Answered by Dr. Aida Abaz Quka

What causes numbness in the arm after a blood draw?

Hi doctor,

I had blood drawn five weeks ago and since then felt numbness and tingling in my right arm and right leg. Although numbness and tingling have gotten better, I still feel slight numbness in right pinky and third finger. I also feel burning/pinching in the crease of my arm where she drew blood/next to elbow. Also, when I am sitting at the computer, the tingling starts again in my entire right arm but mainly forearm. Is this permanent nerve damage? I am doing Bikram yoga but still feel these symptoms. Do I need to get an electrocardiogram (EKG) done?

14 Jun 2024 - 1 min read

What could be the reason for seizures in my child?

Hello doctor,

I have a few questions about my child, who was very ill nine months back. At the beginning of his illness, he had two short seizures within 20 minutes. These two seizures did not have jerking motion, and he was not incontinent. A month later, he developed a peritonsillar abscess which was removed successfully. He had another seizure five days after the surgery that lasted a bit longer with slight twitching in his hands but was incontinent of his bladder.

He had an MRI (magnetic resonance imaging) that was normal. Two months later, EEG (electroencephalogram) EEG was found to be abnormal in the awake and asleep states due to rare right frontal spikes wave discharges (F4), placing the patient at risk for focal and secondarily generalized seizures. During sleep, these appeared to be bifrontal with synchrony, so it cannot completely exclude a fragmentation of primary generalized epilepsy.

The tests for CMV (Cytomegalovirus) and EBV (Epstein Barr virus) were negative.

1. Do you suspect juvenile onset epilepsy in my child? If so, is the EEG confirming the condition?
2. Do you suspect that he had seizures as he was sick, and it is not epilepsy?
3. Would you recommend putting him on medication?
4. What is the probability of him having another seizure, and when?
5. Is SUDEP (sudden unexpected death in epilepsy) a concern in his case?
6. Is it better or worse to get epilepsy at this age?
7. Are the results of this EEG severe or mild?
8. Would you recommend having a more extended EEG?

Below is a timeline of events:

• My child was diagnosed with Charcot Marie tooth through a genetic test. He was under medication tablet Amoxicillin 825 mg twice daily, tablet Tylenol 600 mg, and two extra-strength Tylenol PRN for pain nine months after peritonsillar abscess removal.
• Five days later, he had symptoms of the illness and requested to stay in bed.
• The next day while taking him to urgent care, he had a seizure in the parking lot, which lasted for one minute, and he woke up confused but alert and oriented after a few minutes. He had another attack down the street to urgent care when his blood sugar and blood pressure levels were normal. The lab reports showed negative for a flu test, CT (computed tomography) scan, and Streptococcus. Slight dehydration was noted; he was given fluids intravenously and discharged the same day.
• The next day I took him to a primary care physician who identified fluid in the left ear and recommended to follow-up with a neurologist regarding the seizure activity. The doctor strongly suspects infectious mononucleosis as he had swollen lymph nodes and a sore throat and scheduled for a follow-up at the end of the week.
• A day later, he had extreme pain in his left ear with fluid running out. He was taken to the emergency unit and was tested for streptococcus and infectious mononucleosis. He was identified with a ruptured left eardrum and right ear infection. He was treated with tablet Zithromycin and ear drops and was scheduled for a follow-up with an ENT (Ear Nose Throat) specialist.
• After five days, the MRI report stated fluid in the mastoid cells. Four days later, the rupture in his eardrum was healing, and he could hear. And the ENT specialist identified that the fluid is due to a past infection, which will resolve soon.
• A Methylphenidate skin patch was recommended to reduce impulsive behavior.
• After a week, he was sick and sounded like a hot potato. There was a swelling noticed at the back of the throat. However, the tests for Streptococcus and Infectious mononucleosis were negative.The physicians put him on a steroid dose pack to help with swelling in the throat.
• The primary care provider ordered a CT scan of the neck, and the MRI result was positive for a peritonsillar abscess. The next day, a tonsillectomy was performed.
• After a week, he had a seizure attack and was not breathing, and his body turned blue. He was taken immediately to the emergency visit and was stabilized.

The EEG performed showed the results that I have attached in your mail.

11 Jun 2024 - 1 min read

Is it safe to use Orphenadrine and Magnesium in epileptics?

Hello doctor,

Due to muscle spasms, I was given Orphenadrine and Magnesium. Is it safe to use these medications for patients with controlled epilepsy on Valproate?

10 Jun 2024 - 1 min read

What is the treatment for back and leg pain?

Hi doctor,

I have sudden pain in my leg and back three times a day. My doctor recommended high-intensity laser therapy. I am unfamiliar with that treatment and need to know if it is appropriate for this medical issue.

I am currently taking Arcoxia 90 mg.

Could you please review my MRI reports?

10 Jun 2024 - 1 min read

What could be done for trembling sensations in the legs?

Hi doctor,

I am experiencing trembling sensations in both my legs. Primarily in my left leg. In the last few months, there have been various issues, including sharp nerve pains, tingling, pressure, burning, and aching. It typically tends to favor my left leg. More recently, I have a constant trembling in my left leg. While I can feel it during the day, it is constant at night, as soon as my leg hits the bed. It does not feel like restless leg syndrome to me. This has just started recently (about three months ago). I have not had any notable or critical injuries recently. However, I am having trouble in sleeping because of this.

Five years ago, I experienced persistent leg pain caused by anxiety. Doctors could not find anything wrong. And it eventually went away as my fear subsided.

I have done laboratory tests for CBC, vitamin D3 (25-OH), and hemoglobin.

10 Jun 2024 - 1 min read