[53F] Experiencing nerve pain and mobility issues post-Guillain-Barre Syndrome

Patient Description

A 53-year-old female has been experiencing chronic nerve pain in her hands and feet, rated as a 6 on a pain scale, and weakness in her legs, rated as a 7 on a severity scale, which has resulted in difficulty walking. These symptoms began approximately 2.5 years ago following an episode of Guillain-Barre Syndrome. The patient uses a wheelchair for mobility due to numbness in her legs after walking for short periods. She is currently on pregabalin for nerve pain, which provides minimal relief, levothyroxine for medically induced hypothyroidism from past treatment for Graves' disease, and propranolol for an irregular heartbeat. Additionally, she has elevated IgA, enlarged red blood cells, and elevated triglycerides and cholesterol. She also experienced significant gastrointestinal issues a year ago, requiring dietary adjustments.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): This is a neurological disorder characterized by progressive weakness and impaired sensory function in the legs and arms. It's often associated with Guillain-Barre syndrome, which you mentioned you had 2.5 years ago. CIDP is caused by damage to the myelin sheath, the protective covering of the nerves. Typical symptoms include weakness, numbness, and tingling in different parts of the body.

    • Treatment usually involves medications to suppress the immune system and physical therapy to improve muscle strength and function.
  • Peripheral Neuropathy: This results from damage to the peripheral nerves and often causes weakness, numbness, and pain, usually in your hands and feet. It can result from traumatic injuries, infections, metabolic problems, and exposure to toxins. One of the most common causes is diabetes.

    • Treatment involves managing the condition causing your neuropathy and relieving symptoms with medications.
  • Vitamin B12 Deficiency: This can cause a variety of neurological symptoms, including numbness, weakness, and difficulty walking. It can also cause macrocytosis, which is the presence of larger than normal red blood cells, a condition you mentioned you have.

    • Treatment involves supplementing with Vitamin B12.

Please note that these are potential explanations for your symptoms, but only a healthcare provider can provide a definitive diagnosis.

What you can do

Given the chronic nature of your symptoms and their impact on your quality of life, it's important to seek medical attention. Here are some steps you can take:

  1. Schedule an appointment with your primary care provider or a neurologist to discuss your symptoms and potential treatment options.
  2. Keep a symptom diary to track the severity and frequency of your symptoms. This can help your healthcare provider understand your condition better.
  3. Stay active within your ability. Regular physical activity can help maintain muscle strength and function.
  4. Eat a balanced diet to ensure you're getting all the necessary nutrients. If you suspect a vitamin B12 deficiency, consider foods rich in this vitamin like meat, fish, eggs, and dairy products.

What you should look out for

If you notice any of the following symptoms, seek medical attention immediately:

  • Sudden worsening of your symptoms
  • Difficulty breathing
  • Severe pain that isn't relieved by your current medications
  • Changes in your bowel or bladder function

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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6 mo ago


People Also Ask


What is Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and how is it related to Guillain-Barre Syndrome?

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a neurological disorder characterized by progressive weakness and impaired sensory function in the legs and arms. It is often associated with Guillain-Barre Syndrome, as both involve damage to the myelin sheath of nerves. CIDP is typically treated with immune-suppressing medications and physical therapy.


What are the common causes and treatments for peripheral neuropathy?

Peripheral neuropathy is caused by damage to the peripheral nerves and can result from traumatic injuries, infections, metabolic problems, and exposure to toxins. Diabetes is a common cause. Treatment focuses on managing the underlying condition and relieving symptoms with medications.


How can a Vitamin B12 deficiency affect the body, and what are the treatment options?

Vitamin B12 deficiency can cause neurological symptoms such as numbness, weakness, and difficulty walking, as well as macrocytosis, which is the presence of enlarged red blood cells. Treatment involves supplementing with Vitamin B12, either through diet or supplements.


What lifestyle changes can help manage chronic nerve pain and weakness?

To manage chronic nerve pain and weakness, it is important to stay as active as possible, maintain a balanced diet, and keep a symptom diary. Regular physical activity can help maintain muscle strength, and a diet rich in necessary nutrients can support overall health. Consulting with a healthcare provider for personalized advice is also crucial.

1 Comments


Anonymous#19741

6 mo ago

I woke up one day with tingling in my feet and toes. Within a month or so, it (tingling, numbness) ran the length of my legs. I saw my primary care physician and he referred me to a neurologist. As soon as I rode (no balance, "foot drop" in both feet, couldn't walk unaided) into my neurologist's office, he suspected CIDP. He did a nerve conduction study, ordered blood work, an MRI, a CT scan & lumbar puncture. Once the results came back, they confirmed CIDP. I was prescribed Gammagard IVIG and got infusions every three weeks for almost six months. It alleviated a lot of the nerve pain, but did little to improve my strength and/or range of motion. I still couldn't walk unaided and had NO balance whatsoever. I got a rollator and began pedaling everyday. My neurologist decided to switch the IVIG I was getting to another formulation called Gamunex-C. I'm still receiving the Gamunex-C, working through physical therapy and, generally, looking forward to a day when I'm able to walk unaided. I, too, have suffered atrophy in my calves and, as a result, sometimes wake up with edema in my ankles which subsides when I keep my legs elevated. The disorder has really negatively impacted my life. I'm just trying to stay patient, pursue my treatment and physical therapy with as much energy as possible and look forward to a better future.

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