Dr. Aida Abaz Quka
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am feeling really down. I have had a lot of digestive problems for about two years. I have been diagnosed with candida and dysbiosis, but my regular doctor does not seem to know what is wrong with me. I have been very stressed and have suffered anxiety since I was about 16. I was not on any medications and started taking Cymbalta a few months ago. After about three to four days, I started to notice a bit of burning in my feet. I have since stopped taking Cymbalta about a month ago. My feet seemed fine. Then seven days ago, I started getting really bad pain in my feet and burning and tickling and pins and needle feelings. I am not diabetic or alcoholic. I have no idea what has brought this on or whether it can be reversed. I am so stressed out. I have to be on my feet for my job for about four and a half hours every morning. Can this be tested to see if the nerve cells are either dead or just damaged and can it be reversed? This feels like it is going to ruin my life.
Hello,
Welcome to icliniq.com. Regarding your concern, I would agree with you on the fact that your symptoms could be related to peripheral nerve damage. Coming to this point, I would recommend consulting a neurologist and performing an NCS (nerve conduction study) to examine your nerves. Other tests to investigate the possible causes of your symptoms would be: 1. Complete blood count for anemia. 2. Iron plasma levels. 3. Fasting glucose. 4. PCR (polymerase chain reaction) and sedimentation rate. 5. Blood electrolytes. 6. Vitamin D and vitamin B12 plasma levels for possible deficiency. 7. Thyroid hormone levels for possible thyroid gland dysfunction.
Patient's Query
Hello doctor,
I am just wondering if the electronystagmography (ENG) will tell us if the nerves are just damaged or dead. If the problem is one of the problems you asked me to get tested for, can it be reversed? I am wondering what the treatment is if it is not one of those problems causing it. Is my condition idiopathic? Is there anything I can take or do to ease the symptoms? I am trying to eat better and do a 15-minute ride on my exercise bike. I want this to go completely. I am too active to have this ruin my life.
Hello,
Welcome back to icliniq.com. The electroneurography also called nerve conduction studies examine the function of your motor and sensory nerves and determine the degree of the damage. There are other tests that are necessary to identify the possible causes. In case of inflammation or vitamin deficiencies, treatment of the cause would improve the situation. Anyway, it is true that sometimes no cause is identified. In such case, symptomatic relief therapy is started. In this regards, antidepressants like Amitriptyline or Nortriptyline or antiepilepsy drugs like Gabapentin or Pregabalin are the treatment of choice. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. These drugs can also help improve anxiety.
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Neurology
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