Understanding Nerve Pain and Tingling: Possible Rare Disease Insights
Numbness and pain in the hands and feet? Hello Doctor, I am a 43-year-old male. Eight years ago, I underwent an MRI that showed compression at the cervical intervertebral discs C3-4-5-6, which caused mild left arm pain, slight weakness, and numbness in the left fingers. After phy...
Dr. Chen Shunsheng reply Rare Disease
Hello, 1. It is evident that you require a comprehensive neurology consultation, which cannot be resolved online. 2. This is unrelated to multiple sclerosis. 3. Concurrently, there are multiple cervical and lumbosacral radiculopathies that need thorough investigation for unde...[Read More] Understanding Nerve Pain and Tingling: Possible Rare Disease Insights
Understanding ALS: Seeking Expert Advice for Muscle Weakness Concerns
Amyotrophic Lateral Sclerosis (ALS) and Expert Recommendations Hello, I started experiencing twitching in my right triceps and right calf on August 1st, which feels like something is crawling under the skin, but it is not painful. Additionally, I have gradually noticed weakness a...
Dr. Chen Shunsheng reply Rare Disease
Hello, you have already been evaluated by several physicians. You need to have a consultation with a subspecialty in neuromuscular medicine at a diagnostic medical center, which some centers refer to as peripheral neurology. In Taipei, I recommend: Professor Yang Zhi-Chao from Na...[Read More] Understanding ALS: Seeking Expert Advice for Muscle Weakness Concerns
Understanding Persistent Trigeminal Neuralgia: Causes and Treatment Options
Trigeminal neuralgia with persistent paroxysmal pain? Hello, Doctor: My father is currently 66 years old and has been experiencing persistent intermittent stabbing pain around the second branch of the trigeminal nerve. This is not typical trigeminal neuralgia, as he reports that ...
Dr. Chen Shunsheng reply Rare Disease
Priority should still be given to trigeminal neuralgia, or adjusting the medication should take precedence. Organize the medication history, and if necessary, consider using a combination therapy for adjustments. It is also important to rule out the possibility of phantom pain.[Read More] Understanding Persistent Trigeminal Neuralgia: Causes and Treatment Options
Understanding Rare Neuromuscular Diseases: Diagnosis and Testing Options
Neuromuscular diseases Hello Dr. Chen, I have been experiencing weakness in my limbs recently. I went to Kaohsiung Medical University for relevant tests, but they couldn't find any issues. I ultimately chose to pay out of pocket for whole exome sequencing. 1. I would like ...
Dr. Chen Shunsheng reply Rare Disease
Clinical presentation should be the basis for decision-making; it cannot be generalized. It is important to consult several physicians from relevant specialties in clinical practice.[Read More] Understanding Rare Neuromuscular Diseases: Diagnosis and Testing Options
Understanding Tongue Rigidity: Symptoms and Possible Causes
Symptoms of tongue immobility? Hello Doctor: About six months ago, I started to feel a lack of dexterity in my tongue. Initially, it was just a sensation of stiffness that did not affect my speech, and the condition fluctuated. In recent months, whenever I speak a bit faster, I o...
Dr. Chen Shunsheng reply Rare Disease
Diseases affecting tongue movement include lesions of the muscles, peripheral nerves (cranial nerves), brainstem motor nuclei, and upper motor neuron lesions. It is important to see a neurologist as soon as possible to determine the location of the lesion and identify the underly...[Read More] Understanding Tongue Rigidity: Symptoms and Possible Causes
Understanding Left-Sided Weakness and Pain: Possible Causes and Solutions
Numbness and weakness in the left arm and from the calf to the knee? Hello, doctor. I am a 19-year-old student. Recently, I've been experiencing some issues on the left side of my body, and I would like to consult you. I've noticed weakness and a tingling sensation in m...
Dr. Chen Shunsheng reply Rare Disease
Please seek medical attention at a neurology center as soon as possible. This should not be related to posture, and it is important to rule out any potential lesions in the right hemisphere of the brain or cervical spinal cord. Please make an appointment promptly. The association...[Read More] Understanding Left-Sided Weakness and Pain: Possible Causes and Solutions
Exploring Rare Oral Health Issues: Symptoms, Diagnosis, and Treatment
Diagnosis and Treatment of Oral Health Issues Hello Doctor, I have been experiencing symptoms for over five months now, but recently the bloody taste in my mouth has intensified. Sometimes it feels like it's coming from my throat, and at other times I sense a bloody taste in...
