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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46937
Experience:  Board Certified Physician
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My 11-year-old daughter developed pins and needles

Resolved Question:

My 11-year-old daughter developed pins and needles (constant) in both feet 7 weeks ago. She also had reduced sensation from the knees down and weakness of the leg muscles, more around the hips than lower down. A few days before the symptoms started she became very tired, sleeping for longer. We spent 10 days in a paediatric hospital, where the neurologist 1st suspected Guillain-Barre Syndrome. MRI of her spine, lumbar puncture and nerve conduction studies were all normal however, so that was ruled out.
All blood tests also came back normal (I don't have the full list of what they tested for, but it included autoimmune, viral, Lymes screen, as well as the usual bloods. CK levels were normal). Then a brain MRI was also normal. So we were relieved that these were all clear and were discharged. However, 7 weeks on, there is absolutely no change. She is a happy, well-motivated child and wants to be in school, but is only managing half-days at the moment and sleeps for 3 hours in the afternoon (after going to bed early every night and sleeping 12-13 hours at night). Her sensory symptoms are unchanged, she needs to look at her feet to walk, otherwise she trips up (I have seen her do this when it is dark or she forgets to look at her feet). Unfortunately, the team in the hospital seem to have decided it is psychological, even though there is no obvious reason to suspect that, apart from running out of physical tests.
During my research online, I came across an article on mitochondrial disorders and I felt it could possibly fit her symptoms, as all the tests done on her so far could be negative in these disorders, they are difficult to diagnose and really she needs a muscle biopsy and genetic blood tests. Apart from the fatigue, muscle weakness and sensory symptoms, my daughter also had a bad reaction to the general anaesthetic that she had while in hospital for the lumbar puncture. For about 3 days afterwards, her legs were extremely weak, she could not take weight on them at all, I had to use a wheelchair & help her transfer to the toilet. The article I read mentioned delayed recovery from anaesthesia as a sign of mitochondrial disorders.
I feel like I'm going crazy, but my gut instinct, as I look at my child, is that there is something there that the dr's are missing. Where should I go next?
Submitted: 26 days ago.
Category: Medical
Customer: replied 26 days ago.
My daughter has always had slightly low muscle tone (I'm a paediatric physiotherapist myself and I've always felt I needed to help her along through her milestones) but not enough to be delayed (crawled, walked at 16 months). She has joint hypermobility. In the last 2 years has had a few fractures due to trips and falls, which I attributed to the hypermobility, but am now wondering was it part of an evolving picture of something bigger?
Expert:  Dr. David replied 26 days ago.

This is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 26 days ago.

Guillain-Barré syndrome is a rare condition in which your immune system attacks your nerves, leading to muscle weakness and even paralysis.

The exact cause of Guillain-Barré is unknown, but it often occurs after a viral or bacterial infection.

normal MRI scan of hte spine and lumbar puncture and normal nerve conduction studies doesn't rule out viral caused guillain barre syndrome.

her sleeping more now is consistent with a viral infection causing more fatigue.

I'm sure they have done testing to check for mononucleosis viral infection

there are many viral infections which are not tested for

I'm sure she will get better

let me know if you have questions.

Customer: replied 26 days ago.
Hi Dr. David,
Thanks for your reply. I am surprised to hear the part about Guillain-Barre not definitely being ruled out because they were very definite about that in the hospital, they said the protein count in her lumbar puncture wasn't even slightly elevated and it should be over 1000 for Guillain-Barre?? They have tested for mononucleosis and it was negative, would she have other symptoms if it was viral, such as enlarged lymph nodes, sore throat, temperature, even intermittently? Any thoughts on the extreme weakness after the anaesthetic, because that is the part that concerns me most, if she ever needs an anaesthetic again?
Expert:  Dr. David replied 26 days ago.

not all viral infections cause enlarged lymph nodes or sore throat.

for many, it is very normal to have extreme weakness after anesthesia to put you to sleep.

it can take hours and sometimes days to recover from anesthesia

you don't have to worry about that

if she recovered from anesthesia

and is not having these constant pins and needle sensations in her legs and feet, she should have recovered fine from a potential viral infection

hopefully it doesn't happen again

let me know if you have other questions.
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Customer: replied 26 days ago.
Thanks for that, I feel better about the anaesthesia at least now. Unfortunately she still has constant pins & needles, reduced sensation below the knees and weak hip muscles. Do you think we're ok to just sit and wait another while, considering its 7 weeks on, without getting a 2nd opinion?
Expert:  Dr. David replied 26 days ago.

you are welcome

yes, you are safe to wait for her for now.

hopefully the incident won't happen again.

I'm sure she will get better

let me know if you have other questions.
if done for now, please leave Positive Rating of 5 stars so I can get credit for helping you today
we only get credit for helping clients after positive feedback
you may have to scroll up or down to see the ratings area
you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions
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Thanks for using JustAnswers.com

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