3rd POST!!! Unexplained leg weakness

[DaltonsMom]

Any Neurologist, please lend some ideas or advice!!!!
My 15 yr old son has been treated with Keppra for 2.5 yrs. He started out experiencing a sharp pain in the right back quadrant of his head followed by extreme dizziness or brief loss of consciousness. He would sometimes have brief "jerking" of of his leg arm/leg. After, he would have loss of sensation on the left side of his body for 1 -2 hrs. The Keppra seem to finally get this under control. No episodes from 2/07 till 1/08. Then, he had the sharp head pain followed by loss of sensation and movement in his left leg only. MRI, EEG, and nerve conduction were all fine. Yet, it took 1 week for any sensation to return. He still can not feel pain(pin *****) or hot/cold. Just pressure. Movement has come back some what. He is still having to use a walker due to inability to bear all weight on it(it buckles beneath him). Now, after the improvement, he c/o sharp pain running down his neck , his spine , all the way out his affected leg.It Increases in intensity when he touches chin to chest. Awaiting a second opinion. His neuro says he is fine that it is psychogenic. Any suggestions?

Also, as of this second posting, he is now having trouble spelling known words(i. cat, dog,ect) When he attempts to write, what he is trying to write is not spelled correctly(i.e. cellular = qudtyhfc). He can still read fluently and copy written words. Need any suggestions.... I am desperate!!!

[DaltonsMom]

Thank you for your reply. He had no acute infection prior to this onset of symptoms other than a cold back in October. He still has a deep cough from that. He did fall Dec 1st. while on a field trip. His feet slipped out from under him on a wet floor. He hit the back of his head on the tile floor. MD's here say there is no damage from that and that the leg issue would not be from that. No vision problems(i.e. blurred or double). He does wear glasses. No nausea with the headaches. He cannot tell what position his Left great toe is in with his eyes closed. He can tell the right toe. He can still do math and read. He has a brother with severe autism and Mitochondrial Encephalomyopathy. Complex I and III defects. The 15 yr old had been tested in the past also because of symptoms(slightly low muscle tone, fatigues easily,muscle pain after min. use, cont. hand tremors, and of course what I listed in the post). His test was negative.Which they found odd due to his symptoms and familial inheritance. He has just gotten out of the hospital again. The only test done other than basic bloodwork was a MRI of the spine again. It was clear per MD( other than slightly buldging disc. Not compressing anything). I questioned MS. But they said there were no lesions on the MRI so a spinal tap would not be needed. Also said they do not think it is vascular yet an MRA or CTA has not been done. Any ideas or possible tests that may reveal a problem?? Also, since the last post: He is repeating himself @ times. He may say the same thing 2-3 times over a 30 min period and never know he did it. Thsi is not cont. May happen 2 times a day. Also when he is speaking sometimes, he pauses because he says he is "losing" the word(s) he wanted to say.

[Abhijeet Deshmukh, MD]

Hello.

It is indeed difficult do arrive at a diagnosis presently. Some more information would help.

I am amused at the normal EEG finding. OT say that it is a seizure and start medicine, we need to have some conclusive evidence. And a seizure will not leave a weakness.

I would like to ask if he had any infection prior to the start of these symptoms. Does he have any vision problems ? And does he have nausea with the headache.

He has a loss of sensation. Can he tell, with eyes closed, what position his toes, ankle and knees are in. ( joint position sense - you can do it at home. Ask him to close his eyes while you move his great toe upwards or downwards. He has to tell you the position of the toe. )

And the spelling problem is something significant. There must be a dysfunction of some cortical areas concerned with expression of language. Can he do math properly ?

Regards

[ggreg]

Here are three links that will help you understand what is going on with your son.  If you don't agree with his treatment, by all means visit another neurologist.

http://www.epilepsy.com/epilepsy/seizure_psychogenic
http://www.epilepsy.com/medications/b_keppra_use
http://www.familydoctor.co.uk/htdocs/EPILEPSY/EPILEPSY_specimen.html

There is also an "Ask The Doctor" section in this forum, where a physician will answer your questions for a small fee.  This forum here is very busy indeed, it is patient-to-patient, and some people might not respond to your post because they have no answers.