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← Return to Neuropathy Feet and legs
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I am 18 months post a vertebral artery dissection resulting in a stroke. I've recovered extremely well from the stroke, but have developed burning pain in my legs and bottoms of my feet bilaterally, (all other symptoms are with my affected side only). I've been to an expert neurologist at UCHealth in Denver and just met with one at UCSF neuro rehab. (I live in rural Montana, where there is no longer a neurologist.)
Both experts could not explain my symptoms as a result of the stroke, and presentation is not aligned with a diagnosis of neuropathy. Denver doctor wanted to rule out other neural causes and I've had extensive blood work which rules out toxins, MM, leukemia, etc. I've been up and down on gabapentin and it's been recommended to take cymbalta or similar medication.
The neurologist at UCSF has scheduled me to return for an EMG and told me it would definitively rule out neuropathy. (He also wants a spinal MRI done to rule out tumor.) My local physiatrist told me that small fiber neuropathy can not be ruled out by an EMG. (As I've read through the Mayo posts here, she appears to be correct.)
Everything I've read indicates that even if a diagnosis of SFN is made (guessing the punch biopsy is next), there is no treatment other than the aforementioned recommendation of gabapentin or Lyrica, and a low-dose antidepressant.
I am seriously considering cancelling the EMG and MRI in December. I know it is the physician's job to leave no stone unturned in zeroing in on a diagnosis, but if the results do not point to a different treatment, I am reluctant to go down this rabbit hole. I am 75 years old, and want to focus on living the best life I can, enjoying everything possible. I have improved so much since my stroke (I work very hard at it!) and can accept that my damaged brain is sending out strange signals, and that maybe the power of neuroplasticity will continue to re-wire and my neuropathy symptoms will lessen over time.
I would love it if any of you would share your thoughts, as I think about this decision of testing. Thanks! Rebecca
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Neuropathic pain is different for everyone, so giving advice would be a bad idea. I too, want to focus on living the best life I can. I'm ten years older than you are, and my quality of life is pretty high, even with the pain. For me, the best therapy is walking, but that's not for everyone. I keep socially active, and that takes my mind off the pain to some degree. My neurologist wanted to put me on morphine, but I can't tolerate it, so I'm not on any medication except Prednisone for when I have severe inflammation. I do hope you find relief. You sound like a positive person, and that's a plus. Hang in there, and do what works for you.