Discussions By Condition: I cannot get a diagnosis.

Bells Palsy / Tingling numb hands feet / joint pain

Posted In: I cannot get a diagnosis. 28 Replies
  • Posted By: acre44
  • January 2, 2009
  • 05:38 PM

Can anyone help me out with my symptoms and possible solutions? I had been exceptionally healthy 38 year old white male until this and now I am suffering from panic attacks and anxiety over my health that is affecting my whole life and family.

11/23/08 I came down with what I thought was a severe sinus infection. Pain was worse than I had ever had before above my eyes. My forehead was even swelled up and puffy. The ER doc perscribed a Z-pac which I began taking immediately. I began feeling better the next day, pain subsided. On 11/25 my lips became numb. I called the Dr and he said that I was having a reaction to the Z-pac to stop it immediately. That night I had to go to the ER because the whole left side of my face was not working. Diagnosed that night with Bell's Palsy. Put me on prednesone for the inflammation and sent me home. I had appts with optamology, ent and PC dr on 12/11. They all said that it was classic bells and i should see an improvement quickly. The PC prescribed acyclovir just in case. Took that for 5 days. My face returned to normal in a few weeks. The night of 12/14 I began tingling in my feets and hands. I went to the ER. They did sugar check and some blood tests, all normal, sent me home. I went to see my PC Dr on 12/16. I had did my research and others had told me I may have lyme. I live in Pennsylvania and I am outdoors the whole summer. My dog even had ticks removed from our yard. The doctor ordered up the tests but said he would begin treating it as lyme even though I do not remember having a tick or any rash. I began IV ceftriaxone for 20 days. The next day I went in for my IV but my vision was getting blurry, lots of floaters. My spine was tingling and I had a burning sensation in my mid spine. He sent me to the ER for a full work up. They did an MRI, CAT scan, lumbar puncture (spinal tap), full blood work up, CBC, sed rate, etc. The neurologist did a complete physical. ALL were normal. All 3 lyme blood tests came back negative and my spinal fluid was negative for lyme and the protein level was normal. They stopped the IV anti-biotic. The neuros scheduled me for an EMG in mid-January. Since that ER visit I have had pain/stiffness mid spine, tingling lower spine, tingling/numb from knees to foot, tingling/numb from elbow to fingers, knee pain, foot pain, ankle pain, finger pain, elbow pain, sleeping trouble. The pain travels from joint to joint, comes and goes. I can sleep for a few hours then wake up suddenly wide awake, hard to go back to sleep. Two days ago I could feel pressure and tingling of my sciatic nerve down both legs and a sharp pain in my calf and ball of my foot. That lasted one day. The PC Doc thinks it is related to a virus (herpes, shingles, etc.) that caused the bells palsy and that it will get better with time. I never did have a rash or any skin disorder with any of this. I have read about lyme and the negative tests. I have also heard about different viruses causing joint inflammation. I do have joint pain but no swelling and my sed rate is excellent.

Any help would be greatly appreciated.

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28 Replies:

