I started feeling tired and nauseous after Trigger point injections. Kindly help me.

Hello,

Welcome to icliniq.com.

I would also like to know some more details about your symptoms:

1) Since when you started to have symptoms?

2) What were the exact symptoms (apart from feeling tired and not sleeping well)? Please describe in detail.

3) Had any loss of consciousness?

4) Any episodes of unawareness from surroundings?

5) Any seizures or fits or jerks in body parts?

6) What you mean by trigger points? Please describe.

7) Which injections you received?

8) Does some abnormal body activities happen during sleep?

9) Have you had any neck or back pain?

10) Any pain or tingling or numbness or weakness in arms or hands?

Other information:

1) How is your sleep routine? Do you get sleepy soon after lying in bed, or it takes a long time? Once got sleepy, do you have frequent awakenings during sleep? Do you feel fresh on awakening from sleep in the morning?

2) How is your usual mood in day-to-day activities? Happy or toward the sad side (thinking about past events) or toward the worried side (thinking about future things or irritable or something else)?

3) How is your appetite?

The EEG (electroencephalogram) finding description mentioned are of normal patterns in awake and sleep. No abnormal finding was mentioned in the description (attachments removed to protect the patient's identity).

But in EEG's final impression, they mentioned L (left) > R (right) temporal lobe epileptogenic activity. Such epileptogenic activity can be found in patients having seizures or fits, though occasional such activities can be found in normal individuals also. EEG alone is never diagnostic. It is a must to correlated with clinical symptoms and signs.

In NCV (nerve conduction velocity) and EMG (electromyography) conclusion, they mentioned the possibility of some nerve compression in the spine at the level of C4-C5, C5-C6, C6-C7 in the neck with mild affection in two nerves of arms (median nerve and ulnar nerves) and the possibility of some nerve compression in the spine at the level of L5-S1 in the lower back.

Same way, NCV findings also need to be correlated clinically. Alone, NCV does not make a final diagnosis.

Kindly answer the questions for further help and management.

Hello,

Welcome back to icliniq.com.

As per your description and with no significant abnormality in MRI (magnetic resonance imaging), cervical spine and LS spine (lumbar spine) and attached electrophysiological study (attachments removed to protect the patient's identity), there may be the possibility of:

1) Fibromyalgia.

2) Chronic fatigue syndrome.

3) Associated depression or other psychiatric ailments.

4) Connective tissue disorder.

Among these, we can try to get some blood investigations for the search of connective tissue disorder. But for the remaining possibilities, no specific blood or other tests available. That is judged by clinical means only.

The tests that can be done are ANA (anti-nuclear antibody) in IFA (indirect immunofluorescence) method, c-ANCA (antineutrophil cytoplasmic autoantibody, cytoplasmic), p-ANCA (peripheral antineutrophil cytoplasmic antibodies), ENA profile (extractable nuclear antigen antibodies), ESR (erythrocyte sedimentation rate), T3, T4, and TSH (thyroid-stimulating hormone).

For management, try physiotherapy or mediation and daily exercises (jogging 20 to 30 minutes in the morning). For medications, I would suggest you discuss neurologist physically.

I hope this was helpful.