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Having pain in back, neck and shoulder, started diarrhoea and feeling senseless. Any treatment?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Practicing since : 1994
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Dear Dr. XXXXXXX XXXXXXX

I am talking on behalf of my brother, XXXXXXX XXXXXXX aged 28 years old. I am sharing the history of patient as following:

(1) He was in Cyprus from XXXXXXX 2001 to March 2012 and then came back home (Bangladesh) on March 10, 2012.

(2) He did not have any health problem during that time and it started on April 24, 2012. He had pain started on his back (at the end of backbone) and then pain spreaded neck and shoulder. It went for two days.

(3) Third night after dinner diarrhea started and he went to toilet totaling 6 times, and then it stopped after taking saline water.

(4) On the fourth evening he felt pain around his left knee. Two-three hours later his left leg was getting cold and senseless.

(5) Fifth morning he failed to move his left leg. In the afternoon he went to local doctor and he was prescribed some vitamins and pain medications. But the situation did not improve a lot.

(6) Sixth day, he went to see the doctor again and he referred to a hospital (Lab Aid).

(7) Seventh day, he went to Lab Aid and stayed four days and four nights and doctors did all possible tests, but failed to recognize the disease.

(8) Around eleventh day, he saw a neurologist who prescribed some medications and exercise.

(9) His condition was improving slowly, for example, he could up and down leg lying on bed.

(10) Four months later, he went to Apollo Hospitals in Dhaka for second opinion, and his condition is getting worse, for example, he now cannot move his leg up and down lying on bed.

I am sending all test results and medications by your email as a ZIP file. Please UNZIP it to see the files.

Sincerely,
XXXXXX
Posted Fri, 12 Oct 2012 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 4 hours later
Dear Mr XXXXXXX
Thank you for writing to me about your brother. I would be pleased to help in the diagnosis and treatment.
As I am unable to unzip the files, could you please send them in pdf version.
Sorry for causing you a bit of incovenience.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by
 
Follow-up: Having pain in back, neck and shoulder, started diarrhoea and feeling senseless. Any treatment? 2 hours later
Dear Dr. XXXXXXX

Thank you for your prompt response. I am sorry to hear that you could not open the files, however, I just sent three emails to < YYYY@YYYY > in three different attachments as pdf format. Please let me know if you have found them.

Thank you, and I look forward to hearing from you.

Best regards,
XXXXXX
 
 
Answered by Dr. Sudhir Kumar 31 minutes later
Dear Mr XXXXXXX
1. Thank you for sending the reports. I have reviewed them in detail.
2. I must admit that Dr Dash at Apollo Dhaka, along with Prof Chandy have done an excellent job (I have known both of them closely at my previous workplace- CMC Vellore).
3. Your brother is suffering from a neurological problem affecting the left leg. Main problems at this stage are severe weakness of the leg, along with thinning of muscles.
4. The nerves that originate in lower spinal cord (lumbar and sacral regions) and give strength to leg are affected.
5. The common reasons for the same are either viral infections or compression by the disc bulge (slipped disc).
6. In both the above cases (as mentioned in point 5), recovery takes place over time with good physiotherapy. However, one should note that recovery is slow and may be incomplete.
7. In another rare condition, nerves within the lower spinal cord (anterior horn cells) may degenerate. In this condition, disease may get worse over time.
8. At this point, I suggest use of nerve vitamins such as vitamin B12, alpa lipoic acid, benfothiamine, along with good physiotherapy.
9. He can regularly review with Dr Dash at Apollo Dhaka. However, if he wishes to be seen by me, I would suggest he comes here after three months.
I hope your brother recovers well. I would be pleased to answer any follow up queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
 
Follow-up: Having pain in back, neck and shoulder, started diarrhoea and feeling senseless. Any treatment? 15 minutes later
Dear Dr. XXXXXXX

Thank you for your quick response. I have three follow-up questions:

(a) Will he continue the medications prescribed by Dr. Dash?

(b) Will there any special physiotherapy for this sort of damage? If yes, could you please provide me a handout of such special type of exercises?

(c) Would it be possible to give me an idea how long it will take if step (5) is true?

I greatly appreciate your time and suggestions.

Best regards,
XXXXXX
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Dear Mr XXXXXXX
Thank you for getting back.
a) He should continue the medications as per Dr Dash's advice.
b) There is no special physiotherapy. Basically, he needs to do muscle strengthening exercises, which can be taught by any good physiotherapist.
c) Most people take about six months to show any good and meaningful recovery in the above mentioned conditions. Recovery, however, continues for up to two years.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
 
Follow-up: Having pain in back, neck and shoulder, started diarrhoea and feeling senseless. Any treatment? 7 hours later
Thank you very much. I greatly appreciate your suggestions very much, and get in touch with you regarding my brother's condition.

Best regards,
XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 4 hours later
Thank you and best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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