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paresthesia & insomnia following a trauma, no answer..

I'm a 20 something male with no history of insomnia, or  chronic medical conditions.  I never had trouble falling or staying  asleep.
I've been having  trouble falling and staying asleep ever since an impact trauma  2-moths ago.

I dropped on my feet from a height of ~7 feet.  I landed on my feet with my legs unintentionally straight and hit the ground with a strong jolt throughout the body.  

I didn't fall down, remained conscious the whole time, no part of my body struck anything.  I didn't have any bruises, abrasions or signs of contact on my clothing.  

Immediately after the drop, my left hand fingers felt somewhat tingly.  I fell asleep normally that night but I woke up really early and mild tingling sensations were there in my left half of body, mostly in the arm/hand.  I didn't think much of it then.  

Insomnia got worse then plateau'd at not being able to fall asleep or remain asleep.
Two months later, I continue to have insomnia and  mild paresthesia and annoying sensations corresponding to pulse.  The degree of latter two symptoms are position dependent and are worse when lying down or sitting leaning back.  

I've tried Ambien and Lorazepam.  Both allow me to get to sleep, but I wake up after 4-5 hours and I feel tired all day.   I wake up and pull through the day and when I try to get to bed around 12:00 to 1:00 AM, I again wake up around 5-6AM.  

Before the trauma, I could sleep 8-10 hours continuously unassisted and always needed an alarm clock to get up on time.  

I've had a few tests done, but they were only of brain + cervical spine.  No imaging studies below my cervical spine.

-No significant pain as a result of this incident.  

-I DON'T experience nightmares, emotional anxiety or thoughts that are bothersome.

-Radiologists found no abnormalities in head & cervical MRI & CT.  

-The milliseconds were normal for upper and lower body SSEP(Somatosensory Evoked Potential )  test Both sides of my body produced nearly symmetrical result.

-There was no lifestyle/diet/living environment change to trigger the insomnia

So.... what am I missing?
4 Responses
Avatar universal
Hi,

How are you?
Since all your relevant tests are within normal limits it is very difficult to identify a cause. I would suggest you to get a sleep study done if the insomnia persists. Also please stick to your bedtime, do not stay awake past your bedtime. No excitation around the bedtime. Reading or listening to soothing music will also help.
For the paresthesias you can try taking B complex supplements and see if they help.
Take care!
Avatar universal
Dr, Noopur, thank you for your response.

Here are specifics on the MRIs I've got:

Spine MRI:
Sagittal T1, T2.
Axial T2
Coronal T2

Head MRI:
Sagittal T2
Axial T1, T2 and diffusion weighed
Coronal T2

I'm told by the doctor that MRI can not really locate a nerve damage that's not accompanied by more visible damage, such as a ruptured disk.  Could I have the symptoms I'm having due to something well below the cervical spine?  I've never got any imaging studies done below the C.S.

As for B complex, I was actually prescribed 500mcg 2 x daily dose of B12 and I've been on it for about two weeks.  

The paresthesias are a mere annoyance, but I strongly feel sensations pulsates with my heart beat that is seriously annoying.

I do head for bed at a reasonable time, but I actually lay awake with a blank night, all night, unless I take the ambien.  I do make reasonable lifestyle efforts, like avoiding exercise immediately before attempting to sleep and avoiding caffeinated drinks like cola, coffee and such  several hours prior to sleeping.
Avatar universal
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Avatar universal
Hi,

It is difficult to give a straightforward diagnosis at this point. However MRI can show nerve compression. For nerve damage EMG needs to be done.
It would also help to get and MRI of upper and lower back done to rule out nerve compression at these levels.
Please continue with lifestyle modifications and sleep aid and be physically active.
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