Q. I have pain and grip issues in the right hands and legs. Please help.

Answered by
Dr. Abhaya Kant Tewari
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 24, 2021

Hello doctor,

I have SLE with peripheral neuropathy. Please help.

#

Hi,

Welcome to icliniq.com.

1. I have seen the uploaded MRI (attachments removed to protect the patient's identity) and the notes of the doctor who is treating.

2. SLE is a multisystem disease meaning that it can affect various bodily systems like joints, skin, central nervous system, and peripheral nervous system, kidneys, etc.

3. Your doctor has mentioned that you are having peripheral neuropathy and mentioned numbness and tingling, and there is also a history of seizures for which MRI was done. You may have impaired sensation, tingling, weakness in muscles due to the nerves' involvement, impaired touch sensation, etc. If you had mentioned the symptoms related to your peripheral neuropathy, the severity of the disease could have been judged.

3. It is important to document the impairment so as to help us in the follow-up and decide whether the medication is working or not.

4. The medication at the moment remains the same as the disease is autoimmune, affecting different parts of the body. It is good that you have visited a qualified doctor, and he is treating you correctly. You can ask for my help for any neurologic-related issues and frame the questions to which you want to know the answers.

Hi doctor,

Yes, my main symptoms were pain and grip issues in the right leg and hands. Cups fall from hand, handwriting changes, lack of strength and grip. Leg pain, burning, toe twitching, numbness, pain throughout the sciatic nerve, joint pain. Fever, mouth rashes, stiffness, and fatigue have improved with present drugs. Plus tremors in the right side of my face and right hand. Recently I got two fits. The doctor wanted to know if there is active CNS involvement and wanted me to take different neurologist opinions on CNS involvement and if any drug or physiotherapy regimen should be added.

#

Hello,

Welcome back to icliniq.com.

You have seizures (two episodes) and peripheral neuropathy as manifested by the symptoms you have listed. The seizures do not appear to be active SLE, and it seems to be the increased incidence of seizures in SLE patients. Peripheral neuropathy is active involvement as manifested by weakness and other symptoms of peripheral neuropathy, and you have to be treated accordingly. The seizures require antiepileptic drugs. I suggest tablet Levetiracetam XR 750 mg one tablet per day.


Treatment plan:

Tablet Levetiracetam XR 750 mg once a day
Continue as advised by the rheumatologist.


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