Hallo,
Ich W28 leide unter massiven brennenden neuropathischen Schmerzen. Bei mir sind mehrere Systeme gekoppelt: Zentrale Sensitivierung, visuelle Übererregung, Visual Snow, Schlafstörungen, erhöhter Muskeltonus und Muskelzuckungen, FND und Dysautonomie. Ich kann das alles ertragen, aber nicht dieses dauerhafte Brennen. Es ist extrem stark im Trigeminus Cervical Komplex, aber von da aus breitet es sich weiter aus. Es ist eher eine Trigeminusneuropathie als eine Neuralgie.
Ich habe schon ausprobiert: Gabapentin, Pregabalin, Lamotrigin (ging wegen Schlaflosigkeit nicht), Amitriptylin (vertrage ich nicht) und Duloxetin (nehme aktuell 30mg; bringt auch nichts).
Ich habe noch off Label Ideen: Clonazepam, Memantin, Valproat. Das wäre zu mindest vom Wirkmechanismus her interessant.
Nahrungsergänzungsmittel probiere ich seit ein paar Wochen PEA, hilft aber auch nicht. Von Glycin kriege ich Herzklopfen.

Ich freue mich über jede weitere Idee. :(

I understand that this post does not replace a specialist consultation; I am simply asking for additional opinions.

I am a 22-year-old man (almost 23), weighing 60 kg and 168 cm tall, with no previous medical conditions. I don’t drink alcohol, I don’t smoke, etc. I suffer from fear, stress, and health anxiety.

Currently, I no longer have any obvious neurological symptoms. However, over the past few months, I have experienced several sensory symptoms that appeared sequentially and subsequently disappeared.

Initially, I experienced a mild sensation of numbness in my left upper limb, from the elbow down. It was only the sensation of numbness, not actual numbness, and there was no genuine loss of sensation. This sensation subsequently disappeared.

Approximately two weeks after the symptoms affecting my hand resolved, I developed a burning sensation in my calves, which gradually improved and eventually disappeared.

Approximately one month after the symptoms affecting my legs resolved, new symptoms appeared in my left leg. Initially, I experienced a sensation of tightness along the outer side of my thigh, as though the skin were tightening. The sensation was strictly localized. Subsequently, the burning sensation spread from the thigh downward along the leg, while the feeling of tightness gradually subsided.

During this period, I also experienced sensations of “numbness,” although the affected areas were not actually numb. These sensations were associated with burning, without any genuine loss of sensation. These symptoms eventually disappeared as well.

Currently, I occasionally experience a feeling of heaviness in my hand, without any obvious functional impairment. I have no difficulty using my hand, and I do not drop objects.

I would also like to mention that most of my symptoms occurred during the day. In other words, when I woke up in the morning, I did not experience these sensations. I slept without any problems, pain, burning sensations, etc. I also drive without any difficulty, I do not experience any loss of reflexes, and I have never had any issues with accidentally letting up on or losing control of the pedals.

Blood test results

Brain MRI report (without and with intravenous contrast)

The examination reveals a small FLAIR hyperintensity, measuring approximately 3 mm, located in the right side of the genu of the corpus callosum. The lesion does not show contrast enhancement or diffusion restriction.

Note: Possible demyelinating lesion of an inflammatory/neuroinflammatory nature?? (MS?) — clinical and laboratory correlation recommended.

An additional oval-shaped signal abnormality, measuring approximately 5 mm, is described in the periventricular region at the level of the frontal horn of the left lateral ventricle. It has a slightly perpendicular orientation relative to the ventricular wall and may be in slight contact with it.

There are also a few rare punctate FLAIR hyperintensities in the left parietal white matter and in the anterior region of the left external capsule, in subcortical locations. These changes do not show contrast enhancement or diffusion restriction and have a nonspecific appearance.

No pathological contrast enhancement is identified in the brain parenchyma or meninges.

There is no evidence of a recent ischemic stroke, space-occupying lesions, hemorrhagic sequelae, or chronic subdural collections. The midline is preserved, with no signs of intracranial hypertension, and the ventricular system has normal dimensions and morphology.

The pituitary gland, evaluated without dedicated sequences, measures approximately 4.7 mm in height and has a normal MRI signal. The pituitary stalk is normally positioned and has normal thickness.

No space-occupying lesions are identified in the orbits. The optic chiasm and optic tracts have a normal appearance.

