Progressive neurological symptoms

[psychosomatic74]

July’08 felt progressive right calf stiffness and pain. Ketoprofen orally which relieved pain but no stiffness.Had a bad cramp on right calf, neuro clinical exam. was normal as well as venous eco-doppler on both legs.Sept.’08 right arm weakness, another thorough clinical exam. with neurom.neurologist and brain CT, both normal,weakness disappeared after several days.Mid Sept' 08 “favourite neurologist” ordered extensive blood work, brain, cervical and lumbar RMN’s all normal.Sept.‘08 stiffness spread to left calf and right quadriceps,few widespread fasciculations.End Oct ‘08 stiffness on both upper forearms, neck, face, “favourite neuro” made thorough clin. exam.(normal).Clean needle EMG of legs.He put me on delorazepam 3 times a day, said it is psychosis together with BCFS.Medicine improved symptoms.Nov.’08 stiffness/slight pain on left emi-thorax,slight breathing difficulties on that side,Thorax RX, ECG,complete blood work,thorough clin. neuro examin. all negative.Nov.‘08 4 limbs clean EMG with neuromuscolar neurologist,told me it’s it’s a psychosomatic issue.End Dec.’08 pain in feet,clean 4 limbs EMG by a 3rd neurologist.End Jan.’09 stopped benzos,symptoms back almost totally.Normal thorough clinical exam. by "fav. neurologist" told me it is BFS/BCFS. End Feb’09 went to neurom. neurologist reporting the same plus perceived light right hand weakness and minor occasional tingling/twitching external hand, made a thorough clinical examination (normal) told me IT IS NOT ALS OR MND.  it a psychosomatic issue.End Mar’09 clean 4 limbs EMG by my 3rd neurologist, told me it is NOT BFS/BCFS OR ALS.Some weeks ago started feeling slight fatigue on right arm and right quadriceps and int. forearm spasm/cramping espec. after exercising, emi-thorax sympt again, stiffness of bottom of tongue like pulling it, tongue tremor (internal fasics?), occasional slight slurred speech and slight swallowing like lump in throat.Had Otorhinolaryngologist visit which was normal.Please advise me

[Dr_Nassim]

Ok , take it easy, first of all it is almost normal that she have pain now, even till 6 weeks post surgery, I cannot decide if the leakage is serious enough to get back to NY but surely you can try another type of pain killers and wait some time
.Please give her Tegretol 200 (Carbamzepine) starting half tab increasing in a way she get alleviated from her pain.

Another advices : dont let her to create pressure in her body, I mean dont let her  have constipation. Also sneezing and coughing can also induce the same high pressure which will delay the healing

[Dr_Nassim]

Not a lot to tell
1 month ago I had a patient in Lebanon who experienced such weakness in his upper limb, that he even showed tissue edema because of his deep serious lack of muscular tonicity... and nothing on MRI of the brain, of the neck, on the EMG and... 2 days later he normally moved his arm !!! so Do we still have a lot to discover in neurology ?! really amazing.
Now What can Advice you; or you forget obout these weird incident or you start for example Sertraline (Zoloft) in a dose of 50 mg (first 1 tab daily then you increase after 1 week) 3 times daily.

During 10 weeks of this "somehow expensive treatment" you will most probably have only 10-20 % of this kind of symptoms, this is a study result and also my experience.

If you oblige me to name your case; lets name it "Complex" Panic Attacks

You are most welcome
Thank you for giving me and Medhelp confidence
Keep in touch (I liked your letter-style)
Best of Luck
Dr Nassim

[angie343]

Hello Dr. Nassim , I am looking for some advice for child that is twenty years old. We live in FL but she had surgery in NY for tetherd cord, alittle over a month ago. She was having severe headaches but the Nuerologist she saw in FL has precribed her medicine to help her with migraines. They have found in her MRI that she has fluid leakage around the surgery area (lower back). She is experiencing pain and what she discribes as a bulge or a knot and when she presses on it, it feels tender and liquidy at the bottom of the knot.
I need to know if this leakage is serious and should we try to get back to NY to the nuerosergeon that did the operation, we feel like the doctors we have followed up with in FL do not want to help her with the leakage.
Is there anything that may be done to alieviate the pain, she has tried to lye flat but she says it feels like the knot is pressing.
Your advice would mean a lot to us right now. I feel so bad watching her in pain and at this point taking her to the ER probily will not help because of the surgery she had done.
Thank you