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KarayanMD
KarayanMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 750
Experience:  Board Certified Neurologist with Subspecialty in Clinical Neurophysiology. Private Practice.
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My nephew is seriously ill. In the last 6 weeks he has loss

Resolved Question:

My nephew is seriously ill. In the last 6 weeks he has loss all muscle strength. He is a avid gym person. Could bench press 100 pounds but in less than 6 weeks he can barely tie his shoes. He cannot walk 10 feet without being exhusted. One of His eye closed 4 weeks ago.
He has had eye tests, he bas been tested for lymes, ms and md. All have come back negative. His doctor was treating him for lyme in the last 2 weeks -because they did not know what he had. they Stopped treatment this week because they are unsure what he has. they have scheduled a spinal tap for May 20th. But since weds(end of his treatment) he has become weaker--holding on to walls. Today his other eye has started to close. He has no control over opening and closing his eyes. Well do you think we should take him to emergency care immediately or wait to conact his doctor tomarrow?
Submitted: 1 year ago.
Category: Neurology
Expert:  KarayanMD replied 1 year ago.

KarayanMD :

Hi. Thanks for your question.

KarayanMD :

Are you available to discuss?

Customer:

yes

KarayanMD :

I am a board certified neurologist in the U.S.

KarayanMD :

When was the last time he saw a doctor for this condition?

Customer:

Ok great--i really need some advise

Customer:

He saw a doctor on April 25 2013

KarayanMD :

But you are saying that even in the last 3 days, he has continued to get worse?

Customer:

Yes-they were treating for about 3 weeks for lyme --they are very unsure of what he had. Wed. they stopped all treatments. He does not have lyme and they said he does not have ms or md...so they were waiting to do spine tap.

KarayanMD :

Thanks for the information.

KarayanMD :

Do you know if they have considered Guillain Barre Syndrome or Myasthenia Gravis?

Customer:

he started losing more balance friday. today he came home from work and stated he is now having problems keeping the eye open. He has lost all ability to open or close his other eye

Customer:

Well they said Mysathenia

Customer:

they thought he has mysathenia but that was ruled out 4 weeks ago

KarayanMD :

Is there any numbness with his condition?

Customer:

Guillain Barre was also rulled out. We are very scared for him

KarayanMD :

or tingling?

Customer:

he has no feeling in his fingers--progressively in the last 6 weeks...whatever he has it is moving quite quick

KarayanMD :

OK. If there is indeed numbness and tingling, then it certainly is possible this could be GBS or a variant thereof. Of course, also important to exclude would be brain problems with an MRI which may already have been done.

Customer:

I don't know

Customer:

He had a MRI 4 weeks ago...nothing showing-no strokes

KarayanMD :

At this point, I am in agreement that he well may need a spinal tap.

KarayanMD :

Given the progression, his evaluation and treatment should be performed quite urgently.

KarayanMD :

This type of problem would ideally be treated by a specialist in neuromuscular disease, but most general neurologists should be able to handle it anyways at least for initial evaluation and treatment.

KarayanMD :

Also, you should keep in mind that sometimes neuromuscular conditions like this can affect breathing and even the vital signs and heart function, so getting urgent evaluation is warranted.

Customer:

Ok--so basically problem no need to go to emergency tonight. Wait to hear back from his neurologist tomarrow?

KarayanMD :

Actually, in line with my last statement above, I would suggest going to the ER.

KarayanMD :

There likely is a neurologist on call who could help out with the case tonight.

KarayanMD :

Are you guys close to a relatively large hospital?

KarayanMD :

or academic center?

Customer:

Yes...i read only about the breathing could be effected. I am dealing with a nephew living with my older brother. I want him to take him to ER...but last time when his first eye closed they sent him home. Okay....thank you thank you thank you....I will now proceed to get him to the Er

Customer:

Yes we are in nj but near Delaware and Philly.... Jeffererson, CHOPS...all those big hospitals--less than 20 min'

KarayanMD :

Yea I think it makes sense to do so. You are welcome, and please remember to click on happy faces if this discussion was satisfactory. Bonuses are always appreciated. Good luck.

Customer:

Thanks you thank you thank you

KarayanMD :

My pleasure to help out. Best wishes.

Customer:

Bye

KarayanMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 750
Experience: Board Certified Neurologist with Subspecialty in Clinical Neurophysiology. Private Practice.
KarayanMD and other Neurology Specialists are ready to help you

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