question-icon

Suggest Treatment For Polyneuropathy In Arms, Hands, Legs And Feet

default
Posted on Mon, 28 Sep 2015
Question: Hello,
I am writing to get some additional insight with my existing condition. This XXXXXXX I had surgery on back. It was L5/S1 discectomy and laminotomy. Immediately after my surgery I developed polyneuropathy in both arms, hands, legs and feet. My neurologist prescribed Gabapenten. 10 days later, I was admitted again for what was the most painful sciatica I've ever experienced in my right leg/my good side. Turned out I had hematoma and seroma. At first it was believed that my spine was infected. Fortunately, it wasn't, but I was monitored closely for five days in the hospital. In July, the nerve pain became so severe that my neurologist doubled my Gabapenten from 300mg in the morning, afternoon and bedtime to 600mg each time. As a mommy, I could not function at all. I had a lot of help with my kids from my family as my husband was unable to help because he had just begun a new job. I sought the opinion of a neurospine surgeon who ordered and MRI of my brain, cervical and thoracic spine. All was fine except I learned that I had four bulging discs in my neck as opposed to two. At the end of July my neurologist allowed me to start slowly weening off the Gabapenten in preparation to go back to work as a teacher. I felt better with limited nerve pain and pins and needles. Early August, I woke up with a pounding headache. Six days into the headache I had a spinal tap with my neurologist who is still trying to get to the bottom of my issues. Within the two days post spinal tap my headache became excruciatingly painful. I couldn't take the pain and ended up back in the ER with a heart rate of 144, blood pressure 166/96 and concern that I was septic because of elevated lactic acid in addition to my constant elevated sed rate and c-reactive proteins. After 6 long days in the hospital, i was finally sent home, still with headache. Upon returning home, my brain MRI results from the hospital stay came in. There is a 1.2cm pineal cyst on my brain along with flair of hyper intensity in the left frontal subcortical white matter. Both my neurologist and neurospine surgeon are not overly concerned about this new finding that wasn't there four weeks prior. Upon getting my classroom ready to go back to work, my polyneuropathy returned full force along with sciatica in both legs. I am at day 31 of the headache and everything seems to be getting worse. I have been told to see a dr in NYC to figure out what is wrong. I just feel at a loss especially with it being the weekend and my headache being unbearable tonight. Any suggestions would be greatly appreciated. Thank you!
doctor
Answered by Dr. Ajay Panwar (1 hour later)
Brief Answer:
Please upload MRI/Funduscopy/NSAIDS may be taken for immediate relief.

Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I have gone through your detailed medical history.Regarding headache,I would like to know whether-
1)You got a Funduscopic examination done or not?If yes,are you having papilledema or not?If not,get it evaluated by an Eye specialist to see for raised intracranial pressure.
2)Is headache unilateral(on one side-right or left) or bilateral?
3)Do you have accompanying nausea?photophobia?phonophobia?vision abnormalities?
4)Is headache present round the clock or episodic?
I would like you to please upload the scanned MRI images over here.Alternatively,please upload your MRI CD on google drive and paste the link here in follow-up.I would also like to have a look at the CSF reports.

Meanwhile,you should take non steroidal anti-inflammatory drugs(NSAID) like Naproxen(500 mg stat at the time of severe headache only).If headache is not responding to NSAID,Tramadol may be taken.

PLEASE TAKE ALL MEDICINES UNDER A PHYSICIAN'S GUIDANCE.

Regarding neuropathy-
Have you been evaluated for the cause?What about-
1)Blood sugar levels
2)Nerve conduction studies
3)ESR AND CRP was persistently high-Did they find out any infection or vasculitic process in the work-up.

Please follow up with details so that I can answer it well.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1827 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Polyneuropathy In Arms, Hands, Legs And Feet

Brief Answer: Please upload MRI/Funduscopy/NSAIDS may be taken for immediate relief. Detailed Answer: Hi XXXXXXX Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar,a neurologist,here to answer your query. I have gone through your detailed medical history.Regarding headache,I would like to know whether- 1)You got a Funduscopic examination done or not?If yes,are you having papilledema or not?If not,get it evaluated by an Eye specialist to see for raised intracranial pressure. 2)Is headache unilateral(on one side-right or left) or bilateral? 3)Do you have accompanying nausea?photophobia?phonophobia?vision abnormalities? 4)Is headache present round the clock or episodic? I would like you to please upload the scanned MRI images over here.Alternatively,please upload your MRI CD on google drive and paste the link here in follow-up.I would also like to have a look at the CSF reports. Meanwhile,you should take non steroidal anti-inflammatory drugs(NSAID) like Naproxen(500 mg stat at the time of severe headache only).If headache is not responding to NSAID,Tramadol may be taken. PLEASE TAKE ALL MEDICINES UNDER A PHYSICIAN'S GUIDANCE. Regarding neuropathy- Have you been evaluated for the cause?What about- 1)Blood sugar levels 2)Nerve conduction studies 3)ESR AND CRP was persistently high-Did they find out any infection or vasculitic process in the work-up. Please follow up with details so that I can answer it well. Regards Dr.Ajay Panwar, MD,DM(Neurology)