possible neurological problem

[alex7373]

Several years ago I was injured and my philtrum column(the ridge that attaches the nose to the upper lip) lacerated. One of the columns of the philtrum broke. I was tested for possible nerve damage at the time, a nerve conduction test and emg were done. They were both normal. I had the odd muscle spasms at the site of the injury but other than that I didn’t have any other symptoms for about 6 months. MRI of brain with contrast was normal.

Within about a year I started to rack up some strange symptoms. In a short period of time I gained weight in my chest and stomach, lost weight in my arms and legs and lost all the muscle definition in my face, and my bones felt weaker. I was now getting the muscle twitches all over. I would get random surges of energy to parts of my body- surges in my legs and neck, arms. I also started to get really fatigued. I lost the ability to feel an orgasm(I’d ejaculate but wouldn’t feel the sensation). I couldn’t exercise because I was fatigued but when I did exercise I wouldn’t sweat at all and my face would get really warm and red that I would have to stop. At this same time I had difficulty sleeping and sleep disturbances during the night. I would snore a lot(according to my girlfriend at the time) and I’d wake up sometimes gasping for air.

I was referred to an endocrinologist and lots of tests were run. My IGF-1 came back low, a growth hormone stimulation test was performed and an MRI of pituitary gland. I failed the test and was diagnosed growth hormone deficient. MRI results showed a shading of the pituitary gland that my endocrinologist believed to be a tumor. I got a 2nd opinion with a neurosurgeon and he also believed it to be a tumor . I started on the GH treatment 4 months ago.( was tested extensively for cushings disease and it was ruled out)

There still seems to be a neurologic component in all of this. I still can’t sweat, can’t feel orgasm, I get the muscle twitches and muscle jerks(mostly when I’m at rest). I’ve done some research and my problem could be with the Hypothalamus which links the endocrine and nervous systems. There also may be something wrong my neurostransmitters and oxytocin levels.

Another theory I have is that I may have sleep apnea and may have had it for quite some time. I may have had damage to my nervous system with the original injury and my body cannot fully heal itself because of the sleep apnea. Also the apnea theory could explain the lack of sensation with orgasms which are almost certainly neuro-chemical. If my sleep is being disrupted is it possible the hypothalamus is not making the right amount of oxytocin?

Well I’d like your opinion of all this. I plan on asking my GP for a referral for a sleep study to see if I have sleep apnea and then to go form there.

[SanjpatelMD]

Thanks for your question.

Please could you give me the following info:-

1) How many hours do you sleep a night and how long does it take to fall asleep?
2) Do you fall asleep during the day when you do not intend to or sleep on purpose?
3) Have you lost weight..if so how much exactly?
4) Have you had a full neuro exam / EMG
5) Have other people noticed a change in your mood / behavior ?

All the best

[alex7373]

Thanks for your question.

Please could you give me the following info:-

1) How many hours do you sleep a night and how long does it take to fall asleep?
2) Do you fall asleep during the day when you do not intend to or sleep on purpose?
3) Have you lost weight..if so how much exactly?
4) Have you had a full neuro exam / EMG
5) Have other people noticed a change in your mood / behavior ?

All the best

1) It takes me sometimes a couple hours to get to sleep. I typically fall asleep at 1am and wake up at 9am
2)i am sleepy during the day but i don't fall asleep because i am usually at work or school. I could very well dose off if i wanted to tho
3) no my weight has been the same 5' 8 185 lbs
4)i had a neuro exam at the time of the injury - i remember a emg and nerve conduction test
5) well people have noticed a change in my appearance- i've lost what feels like muscle from my face- atrophy at the temples and a bloated lower face.

[SanjpatelMD]

Please could you send me the complete endocrinology results.

These should include things like PRL (prolactin), testosterone, FSH, LH, TSH, TRH etc.

Do you get regular exercise? Has your exercise pattern changed since the injury?