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Neurology (Expert Forum)
childs lower legs have movement but no feeling
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childs lower legs have movement but no feeling
by concernedfather, Sep 12, 2004 12:00AM
My daughter 10 yrs of age 4ft 7in and weighs 79lbs has had a severe continous headache with a low grade fever (was only the first week and never over 100.7)for the past 21 days and has had CT, MRI, and a lumbar tap (with unremarkable results)within the fist week. The second week a blood patch was done at the L1 level for an assumed Spinal headach. Third week a spinal MRI reveiled a "most impressive CSF leak". She then went for a second bloodpatch at the L4 level it has been 2 days since the blood patch and she has no sensory perception knee level and below, reflexes are considered normal. Her headache is still present with increased pain after sitting up 15 minutes. After studing your forum we learned of possible damage to nerves from spinal taps and blood patches. We requested an additional MRI to rule out blood clot compression on the spinal cord. She has been given, Toredol, Zofran, Phenergan supp, Tylenol w/codiene,Motrin, Aleive, Effexor 25mg bid, demoral 10mg IVx2. Sedations for first Blood patch- Versed, Dipravan
Sedations for Spinal and blood patch were on the same day
MRI- Nembutal 200mg IVP
2nd blood patch- Propanol
All Lab work has been normal
Currently hospitalized she has normal movement in her lower legs but can't bear weight and reports inability to feel ground under her feet. The numbness she has described is a non-existance rather than a tingling sensation.
What direction do we take now since we have yet to find a diagnosis?
Sedations for Spinal and blood patch were on the same day
MRI- Nembutal 200mg IVP
2nd blood patch- Propanol
All Lab work has been normal
Currently hospitalized she has normal movement in her lower legs but can't bear weight and reports inability to feel ground under her feet. The numbness she has described is a non-existance rather than a tingling sensation.
What direction do we take now since we have yet to find a diagnosis?
Doctor's Answer
by CCF-Neuro-M.D.-CS, Sep 16, 2004 12:00AM
Wihtout personally examining your daughter and reviewing her tests I can not make a clinical diagnosis. The sensory changes happened after the second blood patch which was performed at the L4 level. A compressive lesion, such as a blood clot, at this level would cause both weakness and sensory loss. Tests which may help elucidate the problem include a MRI of the lumbar spine and an EMG test (muscle/nerve test). There are two parts to the EMG test, one which measures the ability of the nerves to conduct electricity and the other to test the muscle function. She may only require the first part. If both of these tests are normal, than perhaps an evoked potential study of the posterior tibial nerve (in the leg) would be helpful. This measures the conduction of an electrical stimulus from the leg to the brain, and when combined with a median (arm) evoked potential can help differentiate between a problem in the spine or brain. If this is also normal then perhaps a second opinion would be reasonable. You could discuss this possibility with your doctors. If she needs to be transfered to another hospital for this, request an academic children's hospital. Good luck.
