Q. I have hyperreflexia. Can this be neurological?

Answered by
Dr. Lalit Bansal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 12, 2016 and last reviewed on: Feb 27, 2020

Hello doctor,

I am 37 years old. Three years ago I had spine surgery for herniated disc L5-S1. After the surgery strange symptoms began. Four hours after surgery when I tried to sleep I got myoclonic jerks. Then I had problem with ligaments. My ligaments started to stretch so easily that I began to hurt myself. I was healthy before surgery and had no problems. I also have hyperreflexia. I have done MRI of head and whole spine and the reports are fine. Rheumatologic test and genetic test for connective tissue are negative too. Muscle enzyme and EMG testing's were fine. But, my problem is getting worse. And all this started after general anesthesia and never stopped. Neurologist says I have hyperreflexia and it is symmetrical. But they do not know the reason for the same. Can this be something neurological? Is there any neurological condition that would affect ligaments? Which tests do I need to do? Please help.

#

Hi,

Welcome to icliniq.com.

  • With MRI brain, spine, EMG (electromyography) and genetic workup being normal, it seems unlikely to be neurological.
  • One think to look at would be what anesthetic agents or medicine you received during your surgery. If it has any long term such side effects then please provide the information so that we can look that in depth.

Revert back with the detailed information to a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Hi doctor,

I was given Midazolam 2 mg, Propofol 200 mg, Cefazolin 2 mg, Atropine 1 mg, Fentanyl 0.3 mg, Rocuronium 40 mg, Neostigmine 2.5 mg and anesthetic Sevoflurane 63.5 ml. For pain after surgery they gave me Tramadol 200 mg and Metamizole 2.5 mg. I am aware that it has to do something with anesthesia but I do not know what. The feeling is like all the medicines go into ligaments and never get out. As crazy as it sounds.

#

Hi,

Welcome back to icliniq.com.

  • Joint laxity or hyperextension (exercise that works the lower back) does not seem to be side effect of any of these medications.
  • One possibility could be genetic. And if targeted testing is normal then you probably would need extensive testing or complete examination.
  • Does anyone in your family have similar problem?

Revert back with the information to a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Hello doctor,

No one in our family has that and I was completely healthy before. And the symptoms began immediately after surgery. They tested all genes. And they also say that I am not typical for genetic diseases. I am desperate because of all the pain and disabilities. When I go to orthopedician, he is afraid to examine me. I do not feel like I have some disease but still falling apart. Which specialist to go to?

#

Hi,

Welcome back to icliniq.com.

  • You can have an evaluation with neuromuscular specialist for hypermobile joints. They can decide if you need a muscle biopsy to look for any connective tissue abnormality.
  • Genetic testing is extensive and depends on how much one evaluate.
  • I do not think you had whole examination test performed. There is a small possibility but you may be susceptible to a medicine with underlying genetic predisposition.

Investigations to be done:

Neuromuscular specialist evaluation

Regarding follow up:

For further information consult a neurologist online.---> https://www.icliniq.com/ask-a-doctor-online/neurologist

Hello doctor,

Thanks for answering. Since operation I have something like sleep myoclonus. Just before falling asleep my hands, feet and fingers start to move all of a sudden, that wake me of. It is not like when falling asleep and you think you will fall than you twitch. I did not have any of this before surgery. Should EEG be done? My doctor said this laxity could be related to enzyme. Which specialist should I meet for enzyme test?

#

Hi,

Welcome back to icliniq.com.

  • You can get EEG - electroencephalogram to confirm what these jerks are and this would help in both psychological and medical management.
  • Neuromuscular or neurometabolic specialist should be of help to you.

For further queries consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist


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