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Whether Its RLS, Neuropathy Or Due To Anxiety?
Question: Query for Neurology-Specialist, thanks.
Hello Doctor, Since last 2 years i am suffering from constant XXXXXXX electric charge running like sensations in nerves of both feet lower side accompanied with little lightness sensation in calves muscles throughout day and night, sensations are usually worse in night. While sitting, i feel restless feeling in legs, i also get seldom twitches in both feet skin and fingers, also burning sensation on and off only in right feet during night.
I have no sugar issues, Vit b12 is normal and so is Vit-D is fine. Iron and thyroid also normal but i suffer from anxiety and stress issues, Initially diagnosed as RLS by neurologist, i was prescribed gabapentin at start, relief was instant but it always give me jittery feeling inside body so i was switched to pregabalin/Nortriptyline combination med. which works normal so far. I have also taken NCS/NCV test which was almost normal , only suggesting "Mild motor axonal peroneal neuropathy in right leg."
So my issue is i want to be sure what i am suffering from, whether its RLS, Neuropathy or due to Anxiety?? atleast i should know exactly what i am suffering from? since neuropathy symptoms match with rls to much extent.
Hello Doctor, Since last 2 years i am suffering from constant XXXXXXX electric charge running like sensations in nerves of both feet lower side accompanied with little lightness sensation in calves muscles throughout day and night, sensations are usually worse in night. While sitting, i feel restless feeling in legs, i also get seldom twitches in both feet skin and fingers, also burning sensation on and off only in right feet during night.
I have no sugar issues, Vit b12 is normal and so is Vit-D is fine. Iron and thyroid also normal but i suffer from anxiety and stress issues, Initially diagnosed as RLS by neurologist, i was prescribed gabapentin at start, relief was instant but it always give me jittery feeling inside body so i was switched to pregabalin/Nortriptyline combination med. which works normal so far. I have also taken NCS/NCV test which was almost normal , only suggesting "Mild motor axonal peroneal neuropathy in right leg."
So my issue is i want to be sure what i am suffering from, whether its RLS, Neuropathy or due to Anxiety?? atleast i should know exactly what i am suffering from? since neuropathy symptoms match with rls to much extent.
Brief Answer:
In my opinion, most likely RLS than peripheral neuropathy.
Detailed Answer:
Hello,
I have read your question.
In my opinion, yours is most likely restless legs syndrome that is causing these symptoms than peripheral neuropathy.
Some of the daily symptoms may be justified also by anxiety.
Iron levels in the blood should be evaluated in order to evaluate correctly secondary RLS.
If low iron levels, there is a chance to improve significantly for the RLS symptoms after the correction.
Mild motor axonal peroneal neuropathy in the right leg found in the nerve conduction study may indicate mostly minor damage to this nerve by factors such as minor trauma, etc.
Hope you found the answer helpful.
Feel free to ask if you have further questions.
Thanks.
In my opinion, most likely RLS than peripheral neuropathy.
Detailed Answer:
Hello,
I have read your question.
In my opinion, yours is most likely restless legs syndrome that is causing these symptoms than peripheral neuropathy.
Some of the daily symptoms may be justified also by anxiety.
Iron levels in the blood should be evaluated in order to evaluate correctly secondary RLS.
If low iron levels, there is a chance to improve significantly for the RLS symptoms after the correction.
Mild motor axonal peroneal neuropathy in the right leg found in the nerve conduction study may indicate mostly minor damage to this nerve by factors such as minor trauma, etc.
Hope you found the answer helpful.
Feel free to ask if you have further questions.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor for clarifying, my iron stays around 100-120 and every morning as soon as i wake up i have to deal with these sensations eventhough it's of mild intensity but can be felt throughout day upon sitting or at rest. Due to these Gabapentin class medicines i am also facing sexual dysfunction like low libido and ejaculation difficulty- i feel like penile muscles needed for ejaculation have contracted because there is just minimum force, its been coming to almost 2 years of being on the medication. 1.5 years i was put on gabapentin but with time i felt it used to give me internal shaking feeling so consulted doctor, he switched it to Pregabalin and nortryptline combination med, he is saying it will help with my anxiety as well. So far its been fine but does this mean now i have to take this medicine life-long?? Does these sexual side-effects stays as long i stay on Pregabalin? I had a better life overall with gabapentin but i guess Pregabalin is far more effective and works real fast in my experience.
Brief Answer:
I would explain as follows.
Detailed Answer:
Welcome back.
Medications such as pregabalin are usually used for long periods of time (months to a few years) when it comes to RLS.
It is necessary to stop gradually, let's say after one year, pregabalin to see if it is necessary to continue it or not.
Pregabalin does not cause sexual dysfunction as an adverse effect ( or at least it may cause it in very few cases), nortriptyline may cause such issues.
In my opinion, for now, you should lower the dose of nortriptyline to see if it is affecting sexual function.
You should consider also being treated with pregabalin alone, if sufficient improvement of symptoms, nortriptyline should be discontinued.
Discuss with your Doctor these issues.
Hope this helps.
Take care.
I would explain as follows.
Detailed Answer:
Welcome back.
Medications such as pregabalin are usually used for long periods of time (months to a few years) when it comes to RLS.
It is necessary to stop gradually, let's say after one year, pregabalin to see if it is necessary to continue it or not.
Pregabalin does not cause sexual dysfunction as an adverse effect ( or at least it may cause it in very few cases), nortriptyline may cause such issues.
In my opinion, for now, you should lower the dose of nortriptyline to see if it is affecting sexual function.
You should consider also being treated with pregabalin alone, if sufficient improvement of symptoms, nortriptyline should be discontinued.
Discuss with your Doctor these issues.
Hope this helps.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor, Nortriptyline strength is of just 10 mg but my doctor saying we will be using for 2 months and then remove it. He is also taking consideration of anxiety, as i told him that in past i have tried taking treatment for anxiety as well using SSRI/SNRI but all medicines increases RLS symptoms intensity drastically so never able to take those.
One last query doctor, Does pregabalin(SR) Sustained released version will cause daytime sleepiness? I am considering that one because at least it will help me throughout 24 hours but at the same time i don't want to be sleepy during day while i want effectiveness as well.
One last query doctor, Does pregabalin(SR) Sustained released version will cause daytime sleepiness? I am considering that one because at least it will help me throughout 24 hours but at the same time i don't want to be sleepy during day while i want effectiveness as well.
Brief Answer:
I would explain as follows.
Detailed Answer:
Hello again.
Pregabalin SR is more unlikely than other forms of pregabalin to cause daytime sleepiness, due to more prolonged and equilibrated absorption.
So, in my opinion, it is worthy to try this form of pregabalin in your case.
Hope this helps.
Take care.
I would explain as follows.
Detailed Answer:
Hello again.
Pregabalin SR is more unlikely than other forms of pregabalin to cause daytime sleepiness, due to more prolonged and equilibrated absorption.
So, in my opinion, it is worthy to try this form of pregabalin in your case.
Hope this helps.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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