[22F] Experiencing leg paralysis, body pain, and abdominal pain

Patient Description

A 22-year-old female presents with leg paralysis, constant neuropathic body pain rated 7/10, and stabbing abdominal pain also rated 7/10. The patient has a history of Guillain-Barre syndrome, Epstein-Barr virus, chronic regional pain syndrome, and low thyroid function. She has been taking duloxetine, tramadol, buspirone, erythromycin, and Carafate for various durations, with duloxetine and buspirone being taken for two years, tramadol for four years, and erythromycin and Carafate for three years. The patient experiences intermittent fevers and occasional bladder control issues but reports no changes in bowel habits or weight. She has a family history of low thyroid, Parkinson's disease, and restless leg syndrome. Known drug allergies include sulfa, hydrocodone, and codeine, which cause intense internal itching.

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Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

  • Chronic Pain Syndrome: Given your history of chronic regional pain syndrome (CRPS) and your current symptoms of constant body pain, it's possible that your CRPS is causing your current symptoms. CRPS is a form of chronic pain that usually affects an arm or a leg and typically develops after an injury, surgery, stroke or heart attack.

    • Treatment for CRPS is most effective when started early. In the later stages, treatment tends to focus on managing the symptoms. This can involve a combination of physical therapy, medications, and sometimes surgery or other procedures.
  • Guillain-Barre Syndrome (GBS): This is a rare neurological disorder in which your body's immune system attacks your nerves. Given your history of GBS and your current symptoms, it's possible that you're experiencing a relapse or post-GBS syndrome.

    • Treatment for GBS often involves hospitalization, especially if the condition is severe. Treatment options include plasma exchange (plasmapheresis) and immunoglobulin therapy.
  • Abdominal Wall Pain: This is a type of pain that occurs when the nerves in the abdominal wall are irritated. It can cause sharp, stabbing, or shooting pains.

    • Treatment for abdominal wall pain often involves medications to manage the pain, as well as physical therapy.
  • Thyroid Disease: Given your history of low thyroid, it's possible that your current symptoms are related to your thyroid condition. Thyroid disease can cause a variety of symptoms, including pain, fatigue, and changes in weight or appetite.

    • Treatment for thyroid disease often involves medication to manage the symptoms.

Please note that these are just possibilities and not a definitive diagnosis. It's important that you consult with a healthcare provider who can evaluate your symptoms and medical history in person.

What you can do

In the meantime, here are some things you can do to manage your symptoms:

  1. Continue taking your prescribed medications as directed by your healthcare provider.
  2. Try to maintain a healthy lifestyle. This includes eating a balanced diet, getting regular exercise, and getting enough sleep.
  3. Try to manage your stress levels. Stress can often make pain worse. Techniques such as deep breathing, meditation, and yoga may help.
  4. Keep a symptom diary. This can help you track your symptoms and identify any patterns or triggers. This information can be helpful when you consult with your healthcare provider.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe pain that doesn't improve with rest or medication
  • Difficulty breathing or shortness of breath
  • Changes in your vision or speech
  • Loss of consciousness or fainting
  • Severe abdominal pain or vomiting
  • Any other symptoms that are severe or concerning to you

Remember, it's important to consult with a healthcare provider for a proper diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms and treatment options for Chronic Regional Pain Syndrome (CRPS)?

CRPS is characterized by severe, persistent pain, often in an arm or leg, that can develop after an injury or surgery. Treatment options include physical therapy, pain management medications, and sometimes nerve blocks or other procedures. Early intervention is crucial for better outcomes.


Can Guillain-Barre Syndrome (GBS) relapse, and what are the treatment options if it does?

Yes, GBS can relapse, although it is rare. If a relapse occurs, treatment options include hospitalization, plasma exchange (plasmapheresis), and intravenous immunoglobulin therapy to manage symptoms and support recovery.


How can low thyroid function affect overall health, and what are the treatment options?

Low thyroid function, or hypothyroidism, can lead to symptoms such as fatigue, weight gain, and depression. Treatment typically involves thyroid hormone replacement therapy to normalize hormone levels and alleviate symptoms.


What are the potential side effects of long-term use of medications like duloxetine and tramadol?

Long-term use of duloxetine can lead to side effects such as nausea, dry mouth, and fatigue, while tramadol may cause dizziness, constipation, and dependency. It's important to regularly review medication use with a healthcare provider to manage any side effects and adjust treatment as necessary.


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