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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do Intermittent Pain And Weakness In The Lower Limbs Indicate?

I was just diagnosed with GBS after having an EMG. I received Steroids in the hospital for the pain. Now I was referred to a rheumatologist. I still have intermittent pain, and weakness in the lower extremities. This has been going on for 4 months. Why was i referred to a rheumatologist and what will he do.
Wed, 11 Jan 2017
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General & Family Physician,  's  Response
Hi,

Initially I would like to describe you about gbs - gbs is also called as acute inflammatory demyelinating polyradiculoneuropathy. GBS is the most common acute polyneuropathy. Triggers of gbs:

- campylobacter jejuni, cmv, mycoplasma, zoster, hiv, ebv, vaccinations, this trigger causes an immune mediated reaction causing antibodies that attack the nerves.

Symptoms of gbs:

- few week after infection a symmetrical ascending muscle weakness starts.

Weakness may affect all 4 limbs and can lead to paralysis, proximal muscles are more affected like the trunk, respiratory and cranial nerves, pain in the back and the limbs. Autonomic dysfunction causes increased sweating, increased pulse, BP changes, arrhythmia, slow nerve conduction can be seen, respiratory involvement can be seen, CSF analysis shows protein > 5.5g/l, normal CSF white cell counts, to know the lung involvement FVC done.

There can be reduced power and reduced or absent tendon reflexes, rheumatologist consultation needed to rule out other causes of peripheral neuropathy like sjogrens syndrome, chrug strauss, pan, myasthenia treatment included are immunoglobulin, plasma exchange, low molecular weight heparin, compressive stocking to decrease risk of venous thrombosis.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Pavani
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What Do Intermittent Pain And Weakness In The Lower Limbs Indicate?

Hi, Initially I would like to describe you about gbs - gbs is also called as acute inflammatory demyelinating polyradiculoneuropathy. GBS is the most common acute polyneuropathy. Triggers of gbs: - campylobacter jejuni, cmv, mycoplasma, zoster, hiv, ebv, vaccinations, this trigger causes an immune mediated reaction causing antibodies that attack the nerves. Symptoms of gbs: - few week after infection a symmetrical ascending muscle weakness starts. Weakness may affect all 4 limbs and can lead to paralysis, proximal muscles are more affected like the trunk, respiratory and cranial nerves, pain in the back and the limbs. Autonomic dysfunction causes increased sweating, increased pulse, BP changes, arrhythmia, slow nerve conduction can be seen, respiratory involvement can be seen, CSF analysis shows protein 5.5g/l, normal CSF white cell counts, to know the lung involvement FVC done. There can be reduced power and reduced or absent tendon reflexes, rheumatologist consultation needed to rule out other causes of peripheral neuropathy like sjogrens syndrome, chrug strauss, pan, myasthenia treatment included are immunoglobulin, plasma exchange, low molecular weight heparin, compressive stocking to decrease risk of venous thrombosis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Pavani