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What Causes Severe Leg Pain With History Of Migraines In A Teenager?

Posted on Thu, 31 Mar 2016

Question: My son is 16 years, 6'3 and 140 pounds. He has no health issues except migraines brought on by stress. They happen 2-3 times a month. Overall he is in otherwise excellent health. He is suffering paintings right leg that makes it hard to walk. It s more painful when stressed and non existent when content and happy, he has suffered no injury and fences as his sport where he excels and wins medals. The Butse at the school thinks it's all in his head. I live 10 hours away so I am not there to see this.

He did suffer a Hemipeligic Mograine a year ago which paralysed him for a few days. He appeared to make a full recovery and while he was home all Summer he needed no help and had no pain. Since being back in school, his leg hurts him often. Please help us if you can! Our primary care provider who had known my son his entire life has no idea either.

Answered by Dr. Alexander H. Sheppe (2 hours later)

Brief Answer:
Consultation

Detailed Answer:
Hello, Warm Welcome. I appreciate your trust in HCM and thanks for your question.
I have thoroughly reviewed health query you raised,

You describe your son as someone who has a history of migraine, including an episode of paralysis that spontaneously improved, and pain in his leg that worsens with stress.

This is a classic picture of somatization. Let me be clear about what this means. This means your son is having REAL physical symptoms, but the origin of these symptoms is not neurologic in nature. That is, his leg pain is real, but this is not caused by alterations in nerve function, blood supply, or other organic changes. This is related to brain chemistry and the effects of neurotransmitters such as serotonin and norepinephrine on the brain and body.

I recommend your son do two things. First, he needs treatment with an SNRI antidepressant such as venlafaxine. This will help address his stress and his leg pain. Second, he needs psychotherapy to understand how his mind affects his body, and to give him more control over this.

I am confident that with this treatment your son will get better!

Please remember to rate and close this answer if you find it satisfactory.

In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Alexander H. Sheppe (4 days later)

Thank you so Much! He will see a Dr this week!

Answered by Dr. Alexander H. Sheppe (6 hours later)

Brief Answer:
Followup

Detailed Answer:
It is my pleasure, you're very welcome!

Please remember to rate and close this answer thread when you are satisfied.

In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Raju A.T