Dr. Chen Shunsheng reply Rare Disease
Your issue is quite complex and involves multiple specialties. It is recommended that you visit a medical center's Department of Oral Medicine and Otolaryngology in person. The primary concern is to rule out the possibility of head and neck tumors.[Read More] Exploring Rare Oral Health Issues: Symptoms, Diagnosis, and Treatment
Understanding Leg Weakness: Insights into Rare Muscle Disorders
Leg weakness Hello Dr. Chen: About a year ago, I gradually began to feel weakness in my leg muscles, and now even squatting and standing up is very difficult. I feel like I don't have enough strength to go up and down stairs. X-rays revealed herniation of the S5 and L1 inter...
Dr. Chen Shunsheng reply Rare Disease
It is a rare disease belonging to the field of neurology. For consultation, it is recommended to visit a nearby neurology training center: Northern Taiwan: National Taiwan University Hospital, Taipei Veterans General Hospital, Chang Gung Memorial Hospital... Central Taiwan: China...[Read More] Understanding Leg Weakness: Insights into Rare Muscle Disorders
Understanding Tourette Syndrome: Treatment Options and Symptom Management
Tourette syndrome Hello doctor, I would like to ask you about Tourette syndrome. Is there a medication that can cure this condition, or can it only alleviate the tic symptoms? Thank you for your response, doctor.
Dr. Chen Shunsheng reply Rare Disease
Symptoms can be managed with medication, and in some patients, symptoms may diminish as they grow older.[Read More] Understanding Tourette Syndrome: Treatment Options and Symptom Management
Understanding Tongue Weakness: Seeking Answers for Rare Conditions
Tongue weakness I feel like my tongue has lost its strength, and it has been this way for over five years. I used to think that as long as it didn't affect my physiological functions, it was okay even if speaking was sometimes difficult. However, the reality is that I can ba...
Dr. Chen Shunsheng reply Rare Disease
There are three possible conditions: 1. Peripheral or distal lesions: involving the tongue muscles, hypoglossal nerve, or hypoglossal nerve neuropathy. These occurrences are rare, and even less so when they occur in isolation. In addition to weakness, the tongue may exhibit signi...[Read More] Understanding Tongue Weakness: Seeking Answers for Rare Conditions
Understanding the Risk of vCJD from Hepatitis B Immunoglobulin
Regarding human variant Creutzfeldt-Jakob disease (vCJD) Hello Dr. Chen, I have a low concentration of hepatitis B antibodies (close to 10). Last week, due to a potential exposure to hepatitis B (I am not a healthcare worker), I went to the hospital and received a self-paid injec...
Dr. Chen Shunsheng reply Rare Disease
In theory, it should be noted that there are no reports of this worldwide; only two patients with the new type of Kuru disease were exposed to the same batch of polio vaccine, but a causal relationship could not be established. As for the hepatitis B vaccine, there are no such re...[Read More] Understanding the Risk of vCJD from Hepatitis B Immunoglobulin
Can Botox Treat Nystagmus? Hospitals in Taiwan Offering Treatment
Nystagmus Can botulinum toxin be used to treat nystagmus? Which hospitals in Taiwan offer this treatment?
Dr. Chen Shunsheng reply Rare Disease
Congenital nystagmus may be treated with botulinum toxin injections to alleviate the eye movement. The efficacy of botulinum toxin for acquired nystagmus is still under investigation. Injections should be administered by an ophthalmologist, so please consult with the ophthalmolog...[Read More] Can Botox Treat Nystagmus? Hospitals in Taiwan Offering Treatment
Understanding Autoimmune Encephalitis: Treatment Options for Rare Cases
Autoimmune Encephalitis Dear Dr. Chen, There is an 8-year-old girl who was admitted to the Kaohsiung Chang Gung Memorial Hospital's intensive care unit on November 2, 2014. Her condition has not improved, and the doctors have diagnosed her with: 1. Suspected autoimmune ence...
Dr. Chen Shunsheng reply Rare Disease
It is advisable to discuss the patient's condition with the attending physician, especially since the specific medical information cannot be fully grasped, and relying on online suggestions is not recommended.[Read More] Understanding Autoimmune Encephalitis: Treatment Options for Rare Cases
Understanding Elevated Creatine Phosphokinase Levels in Infants: Causes and Concerns
Regarding the issue of elevated creatine phosphokinase levels in infants! Hello Dr. Chen, My younger brother is currently 1 year and 1 month old. On March 12, he had a blood test at Kaohsiung Chang Gung Memorial Hospital, and the results showed elevated total cholesterol levels...
