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What Are The Side Effects Of Prednisone?
Question: In October of last year I had a 4-5 week course of an upper respiratory infection at which time I went to see my Primary Doctor. He gave me an ATB and put me on prednisone for about a week. I had severe side effects from prednisone; anxiety, insomnia, rapid heart beat, fluctuating BP, clenching of my teeth, fuzziness in the head and blurred vision, trouble breathing (or a sensation of trouble breathing really). Since then some of these awful symptoms have gone away, however the anxiety, occasional elevated heart rate (now just for a couple of minutes in the morning), tension in my posterior neck muscles and occasional days of fuzziness in the head are left. EXCEPT that I also now have begun to have some tingling in my face (mostly left, but occasionally some on the right side of my mouth) The neurologist I spoke with said that I might be developing a cold sore in my mouth so to watch for that... in the meantime I will say I noted a solitary mucous vesicular lesion in my mouth which came and went but I also have some tingling sensation on my L lower leg/foot area. Sometimes it is on my R lower leg. I realize the cold sore would surely not be responsible for that too. My question is.... I have been told that my symptoms are likely from a reaction to the steroids and that it will pass in time. They have checked my bloodwork multiple times including thyroid and cortisol levels, etc and all have been normal.
What are your thoughts?
What are your thoughts?
Brief Answer:
I agree with your doctors.
Detailed Answer:
I read your question carefully and I am sorry about the symptoms you are experiencing.
Looking at your description of the events I don't think that you have any serious neurological condition, the symptoms do not correspond to the brain or spinal cord lesions clinical presentation. The side switching of your symptoms is something which often puts us neurologists at ease because brain lesions involve usually only one side.
Your symptoms seem most probably related to anxiety. Corticosteroids at times do trigger anxiety do to disrupting chemical balance in your body and it can take some time for things to return as before. Anxiety disorders are very common in the general population so it may well be you are a predisposed person and the treatment triggered the appearance.
I would recommend some routine blood tests including Calcium and Magnesium, vitamin B12 levels, check with your doctor as you might already have done them. If tingling in the legs persists in time perhaps peripheral nerve conduction studies might also be considered.
Regarding treatment if symptoms are too bothersome a short course of benzodiazepines (not long term, develop tolerance and dependance) might be helpful.
I remain at your disposal for further questions.
I agree with your doctors.
Detailed Answer:
I read your question carefully and I am sorry about the symptoms you are experiencing.
Looking at your description of the events I don't think that you have any serious neurological condition, the symptoms do not correspond to the brain or spinal cord lesions clinical presentation. The side switching of your symptoms is something which often puts us neurologists at ease because brain lesions involve usually only one side.
Your symptoms seem most probably related to anxiety. Corticosteroids at times do trigger anxiety do to disrupting chemical balance in your body and it can take some time for things to return as before. Anxiety disorders are very common in the general population so it may well be you are a predisposed person and the treatment triggered the appearance.
I would recommend some routine blood tests including Calcium and Magnesium, vitamin B12 levels, check with your doctor as you might already have done them. If tingling in the legs persists in time perhaps peripheral nerve conduction studies might also be considered.
Regarding treatment if symptoms are too bothersome a short course of benzodiazepines (not long term, develop tolerance and dependance) might be helpful.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Calcium was done on a Comprehensive Metabolic Panel as well as electrolytes, etc. I take Vit B12 1000mg daily sublingually. I do have a low Vit D level if I don't take VIt D, but my last level was 41.0 less than a year ago.
I did not have a magnesium done, but the last time I had one done about a year ago it was 2.2.
Most of my symptoms are on the left, but I will say that I felt much more comforted when I had even a couple on my right side.
Do you think it would be necessary to obtain any imaging studies at this time OR are you confident that it is likely transient and will pass with time. AND... it has been almost 6 months having symptoms of one sort or another. Is there any predictor of how much longer it would take to see complete resolution?
I did not have a magnesium done, but the last time I had one done about a year ago it was 2.2.
Most of my symptoms are on the left, but I will say that I felt much more comforted when I had even a couple on my right side.
Do you think it would be necessary to obtain any imaging studies at this time OR are you confident that it is likely transient and will pass with time. AND... it has been almost 6 months having symptoms of one sort or another. Is there any predictor of how much longer it would take to see complete resolution?
Brief Answer:
Read below.
Detailed Answer:
Since you have already seen a neurologist and I assume he made a neurological exam which was normal I don't consider imaging necessary, there would have to be something either in your history or in physical exam to require imaging and in your case there isn't.
The fact that it's been 6 months, while frustrating not to be symptoms free yet, reinforces the lack of a brain condition which would likely evolve and manifest some signs.
There are no exact predictors. I say that also because the longer it is since you took Prednisonne, the likelier it is for your anxiety to be more a psychological effect rather then a direct one, meaning the initial chemical trigger is gone but you are finding it difficult to get past it. That's why I suggested, if symptoms really bothersome, a course of anti anxiety medication to try to break the cycle.
I hope to have been of help.
Read below.
Detailed Answer:
Since you have already seen a neurologist and I assume he made a neurological exam which was normal I don't consider imaging necessary, there would have to be something either in your history or in physical exam to require imaging and in your case there isn't.
The fact that it's been 6 months, while frustrating not to be symptoms free yet, reinforces the lack of a brain condition which would likely evolve and manifest some signs.
There are no exact predictors. I say that also because the longer it is since you took Prednisonne, the likelier it is for your anxiety to be more a psychological effect rather then a direct one, meaning the initial chemical trigger is gone but you are finding it difficult to get past it. That's why I suggested, if symptoms really bothersome, a course of anti anxiety medication to try to break the cycle.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I wanted to clarify one thing I said in my last message. I said that I had been having symptoms (one or another) for about 6 months now. I meant the other symptoms that began with the prednisone i.e. insomnia, anxiety, rapid heart beat, etc. I have only been having the tingling sensations for maybe 3-4 weeks or so. That is fluctuating and comes and goes. Some days it is hardly there.
Thanks for your help!
Thanks for your help!
Brief Answer:
Read below.
Detailed Answer:
Thank you for that info, while not sure about exactly how many weeks, from the way you put your question, I imagined that they had appeared later then the previous ones.
They are a common finding in anxiety though. If those abnormal bilateral tingling sensations are a constant, as I said nerve conduction studies/electromyography makes sense as an additional test.
Wishing you good health.
Read below.
Detailed Answer:
Thank you for that info, while not sure about exactly how many weeks, from the way you put your question, I imagined that they had appeared later then the previous ones.
They are a common finding in anxiety though. If those abnormal bilateral tingling sensations are a constant, as I said nerve conduction studies/electromyography makes sense as an additional test.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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