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Suggest Remedy For Pain Caused By Arthritis
Question: History of cervical arthritis...was in ER Sunday with paresthesias left face. Negative CT scan of head and labs.
Having "pressure feeling" back of head at base of skull. Given RX Prednisone 20mg #5 one daily. Hasn't really helped. ? from arthritis in spine. Should I have an MRI of neck???? head???? Now having paresthesias seems like both lips, both sides
Having "pressure feeling" back of head at base of skull. Given RX Prednisone 20mg #5 one daily. Hasn't really helped. ? from arthritis in spine. Should I have an MRI of neck???? head???? Now having paresthesias seems like both lips, both sides
Brief Answer:
Please tell a few details.
Detailed Answer:
Hi xxxxxxxxxxx,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I would surely like to address your concerns in the best possible manner but I need to know a few details beforehand-
1)Since how many days did the paresthesias start?
2)How was the onset of paresthesias-sudden or gradual?
3)What was the course-intermittently improving and worsening or constantly worsening?
4)Any complaint in extremities,vision,speech or swallowing?
5)Do you have history of other diseases like Diabetes,Hypertension,Thyroid disorder,Anxiety(or depression) or any other chronic illness?
The above details may provide historical clues to narrow down the differential diagnosis of these paresthesias.So,I shall be glad to have you in follow-up with the same.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Please tell a few details.
Detailed Answer:
Hi xxxxxxxxxxx,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I would surely like to address your concerns in the best possible manner but I need to know a few details beforehand-
1)Since how many days did the paresthesias start?
2)How was the onset of paresthesias-sudden or gradual?
3)What was the course-intermittently improving and worsening or constantly worsening?
4)Any complaint in extremities,vision,speech or swallowing?
5)Do you have history of other diseases like Diabetes,Hypertension,Thyroid disorder,Anxiety(or depression) or any other chronic illness?
The above details may provide historical clues to narrow down the differential diagnosis of these paresthesias.So,I shall be glad to have you in follow-up with the same.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Onset 11/1/15 @ 4:00pm. Started with tingling left lips and gradually went up left face. Went to local ER @ 7:00 pm where I had the CT of head & labs. No other symptoms at all. Started Prednisone 11/2/15 5:30 pm. Seemed to be better yesterday but worse again today. No other medical issues except Hypothyroid which is controlled with Levothyroxine 50 mcg daily. Recent labs normal. I do have significant neck issues with documented arthritis on x-ray. I do have this pressure base of skull which I have had over past year off & on. Have been evaluated, but the doctors do not seem concerned about this. I am VERY CONCERNED especially with this new symptom. That is why I was wondering if MRI is needed for further evalution.
Brief Answer:
Neurological examination is mandatory/MRI Brain
Detailed Answer:
Hi xxxxxxxxx,
Thanks for being in follow-up and providing further details.
With this new symptom,my biggest concern is not to miss out something important like ischemia or MS. MRI Brain should be done to rule out any structural lesion in the brain.MRI cervical spine(neck) is however,unlikely to help because we are not localizing the pathology in neck or cervical spine.
So far,this advise is based on the clinical history,but I am of the strong opinion that you should visit a neurologist and get examined by him in order to have an objective assessment of the symptoms.That will further guide the investigations well.
If you have further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Neurological examination is mandatory/MRI Brain
Detailed Answer:
Hi xxxxxxxxx,
Thanks for being in follow-up and providing further details.
With this new symptom,my biggest concern is not to miss out something important like ischemia or MS. MRI Brain should be done to rule out any structural lesion in the brain.MRI cervical spine(neck) is however,unlikely to help because we are not localizing the pathology in neck or cervical spine.
So far,this advise is based on the clinical history,but I am of the strong opinion that you should visit a neurologist and get examined by him in order to have an objective assessment of the symptoms.That will further guide the investigations well.
If you have further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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