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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Hello... I started having some arm pain sometimes feeling like its losing circulatio

Resolved Question:

Hello... I started having some arm pain sometimes feeling like it's losing circulation in beg of April. I also had an incident around that time where my left arm had sharp burning & numb for about a min and I couldn't talk but went away. End of June I had sudden stiffness in the right side of my neck & also found a Lump on the right back of my head while massaging the pain...lymph node? Around July 12th I suddenly had stiff neck (like whiplash but no injury)& and pain in hand and fingers(pointer & middle finger). Since I have had those pains with pain in right arm & now lower back aches into sides and my spine feels bruised. I now also have sore throat off and on w/ jaw tension (almost feels like my tongue swells but it doesn't). Fever off & on 99.3-100.5 for about a month, some days 97.8. I noticed some days i'm ok and sometimes it's bad...(worse in the evening after I slow down for the day). Was 128lbs in Apr now 103lb & tired of being sick with no answers.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

neuromd2012 :

Welcome to Just Answer. I am an Adult Neurologist and was contacted to answer your question.

Customer:

Do I need to type my question again or do you have it?

neuromd2012 :

hello

neuromd2012 :

I do not have a question. I really cannot diagnose you here online, without any laboratory studies, or a physical/ neurological exam

neuromd2012 :

I can answer questions

Customer:

Did you read my situation? If so... my question would be have you ever heard of these symptoms or situation and what could be causing it?

neuromd2012 :

well

neuromd2012 :

you have an enlarged lymph node, and some low level fever

neuromd2012 :

you workup for an inflammatory disease, as I can tell from here, was negative

neuromd2012 :

what about your CBC?

neuromd2012 :

do you have a normal WBC count?

Customer:

Only thing I got from doc was red blood cell count was low but that was back in April

Customer:

I think wbc was normal back then

neuromd2012 :

how do explain your weight loss?

neuromd2012 :

did you have thyroid function tests?

Customer:

Not sure... it just kind of happend. I didn't even notice until my clothes were fitting diff.

Customer:

Thyroid was normal back in beg Apr too

neuromd2012 :

well, if there are no answers, you could get the lymph node biopsied

neuromd2012 :

and see if there is any positive markers for inflammatory diseases, a positive culture,

Customer:

is the MRI pointless then?

neuromd2012 :

Since you had the neck pain,

neuromd2012 :

maybe they are looking for some sign of Meningeal enhancement

neuromd2012 :

I think in this case, with no diagnosis, and the arm pain,

neuromd2012 :

they are looking for some type of neoplastic disease that could cause arm pain, weight loss,

neuromd2012 :

such as an extraaxial lesion. did you get a breast examination?

Customer:

I've researched MS, Lymphomia, lupus, carpel tunnel... does any of this seem similar to those? When I look up my symptoms it could be so many things.

neuromd2012 :

I agree. you cannot have lymphoma with a normal CBC

neuromd2012 :

carpal tunnel does not give you neck pain and an enlarged lymph node

neuromd2012 :

lupus, you need a positive ANA, or dsDNA on the serology testing

neuromd2012 :

and you need joint pain, rashes or skin lesions, kidney or liver problem,

neuromd2012 :

there are many criteria for lupus, did you have an ANA?

neuromd2012 :

MS is a difficult diagnosis, you need lesions on the MRI scan for a starter,

neuromd2012 :

then you need a clinical diagnosis, neurological problems that come and go over time

neuromd2012 :

visual symptoms, ataxia or falling down, incoordination,

neuromd2012 :

weakness/numbness

Customer:

I think Ana was done and normal.

neuromd2012 :

the fever is not consistent with MS

neuromd2012 :

nor is the weight loss

Customer:

I've had blurred vision that came on suddenly. I think they are trying to rule out if I had a stroke in march.

neuromd2012 :

so I would agree you need the MRI's

neuromd2012 :

I see

Customer:

Have you ever seen these symptoms from a stroke?

neuromd2012 :

you didn't mention blurred vision

neuromd2012 :

fever is not part of a stroke

neuromd2012 :

pain is one sided in stroke

Customer:

Sorry.. yes my vision did get worse

neuromd2012 :

half of your body, if you get pain from stroke

neuromd2012 :

did they do a CEA level?

neuromd2012 :

could you have sarcoidosis?

Customer:

Could the lump be a cyst pushing on a nerve something similar?

Customer:

I'm not sure what sarcoidosis is

neuromd2012 :

let me get you a webpage on sarcoid, you would need a chest X ray for this diagnosis,

neuromd2012 :

and then the MRI's will help

neuromd2012 :

you get lymph node enlargement, fever, weight loss

neuromd2012 :

http://emedicine.medscape.com/article/301914-overview

Customer:

last mri only showed 3 small lesions on front right of brain two years ago.

neuromd2012 :

here is a webpage on that disorder, which is fairly common in the white population

neuromd2012 :

I see

neuromd2012 :

did you have visual symptoms then? you did not mention double vision

Customer:

he told me not to be alarmed... it could be from childhood trauma or anything and put me on topomax for migraines

neuromd2012 :

I see

Customer:

No double vision. No vision issues with first mri

neuromd2012 :

well if your MRI shows additional white matter lesions

neuromd2012 :

I would encourage you to get a lumbar puncture for excluding demyelinating disease

neuromd2012 :

like MS, CNS lupus, CNS Sarcoid, vasculitis ok?

Customer:

Ok. That makes sense. The MRI will show if anything else needs to be done.

neuromd2012 :

yes

neuromd2012 :

it will give you some direction I hope

neuromd2012 :

please get back to me if you get results you do not understand, and I can help explain the findings

Customer:

This is frustrating... at least I know I can rule out lymphomia and I've been worried about the lump being a tumor... even if it's not cancerous... but just something that needs to be removed.

neuromd2012 :

well if that lump hangs around, I would ask to get it biopsied, as there are histological techniques you can do to determine

neuromd2012 :

if this is some cancer

neuromd2012 :

that may be the best option, after the MRI

Customer:

Do you know if the upper gi results would help relate any of my symptoms if they see something in those results? Or does it seem more like a neurological issue?

neuromd2012 :

I don't think a GI issue would effect your vision

neuromd2012 :

it seems more like a neurological issue with the pain, the jaw problem, the stiffness,

Customer:

Ok. That makes sense too. I think I'm just taking too much ibuprofen for the pain and worrying too much about functioning and getting work done when I'm sick and why I'm sick. Maybe that's why I've had loss of appetite and weight loss too.

neuromd2012 :

I see.

neuromd2012 :

well you need a diagnosis, that would help

neuromd2012 :

when you get the MRI's get them with gadolinium (contrast)

neuromd2012 :

ok?

neuromd2012 :

I hope I was able to give you some useful information

neuromd2012 :

Dr Frank T

Customer:

Yes. all of this is difficult because I don't have insurance. I've just applied for assistance though. I've considered ignoring it and if it's something serious I will eventually pass out or have something alarming happen, but it is hard to go day to day with this pain... especially when I own a dance studio and teach for a living. I've always been very healthy. I am starting to feel like it's in my head. Having to get up and change clothing or shower in the middle of the night due to excessive sweating and feeling like I have the flu is not fun.

Customer:

Thanks for the info you provided. I will look into some of the other things you mentioned.

neuromd2012 :

good luck to you

neuromd2012 :

bye

Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and 2 other Neurology Specialists are ready to help you
Expert:  Dr. Frank replied 1 year ago.
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