Intolerance to lasers?

[twitchychick]

Hi all.

Have not been dx w/ ms, have appt next month w/ neuro. I was diagnosed w/ pnhs (perpheral nerve hyperexcitability syndrome) but have not had mri since symptoms started.

Here is my question.  I bought a no!no! hair treatment. It uses a pulse of light/heat to remove the hair and destroy the follicle(sp) where you do not have to shave, etc after a couple months of treatment. (It's basically home laser hair removal, a much lower pulse.) I finally opened it, charged it, read the cd booklet on how to operate it. Decided to try it on my shin today. Lowest possible setting. Tried to put it on my skin 3 or 4 times. Each time the light came on, my leg spasmed. It couldn't have been on a second. But I jerked, like I do when they test my reflexes. This was the middle of my shin, not my knee. And it wasn't hot, not that I could feel anyway. Anyone have any similar experience with lasers? Just wondered if I'm going to be able to use it or not. Doesn't look like I will be still long enough. :(

Thanks
TW

[COBOB]

I take Tegretol (carbamazepine), 200 mg three times a day for TN.  I have no side effects I notice and I have been taking since Aug.  I do get breakthrough pain if I miss a dose.

Bob

[twitchychick]

Thanks for that info. I think they were hoping it would help with migraines. The neuro said if that were no help she would suggest a membrane stabilizing medication. Her drug of choice would be carbamazepine, 200 mg at night to start, then increasing weekly to a goal of 400 mg. I do not know much info concerning that drug. Just that it is used for seizures? Any side effects that you know of?

[COBOB]

Nortriptyline is a second generation (I think) tricyclic antidepressant.  It is often used to treat neurogenic pain, but I doubt it do anything for the fasciculations and spams.  Most of the time, fasciculations and spams are treated with antiseizure medications or beta blockers.  

Bob

[twitchychick]

Thanks for the input Bob. That really makes a lot of sense. They did do an EMG and my official diagnosis is "facial spasms, fasciculations, paresthesias." It also says "a cramp fasciculation protocol demonstrated some after discharges lasting 2-3 seconds following low to high frequency stimulation." There was also some reference to my hyperreflexia (?) but that the neuro who saw me thought it "may be normal for her."  I have been taking nortriptyline for the twitching, but it has made no difference. I do have several new symptoms, however, and am wondering if more testing should be done. I have an appointment with a "movement disorder" neuro in November.

I really enjoy reading your posts. You have a very clear way of presenting information and it's easier for me to grasp than some other forums I've read. I always learn something from your posts, so thank you!

I tried again to use the no!no!.  It is definitely a no no for me!  It's already boxed up and ready to ship back.

Thanks again, Twitchy

[COBOB]

OK, I have an engineering theory we could prove with an EMG/NCS, but you seem too nice to use as a lab rat.

Lasers are tuned to a specific wavelength measured in nanometers.  Red lasers are absorbed by some tissues in the human body and converted to heat. Other tissues can use the red laser light to facilitate other chemical reactions in the skin.   I know that there is a treatment for peripheral neuropathy that uses pulsed red laser light to (theoretically) generate nitric oxide in the peripheral nerves to restore conduction.  The presence of additional quantities of nitric oxide on top of perpheral nerve hyperexcitability syndrome may cause some interesting discharges.  This is all a theoretical discussion.  

Did the diagnose your peripheral nerve hyperexcitability syndrome with an EMG/NCS?   There are two parts to this.  When the do the EMG/NCS, they provide a stimulus (a shock) and measure the SNAP (sensory nerve action potential ) and then the body's motor response to that stimulus, the CNAP (compound nerve action potential.)  In mono and poly neuropathy, there are decreases in these action potentials indicating damage to nerves outside the CNS.  In the case of  peripheral nerve hyperexcitability syndrome, it is related to fasciculation disorders and hyperreflexia, so I would think it is possible for a laser to generate enough energy to to exceed the SNAP threshold and trigger a response.

Bob