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Dr. David
Dr. David, Doctor (MD)
Category: Health
Satisfied Customers: 42794
Experience:  Experienced and Compassionate Physician Trained in NYC Ready to Help.
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Recap in case this is a new person: Peripheral Neuropathy

Customer Question

Recap in case this is a new person: Peripheral Neuropathy from head to toe on both sides. Pain felt. EMG normal, bee stings and muscle spasms (not dramatic, but felt) everywhere below neck. BPII on Lamictal and Seroquel for four years, feeling balanced and 'normal' at time of onset of symptoms. Psychiatrist does not think it is anxiety induced but anxiety aggravates it and I'm working on that. On 600 Neurontin daily plus Propranolol 40 daily for anxiety in addition to regular meds. Also recently came off HRT: All blood tests normal except high positive ANA but no confirmation with dsdna nor symptoms. No cancer found MRIS of spine and brain normal CT of chest normal. Some consensus among docs that I may have injured my neck (a possibility due to increased activity and sever strain prior to neuropathy. At times neck is painful and throbbing at the base just above my cervical spine. Docs argue over whether cervical w contrast MRI shows significant enough compression and disc bulge (minor) to have this kind of impact. You had (Dr. Bonilla for the record) mentioned that a nerve block wouldn't really help. What would? I go to PT and do exercises daily (Pt 2x a week with traction) and continue to exercise at the gym doing the elliptical and the recumbent bike. Other than that, is there anything that I can be proactively pursuing or is it just a waiting game? Also I have been using a Quell device for pain relief, is the electrical stimulus from that device likely to be beneficial or detrimental in any way? It generates small electrical pulses and is worn on the calf of the leg to minimize pain. It does but sometimes afterward my nerves seem stimulated and I don't know if that's a good thing? I realize this is a lot of info and thank you in advance for your response!
Submitted: 5 months ago.
Category: Health
Expert:  Dr. David replied 5 months ago.

This is Dr David

I think we talked on the phone yesterday.

I suggested total MRI scan with contrast

and also to see if steroid therapy would help because of your ANA issues

and asking your psychiatrist to consider changing your bipolar medications to see if that helps.

Customer: replied 5 months ago.
thank you for that. Re neck injury possibility and nerve block, you said that would not be of value. Can you tell me why, bc that's the next step my doc is heading. Is there anything else I can do for that or do you think it's a dead end? Would a spinal tap of any value diagnostically? I am talking to my doc about meds change. Will discuss MRI scan with contrast and steroid therapy due to ANA.
Expert:  Dr. David replied 5 months ago.

nerve blocks tend to help decrease pressure on nerves outside of the spinal cord.

these are nerves which have left the spinal cord and are being pinched at the neuro-foramen or elsewhere.

these nerve would cause pain or numbness or weakness in just one arm or leg

but you have symptoms all over.

most likely a spinal tap would be normal.

Customer: replied 5 months ago.
Sorry to be thick as they say but when we spoke yesterday you thought there was a possibility that my neck problem could have this kind of impact? Re: rheumatology is IVIG therapy worth a try before steroids? Are these symptoms reversible or is pain management my only solution? It's been two months since onset.
Expert:  Dr. David replied 5 months ago.

I said there was a small chance that prior injury to your neck spinal cord could possibly be causing the tingling and neuropathy symptoms all over your body. you got conflicting opinions from your doctor if this was the case or not.

you have to talk to your rheumatology doctor about what treatments would be best to try if we think there is a chance your symptoms are caused by an autoimmune process. usually steroids are the easiest and most successful treatments for autoimmune conditions.

the cause of your symptoms are not known yet, so we don't know if they are reversible or not. you need more testing.

let me know if you have other questions.

if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

here is my website if you need to reach me:

http://www.justanswer.com/medical/expert-dr-david/

Thanks for using JustAnswers.com

Customer: replied 5 months ago.
I will absolutely give you a good rating. Thank you for your help. What further testing would you think makes sense at this point? There is a long list of tests my doc wants to do including EEG, spinal tap nerve biopsy etc.
Expert:  Dr. David replied 5 months ago.

I would do what your doctor's have recommended at this point.

and see what the results of those tests are at this point.