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Suggest treatment for blurred vision and muscle weakness

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Posted on Mon, 18 May 2015
Question: Your Deadline: Monday, May 4, 2015 at 12:00:00 AM EST [?]
Hi I've had two episodes after I've taken Humira where I develop confusion, unsteady balance, problems with fine motor skills, double and blurred vision, hoarse and stecaato speech, trouble swallowing, muscle weakness and spasms, bradykinesia, eyelid droop, facial weakness, difficulty with word finding and about 2 to 3 days of confusion. The symptoms are strokelike. They last about two weeks. Symptoms begin with the week of Humira and are more mild in between treatments. These sxS are difficulty testing, memory issues and fatigue. I don't take my Humira every two weeks. I was hospitalized with each reaction. mri/mra and ct negative. MYathenia gravis testing was negative. They did not do an emg or immune work up. What is your differential for these symptoms and what tests should would you rec? This definitely correlates with Humira injections and I am wondering what could Humira unmask or even cause? Thank u.
doctor
Answered by Dr. Shruti Rijhwani (1 hour later)
Brief Answer:
Lupus like lesion should be ruled out.

Detailed Answer:
Dear Madam,

Thank you for posting your query on HCM.

Well, looking into your problem I would like to tell you that what you are telling is a rare phenomenon . Since you insist it follows humira administration there is a possibilty of drug induced lupus . Also demyelinating lesions are a possibilty like multiple sclerosis.

Various infections can also occur specially the viral ones which needs to be ruled out . I would advise you to get a Lumbar Puncture and CSF examination done plus MRI brain to see whats going on. It would be difficult to comment anything till we have some clue in form of investigations .

This would be bare minimum to reach to a diagnosis. Any other concerns please let me know .

Take care.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Shruti Rijhwani (29 minutes later)
Eho would do the lp? Mri and mra eere negative. Im totally unsure about humira as cause- but twice now the symptoms have wosened with humira admin- wouldnt sny immune do of vires possibly worsen with a tnf inhibitor?
doctor
Answered by Dr. Shruti Rijhwani (5 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

MRI brain may not show abnormalities always . CSF examination may show some abnormalities which can give us a clue . In demyelinating lesions sometimes the neurological deficits can be transient so that remains the priority disease which needs consideration.

Plus if you think humira is causing all that you should stop it only after consulting your prescribing doctor to get an alternative.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
Dr.
Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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Suggest treatment for blurred vision and muscle weakness

Brief Answer: Lupus like lesion should be ruled out. Detailed Answer: Dear Madam, Thank you for posting your query on HCM. Well, looking into your problem I would like to tell you that what you are telling is a rare phenomenon . Since you insist it follows humira administration there is a possibilty of drug induced lupus . Also demyelinating lesions are a possibilty like multiple sclerosis. Various infections can also occur specially the viral ones which needs to be ruled out . I would advise you to get a Lumbar Puncture and CSF examination done plus MRI brain to see whats going on. It would be difficult to comment anything till we have some clue in form of investigations . This would be bare minimum to reach to a diagnosis. Any other concerns please let me know . Take care. Dr. Shruti