Dr. Chen Shunsheng reply Rare Disease
For case management issues, it is advisable to consult the attending physician directly.[Read More] Understanding Elevated Creatine Phosphokinase Levels in Infants: Causes and Concerns
Jaw Pain While Chewing: Understanding Rare Conditions
Pain in the cheek during chewing? Hello, doctor: I experience pain in my cheek when chewing, especially with the first bite. It feels like the cartilage inside my right cheek gets stuck and, when it finally moves to the correct position, the pain radiates to the area near my ear ...
Dr. Chen Shunsheng reply Rare Disease
Differential diagnosis: Trigeminal neuralgia, jaw issues. First, consult a dentist, then a neurologist.[Read More] Jaw Pain While Chewing: Understanding Rare Conditions
Can Haining Medication Be Taken with Lithium? Understanding Rare Disease Treatments
Hanin Pharmaceuticals Hello: Can I take Hainingke with lithium salts together?
Dr. Chen Shunsheng reply Rare Disease
The combination of Haloperidol with lithium salts and antidepressants can lead to increased drug concentrations, which may enhance the risk of extrapyramidal side effects. Close monitoring and dosage adjustments are necessary.[Read More] Can Haining Medication Be Taken with Lithium? Understanding Rare Disease Treatments
Managing Symptoms and Improving Quality of Life in EDMD Patients
Emery-Dreifuss muscular dystrophy (EDMD) is a genetic disorder characterized by muscle weakness and Hello Doctor: I am a patient with Emery-Dreifuss muscular dystrophy (EDMD), diagnosed by Dr. Jian from Chang Gung Memorial Hospital in Keelung. Although I have had less physical st...
Dr. Chen Shunsheng reply Rare Disease
The diagnostic criteria for Emery-Dreifuss muscular dystrophy (EDMD) require the identification of at least two affected males and one asymptomatic female or one female with cardiac conduction defects and cardiomyopathy in the family. Diagnosis of EDMD in a family can be establis...[Read More] Managing Symptoms and Improving Quality of Life in EDMD Patients
Understanding Myasthenia Gravis: A Daughter's Concern for Her Mother's Health
Myasthenia Gravis - Symptoms in Mothers? Hello Dr. Chen, my mother is currently 65 years old. Previously, she had difficulty speaking clearly and consulted many doctors in Kaohsiung and underwent a full health check-up. Some doctors said there was no problem, while others suggest...
Dr. Chen Shunsheng reply Rare Disease
My email had some issues with Apple, which is why I'm only able to respond now. The elderly patient has developed new-onset myasthenia gravis, and it is essential to investigate the underlying cause. Additionally, there is indeed a problem with aspiration pneumonia.[Read More] Understanding Myasthenia Gravis: A Daughter's Concern for Her Mother's Health
Navigating Rare Disease Care: Challenges with Acute Polyneuropathy Treatment
Thank you for your response? Hello, I am a patient with acute intermittent porphyria. You responded by saying (discuss with the attending physician, he will pay attention to the usage). I was diagnosed with this condition at Linkou Chang Gung Memorial Hospital, but when I went to...
Dr. Chen Shunsheng reply Rare Disease
Rare diseases require a highly specialized team. For your issue, I recommend Dr. Chih-Cheng Huang from the Department of Neurology, specializing in neuromuscular disorders. He has trained at the Mayo Clinic in the United States, is very nice, and most importantly, I have informed...[Read More] Navigating Rare Disease Care: Challenges with Acute Polyneuropathy Treatment
Understanding Calf Muscle Weakness: Insights on Rare Conditions
Weakness in the calf muscles? Hello Dr. Chen, I apologize for the interruption. I would like to ask for your advice. I have been experiencing gradual weakness in my calf muscles (especially the posterior side) for over two years now. Climbing stairs has become increasingly diffi...
Dr. Chen Shunsheng reply Rare Disease
It is possible that there is lumbar nerve root pathology, peripheral nerve issues, or myopathy. Please consult a neurologist.[Read More] Understanding Calf Muscle Weakness: Insights on Rare Conditions