Potential Mild Bell's Palsy: Seeking Clarity
Diagnosis updates: F30 - UCTD, ovarian teratoma in remission, fatty liver. I have been collaborating with my neurologist to identify the root of my symptoms and was recently directed to a neuro-ophthalmologist due to reduced vision and color perception in my right eye, accompanied by episodes of vertigo. My neurologist is somewhat uncertain about the underlying issue and has suggested that I undergo an EEG soon. A year ago, an MRI revealed a lesion on the left side of my brain, but that has since resolved. I recently underwent an EMG, which yielded abnormal results that did not align with chemotherapy-induced neuropathy and hinted towards a different issue. Before starting chemotherapy, I experienced pronounced neurological and autoimmune symptoms, leading to a near-diagnosis of systemic lupus erythematosus (SLE). However, an EMG performed prior to chemotherapy declared a diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP), though that test was poorly executed due to a troubling interaction with the physician involved. I recall an incident at work where I suffered from an excruciating headache, experienced slurred speech, and had difficulty concentrating. The sensations mirrored my flares, as my malar rash darkened and my face became excessively flushed. That headache, particularly intense at the lower right side of my head, coincided with a diagnosis of elevated blood pressure. At that time, my primary care physician did not conduct further examinations regarding that episode, and the facial asymmetry accompanied by drooping appeared approximately a month later. Could these symptoms indicate a mild stroke, or are there autoimmune disorders that might present stroke-like signs? Occasionally, I still experience similar headaches, albeit milder, and I had another unusual incident during a visit to the emergency room. I attempted to communicate with a nurse when the headache resurfaced, albeit less severe, and then my head inexplicably dropped, resulting in disjointed speech. The facial drooping has shown some improvement recently, yet in the past few months, I've started experiencing sharp, intense pains in my right arm and leg. Additionally, when I attempt to run, my right leg feels heavy and numb, and my right arm exhibits the same symptoms if I raise it above my head. According to my neurologist's interpretation of the EMG results: **RESULTS:** No bilateral superficial peroneal SNAPs were found. Normal right tibial compound muscle action potential (CMAP). Left tibial CMAP displayed prolonged latency and low amplitude. Right peroneal CMAP was low in amplitude. Left peroneal CMAP was normal. Needle EMG results were normal for lower extremities. **IMPRESSION:** This indicates an abnormal study, suggesting evidence of bilateral lower extremity axonal neuropathy. I am reaching out for insights or guidance to help clarify my situation or identify any potential past incidents that may have contributed to my current condition.
Answers (1)
9/15/2025, 10:42:33 AM
OpenHealth AI
It's understandable to be concerned given the complexity of your symptoms and the various tests you've undergone. From your description, it sounds like you are experiencing a range of neurological symptoms that may or may not be associated with autoimmune conditions or other neurological disorders.
Main Points:
- Your symptoms could stem from autoimmune disorders or neurological issues, and a mild stroke is a possibility, but unlikely given the context.
- The abnormal EMG results indicate that there may be an issue with the peripheral nerves, particularly affecting the lower extremities.
- It's essential to continue working closely with your healthcare team, particularly with your neurologist and neuro-ophthalmologist.
Explanation:
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Symptoms and Historical Context: You've mentioned episodes of intense headaches, facial drooping, slurred speech, and neurological symptoms, which suggest a significant neurological history. The resolution of the brain lesion is promising, but the persistence of neurological signs warrants further investigation.
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Diagnostic Considerations:
- Mild Stroke: While symptoms like slurred speech and facial drooping can indicate a stroke, the chronic nature and variability of your symptoms may align more closely with an autoimmune disorder. Inflammatory conditions can mimic stroke-like symptoms through neurological impact.
- Autoimmune Disorders: Given the history of potential systemic lupus erythematosus (SLE) and the indications of chronic inflammatory demyelinating polyneuropathy (CIDP), it's possible your underlying autoimmune condition is contributing to both the neuropathic symptoms and the episodic headaches.
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EMG Results: The abnormal EMG suggesting "bilateral lower extremity axonal neuropathy" can explain some of the numbness and heaviness you're feeling in your legs and arms. This implies nerve damage that should be further understood and monitored.
Next Steps:
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Symptom Diary: Keep a detailed diary of your symptoms, noting the type of pain, intensity, duration, and any triggers or alleviating factors. Include information about your headaches, fatigue, and any unusual neurological episodes. This will help your healthcare team understand the frequency and impact of your symptoms.
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Follow-up Tests: Consider ensuring that your upcoming EEG and any further imaging scans (like an MRI focused on lesions) are prioritized. Discuss with your neurologist the need for potentially repeating the EMG with a more focused approach or employing other diagnostic tests.
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Manage Headaches and Neurological Symptoms:
- Continue to develop strategies for managing headache triggers. This can include maintaining hydration, regular sleep patterns, and potentially keeping a food diary to identify any dietary influences.
- If you have not done so, consider discussing the use of medications that may alleviate nerve pain or headaches with your healthcare provider.
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Collaborate Closely: Maintain open communication with both your neurologist and neuro-ophthalmologist. Ensure they are aware of all your symptoms and any changes in your condition.
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Support and Education: Join support groups for individuals with neurological or autoimmune conditions. These can provide valuable coping strategies and shared experiences.
Please remember, while your symptoms are concerning, you’re actively engaged in pursuing answers, which is essential. Keep nurturing this proactive approach and do reach out to healthcare professionals for any new or worsening symptoms as you progress.
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