  • There are doctors at this forum and they will surly give you a more proper advice, but I wonder if all this isn’t an autoimmune reaction. Ten years ago I experienced a something very similar. All tests were negative. It took three years before I was back to normal. In my case I think it was provoked by mononucleosis and simultaneous severe stomach flu. Do you remember any infections a month or so before all this?
    Felsen 510 Replies
    • January 3, 2009
    • 08:49 PM
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  • I hate to tell you this ,but your symptoms are in what we call a stocking and glove distribution,which means that in all likelihood it's in your head.I,too,would probably get panic attacks if I developed Bell's palsy,but I know of nothing to be worried about.Your pain is real,but it's likelt to be psychophysiological.
    richard wayne2b 1232 Replies
    • January 4, 2009
    • 02:23 PM
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  • I forgot to recommend a few days of Xanax.
    richard wayne2b 1232 Replies
    • January 4, 2009
    • 02:24 PM
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  • Maybe it is "in your head" and maybe it is Ramsay-Hunt syndrome, a result of shingles. Try here: http://www.mayoclinic.com/health/ramsay-hunt-syndrome/DS00878 This site describes the specific test used to diagnose this probem. Ask if you have had this testing & what the results are if so.
    aquila 1263 Replies
    • January 5, 2009
    • 09:02 PM
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  • It is not Ramsay-Hunt syndrome.
    richard wayne2b 1232 Replies
    • January 5, 2009
    • 09:15 PM
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  • blaze doesn't know what she's talking about!Lyme disease dosn't cause Bell's palsy.
    richard wayne2b 1232 Replies
    • January 5, 2009
    • 11:09 PM
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  • SoI was wrong on this one thing richard wayne2b 1232 Replies
    • January 7, 2009
    • 04:18 PM
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  • richard-wayne2, in all seriousness, what about the posting makes you not think about Ramsay-Hunt? The poster states that his/her physician thought it was Ramsay-Hunt. I try to give people info about the dx they have received. Sometimes it's a matter of the patient not really understanding what the dx means in terms of their own personal situation. I'll try to go back into this thread & read your reply, if any. Best wishes.
    aquila 1263 Replies
    • January 7, 2009
    • 05:08 PM
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  • Unless I missed something,the patient didn't have the typical red painful rash of a Herpes Zoster infection.That's why it couldn't be a Ramsay-Hunt syndrome.
    richard wayne2b 1232 Replies
    • January 7, 2009
    • 05:39 PM
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  • I see. Take a look here. We had a rounds on this recently, and the absence of rash was discussed & stuck in my mind: http://www.biomedexperts.com/Abstract.bme/1320648/Varicella-zoster_virus_reactivation_without_rash
    aquila 1263 Replies
    • January 7, 2009
    • 05:47 PM
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  • Now I see where you got it.Thanks.
    richard wayne2b 1232 Replies
    • January 7, 2009
    • 06:54 PM
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  • You're welcome!
    aquila 1263 Replies
    • January 7, 2009
    • 08:09 PM
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  • The doctors probably didn't tell you that 60% of Bells Palsy patients actually have Lymes disease and if you take and steroids or antiviral you are likely to have a negative Lymes test. Even after time has gone by you need a really good extensive full panel test not the quickie that you get back in three day (which have lots of false negative results). Igenex does a good job of full panel testing, even then if you have a negative result and still suspect Lymes you can go to the next step and have the urine test. Your not crazy and if anyone says it is in your head that is simply ignorance.
    Anonymous 42789 Replies
    • February 3, 2009
    • 03:57 AM
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  • Where did you get that information about 60% of Bell's palsy patients having Lyme Disease?I don't believe it.
    richard wayne2b 1232 Replies
    • February 4, 2009
    • 00:36 AM
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  • What I found was that Lyme Disease can cause facial nerve paralysis and the same symptoms as Bell's palsy,which is a whole lot different from what you said.
    richard wayne2b 1232 Replies
    • February 4, 2009
    • 00:42 AM
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  • Okay, sorry to put a damper on things but this person's symptoms are not related to Ramsay Hunt in any manner. Realize that otalgia must be present for a diagnosis of RH and it's specifically why the more formal name for the syndrome is Herpes Zoster Oticus. RH I would certainly not apply here as well. The presentation of RH II follows the distribution of CN VII which courses through the auditory region. The reason that skin eruption may or may not be present or florid is due to the association the RH II has with the varicella zoster virus, also responsible for Bell's Palsy wherein skin lesions are seldom if ever encountered. So to clarify my point, this individual would far more likely have a Bell's Palsy and the VZV can actually be assayed through PCR if his physicians truly wish to either confirm or rule out the presence of the virus. Again, this individual's symptoms are entirely inconsistent with Ramsay Hunt. Realize that because of involvement within the genticulate ganglion, the pinna, the anterior portion of the tongue, the soft palate and more particularly the auditory canal are all affected in RH and once you see the pinna of a patient experiencing RH II, you won't soon forget it. And although I grow weary from doing so, I'll once again comment here that the symptoms are not associated with Lyme disease by any stretch of the imagination. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • February 4, 2009
    • 01:05 AM
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  • Methylcobalamin, a form of vitamin B12, was compared with steroids in a trial involving 60 patients with Bell's palsy. The shortest time required for complete recovery of facial nerve function occurred in the group receiving Methylcobalamin alone. A therapeutic dose would be a minimum of 1500mcg and a maximum of 6000mcg per day, by injection. It was administered by intramuscular injection 3 times weekly for 8 weeks (or until recovery). The results of this study have not been validated, and administration of methylcobalamin has not become a common treatment.http://www.diagnose-me.com/cond/C354600.htm There are a lot of other places this info could have come from. This is just one report of one study finding methylb12 the more effective treatment for bell's palsy.
    Freddd 3576 Replies
    • February 4, 2009
    • 01:08 AM
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  • Dr.Cottle,My wife's pain seems to be severe.I don't know if I told you,but it's radiating up the dorsum of her forearms into her lower arms now.She denies any ventral pain except for her wrists.Thank you.
    richard wayne2b 1232 Replies
    • February 4, 2009
    • 01:55 AM
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  • And,just out of curiosity,what is your specialty?
    richard wayne2b 1232 Replies
    • February 4, 2009
    • 01:57 AM
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  • Hi Richard, I had opened a thread specifically for the purpose of corresponding with you concerning your wife. We seem to constantly pass each other in the night. Again, my recommendation here is to obtain a tricompartmental arthrography, which would be the test of choice in the presence of a negative MRI and chronic bilateral wrist pain. As I had mentioned in the thread to you, I initially had wondered whether an early osteonecrosis of the lunate could be a possibility, which in the early stages presents like a sprained wrist and might escape detection on MRI. I was a neurologist up until my retirement but did a fairly long hitch in emergency medicine prior to crossing over. Might I ask the same? Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • February 4, 2009
    • 02:31 AM
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