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What causes tingling,numbness,pain of legs and arms with weakness and breathing difficulty?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Neurologist
Practicing since : 1994
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About 5 weeks ago had a sore throat, went to Dr and was diagnosed with Strep and took medication for it. After 2 weeks still tightness in throat. Started getting tingling in my fingers and toes. About a week later stiffness in jaw, difficulty opening jaw wide, tingling in face. This week my legs mainly my thighs have been sore and my legs feel really heavy when i walk. Also my back has gotten sore as if I have difficulty standing up straight. Also I feel shortness of breath with minimal physical activity.I'm at my desk now feeling like I'm breathing hard. just sitting at my desk. I walked up the street today and could barely breath. I've been to Dr and had EKG, Chest X-Ray, Blood tests to rule out vitamin deficiencies and other common illnesses. Gone to ENT and they put a camera in my throat and didn't find anything. Suggested it could be related to heartburn but I've never had it before and I am not convinced of this being the answer. The past two days extremely weak and feels difficult to take a full breath. If I run even a block I feel extremely winded.
Posted Sat, 1 Feb 2014 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 4 hours later
Brief Answer: My reply is below. Detailed Answer: Hi, Thank you for posting your query and providing detailed information. Based on your symptoms, the most likely diagnosis could be post-infectious polyradiculopathy or Guillain Barre syndrome (GBS). In this condition, there is tingling, numbness and pain of legs and arms, associated with weakness and breathing difficulty. The diagnosis can be confirmed by clinical examination (where we find sluggish or absent deep tendon reflexes), nerve conduction studies and lumbar puncture. The condition is self-limiting in 50% of people and improves on own. In the remaining, it may worsen (over four weeks). In most severe cases, affected people may not be able to walk at all. I would suggest you to consult a neurologist for evaluation and confirmation of diagnosis. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, India Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in
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Follow-up: What causes tingling,numbness,pain of legs and arms with weakness and breathing difficulty? 13 hours later
Does this sound like an normal pattern of events? The last two nights I've woken up at 2:00am or 3:00am breathing really hard and have been unable to sleep the rest of the night. Almost went to the ER both times. Is this urgent to see a neurologist right away? Dr has sent me to the ENT because it started off with the sore throat/difficulties swallowing but I'm not sure that this is the right path.
 
 
Answered by Dr. Sudhir Kumar 2 hours later
Brief Answer: My reply is below. Detailed Answer: I agree with your concern. I think you should seek an appointment with a neurologist, as neurological weakness of muscles and nerves need to be excluded. ENT evaluation may be done, but neurologist evaluation is more important at this stage. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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Follow-up: What causes tingling,numbness,pain of legs and arms with weakness and breathing difficulty? 1 hour later
Is this a serious condition? I'm looking up online Guillian Barre syndrome and it seems very serious. I haven't been able to reach the Dr yet to get the referral is this something that can wait? With breathing symptoms it sounds like it could be more serious? Should I go to urgent care? Will that be of any benefit at this point?
 
 
Answered by Dr. Sudhir Kumar 6 hours later
Brief Answer: Thank you for getting back. Detailed Answer: The severity of Guillain Barre syndrome differs in different people. So, there is no need to worry, as you seem to have a milder variant. However, if your breathing problem worsens, or if you have facial weakness, or if there is difficulty in swallowing, it may be better to go to ER and seek an early Neurology referral. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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Follow-up: What causes tingling,numbness,pain of legs and arms with weakness and breathing difficulty? 2 hours later
Thanks for your concern. I'll follow up with my PCP Dr. The last few nights I've been unable to sleep due to shortness of breath. Feeling like I can't get a full breath and can't really sleep. Someone mentioned the leg reflex test for this is it accurate? Thanks again.
 
 
Answered by Dr. Sudhir Kumar 5 hours later
Brief Answer: My reply is below. Detailed Answer: Yes, we can test the deep tendon reflexes in the legs. In GBS, they are absent of sluggish. To assess the breathing, the simple bedside test is "single breath count". In this, the person is asked to do counting from 1-2-3- onward without taking a breath. A normal person would be able to count upto 25 or more. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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Follow-up: What causes tingling,numbness,pain of legs and arms with weakness and breathing difficulty? 3 hours later
Ok, thanks again. is it possible these are all anxiety related symptoms? or anxiety is making it worse?
 
 
Answered by Dr. Sudhir Kumar 2 minutes later
Brief Answer: My reply is below. Detailed Answer: All these symptoms may not be anxiety-related, but I agree that anxiety could be making them worse. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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Follow-up: What causes tingling,numbness,pain of legs and arms with weakness and breathing difficulty? 2 days later
Thanks, I went to urgent care yesterday and they ran a battery of testing and did not find anything wrong. They referred me to a pulmonologist due to my breathing difficulties. Feeling as if I cannot take a full deep breathe. I asked for a neurological referral but they didn't think it was necessary. Should I follow back up with my PCP and insist on a neurological referral as well?
 
 
Answered by Dr. Sudhir Kumar 25 minutes later
Brief Answer: Thank you for getting back. Detailed Answer: No, I do not think neurology referral is required at this point. This is because your neurological symptoms are minor and the main issue seems to be breathing difficulty. So, you can follow up with a pulmonologist at present. If you develop worsening of weakness or numbness of hands and feet, then, you can see a neurologist. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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Follow-up: What causes tingling,numbness,pain of legs and arms with weakness and breathing difficulty? 5 hours later
Thanks again could this be a panic attack woke up this morning and can't get a full breath feeling. I'm feeling like I have to go back to urgent care but I don't know what they would do. Can they run pulmonary function testing or those things in the ER? In the urgent care they didn't do any of this. Also ER will be very expensive.
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Brief Answer: My reply is below. Detailed Answer: No, there is no need to go to ER. It would be better to meet the pulmonologist and get the pulmonary function tests. In the ER, they would not have the facility to do the PFT. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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