My symptoms
 

Hi All

I'm a 41-year-old Asian male and new to this forum.

I've been having neurological symptoms over the past year. Random, fleeting twitching all over my body, shooting pains and dull aches, also all over my body, and pins and needles sensations on my arms and legs. I had a head/brain MRI in June this year and it was normal except for bilateral maxillary sinusitis. A cervical spine MRI indicated probems with the C3-C4 and C4-C5 vertebrae. Apparently the shape of my neck is also not normal. I've been examined by three general neurologists and a GP over the last seven months and they said my reflexes and strength levels were normal.

In the last two weeks or so, I've had random and fleeting face and head pain. Most of the time it is fleeting, dull, pressure-like pain, a few times it feels like mild electric shocks. Usually the pain comes without any stimulation but a few times it has come when I tap or squeeze a certain part of my face. I have to tap/press pretty hard to elicit the pain. A few nights ago, I tapped the area just under my right eye and I felt mild electric shocks on the right-corner of my mouth. But I get the pain on the left side of my face too, my chin, lower and upper jaws, temples, scalp, the back of my head and occasionally, tongue. Pain/shocks last for three or four seconds and goes on from the time I wake up until I go to bed. Sometimes the pain goes all the way down to my right toe. The pain is tolerable but I feel tired all the time and my head feels 'heavy'. My left cheek feels slightly numb/heavy. My face feels tingly and I sometimes get that 'ants crawling on my face' feeling. My neck and shoulders ache.

I went to see my neurologist again last Monday and after a whopping five minutes he concluded it was trigeminal neuralgia and prescribed me with 200mg Tegretol. I should add that this doctor is eager to prescribe and not so keen on listening.

My question is: has anyone else had similar symptoms to mine? I'm going to get a second opinion from another neuro before going on the Tegretol which is a strong drug with many side effects but before I do that I'd like to hear what you guys have to say.

Thanks for listening.

PS Over the last couple of days, showers have been terrible. I feel pain/aches on my face (especially on my T-zone) as I shower and my knees tremble a little. Pain/aches go away after the shower but I still have that numb feeling on my lower left cheek.

Trigeminal Neuralgia doesn't give you symptoms all over your body.

When nerves are aggravated, they are stimulated by heat.

So try to use very lukewarm water during your shower, and see if that helps.

Also try a cold pack on the back of the neck for 20 minutes 2 or 3 times a day. If this is a nerve compression issue from the cervical spine, the cold will soothe it. Cold also stops viral replication if you have some virus like Herpes zoster activating in the neck. Place a thin towel or cloth between your skin and the ice pack. Don't overdo it -- only 20 minutes is all that is usually necessary. This also can cool down inflammation, if that is contributing to your sensations.

Pain that goes to the toe, may be lumbar. Here is a dermatome chart showing which nerves cause which symptoms:

http://www.google.com/imgres?imgurl=...w=1039&bih=653

When I had my right knee issues years ago (I dislocated it), the pain only went down that leg to my big toe! When the chiropractor did the adjustment, that pain stopped instantly! (I had it for weeks before I went there). It was very dramatic.

You may have several things happening at once. I'd get that B12 checked first off to see if you are low, to explain if this cause is making your nerves so sensitive. (as I explained in your other thread).

Thanks, mrsD. My cervical spine MRI said that was no nerve impingement but I'll try the cold pack anyway.

B12 count
 

Hi mrsD

When I first joined, you suggested that I get my B12 levels tested. I did this last Wednesday and the results were as follows:

140 pg/ml (normal range is between 211 and 911).

My creatine kinase was 68 IU/L (normal range is between 24 and 190).

I haven't showed these results to my neuro but are they significant? My neuro appointment is next month.

Your B12 is low. Start with an oral supplement at 5mg a day on an empty stomach. Get the methylcobalamin type, if you can.

That low end of the range is NOT normal. Converting your numbers to US pg/ give you about 200. Significant neurological symptoms may be present at this concentration.

I would wonder if you are low in D3 too. See if you can get that measured. If you are not outside much you can start at 2000IU D3 for now.

There are more details on my B12 thread:
http://neurotalk.psychcentral.com/thread85103.html

short answer? YES......that B12 should be over 500, especially because you are symptomatic! Find some methylcobalamin (B12), commonly sub lingual (under the tongue) take on an empty stomach, because most of it will be swallowed. Make sure your Potassium intake is adequate.

Thanks, mrsD and pabb. This is the only exclusively B12 supplement (mecobalamin) available at my local chemist (note that I'm not in the US). They come in 500mcg tabs:

http://www.eisai.jp/medical/products...L_T-FG_EPI.pdf

Other formulations come as B1-B6-B12 combinations and the B12 component is cyanocobalamin which I believe is not as effective as mecobalamin?

What would be the normal range for B12 count using the North American system of measurement? We use pg/ml here. I thought this was the same as in the US?

Do you mean Vit D testing? I'm in the tropics and the sun is always out!

My mistake, I'm, sorry..... here is a conversion chart for some blood work
US vs International.
http://www.unc.edu/~rowlett/units/sc...ical_data.html

I always thought US was the only one who used pg/

In that case my conversion for you is high. Your 140 is very low... much more dangerously so.

The reason to use methyl is because some people have a genetic failure to methylate folate and B12. Using cyano for those people would be fruitless.

So I always recommend the methyl because if you are HERE there usually is a serious reason you are low.

For really low levels like you have you need 5mg daily for a while.

Check with www.iherb.com to see if they ship to your location.
That would be the best place to get the proper form for you.