exclusively heart would be unusual but not unheard of. Likely your physicians have already tested for thyroid problems. Keep the appointment and get a good neurological evaluation.
Sincerely,
CCF Neuro MD
I think that I suggested that amiodarone can cause a neuropathy, and we have seen it several times here at the Clevelend Clinic. I would pursue this avenue and many of the things your describing are noted to occur with amiodarone. Most commonly, there is a tremor of the extremities and not usually a whole body jerk. This would be the most logical pursuit.
The differential is large for tremor and many tests are done if that is what is thought to be occurring. Blood tests, neurological exam and depending on the results of the above, maybe some nerve conduction testing and maybe some imaging. An autonomic problem that is exclusively heart would be unusual but not unheard of. Likely your physicians have already tested for thyroid problems. Keep the appointment and get a good neurological evaluation.
Sincerely,
CCF Neuro MD