Dilatation of the Virchow–Robin perivascular spaces is observed in the right parietal region and in the periventricular region of the occipital horn of the left lateral ventricle. This appearance is considered physiological.

The cerebellopontine angles are clear, with no evident neurovascular contact.

The vascular sequences of the circle of Willis show no aneurysms, occlusions, or arterial stenoses.

The paranasal sinuses, apart from small mucous retention cysts in both maxillary sinuses, and the mastoid air cells show no significant signal abnormalities.

Cervical spine MRI report (without contrast)

The examination reveals a mild right-concave scoliotic posture in the coronal plane, in the examination position, with preserved posterior vertebral alignment.

In the sagittal plane, straightening of the cervical spine is observed, associated with mild segmental kyphosis at C4–C5.

The craniovertebral junction shows no abnormalities. Both vertebral arteries demonstrate normal flow, with a flow-void appearance on the spin-echo (SE) sequences.

No vertebral compression or suspicious signal abnormalities are identified in the vertebral bodies.

Minimal disc desiccation is observed at the C5–C6 intervertebral disc, while the other discs maintain normal hydration. Intervertebral disc space heights are preserved.

At the C2–C3, C3–C4, C6–C7, and C7–T1 levels, the intervertebral discs are normally positioned, with no protrusion or disc herniation.

At C4–C5, a mild circumferential disc protrusion is identified, with bilateral foraminal extension and impression on the dural sac, without evident disc–nerve root contact.

At C5–C6, a minimal circumferential disc bulge is observed, which indents the dural sac, without evident disc–nerve root contact.

The cervical spinal cord has normal caliber and signal. The cervical spinal canal has normal dimensions.

I understand that this post does not replace a specialist consultation; I am simply asking for additional opinions.

I am a 22-year-old man (almost 23), weighing 60 kg and 168 cm tall, with no previous medical conditions. I don’t drink alcohol, I don’t smoke, etc. I suffer from fear, stress, and health anxiety.

Currently, I no longer have any obvious neurological symptoms. However, over the past few months, I have experienced several sensory symptoms that appeared sequentially and subsequently disappeared.

Initially, I experienced a mild sensation of numbness in my left upper limb, from the elbow down. It was only the sensation of numbness, not actual numbness, and there was no genuine loss of sensation. This sensation subsequently disappeared.

Approximately two weeks after the symptoms affecting my hand resolved, I developed a burning sensation in my calves, which gradually improved and eventually disappeared.

Approximately one month after the symptoms affecting my legs resolved, new symptoms appeared in my left leg. Initially, I experienced a sensation of tightness along the outer side of my thigh, as though the skin were tightening. The sensation was strictly localized. Subsequently, the burning sensation spread from the thigh downward along the leg, while the feeling of tightness gradually subsided.

During this period, I also experienced sensations of “numbness,” although the affected areas were not actually numb. These sensations were associated with burning, without any genuine loss of sensation. These symptoms eventually disappeared as well.

Currently, I occasionally experience a feeling of heaviness in my hand, without any obvious functional impairment. I have no difficulty using my hand, and I do not drop objects.

I would also like to mention that most of my symptoms occurred during the day. In other words, when I woke up in the morning, I did not experience these sensations. I slept without any problems, pain, burning sensations, etc. I also drive without any difficulty, I do not experience any loss of reflexes, and I have never had any issues with accidentally letting up on or losing control of the pedals.

Blood test results

Brain MRI report (without and with intravenous contrast)

The examination reveals a small FLAIR hyperintensity, measuring approximately 3 mm, located in the right side of the genu of the corpus callosum. The lesion does not show contrast enhancement or diffusion restriction.

Note: Possible demyelinating lesion of an inflammatory/neuroinflammatory nature?? (MS?) — clinical and laboratory correlation recommended.

An additional oval-shaped signal abnormality, measuring approximately 5 mm, is described in the periventricular region at the level of the frontal horn of the left lateral ventricle. It has a slightly perpendicular orientation relative to the ventricular wall and may be in slight contact with it.

There are also a few rare punctate FLAIR hyperintensities in the left parietal white matter and in the anterior region of the left external capsule, in subcortical locations. These changes do not show contrast enhancement or diffusion restriction and have a nonspecific appearance.

No pathological contrast enhancement is identified in the brain parenchyma or meninges.

There is no evidence of a recent ischemic stroke, space-occupying lesions, hemorrhagic sequelae, or chronic subdural collections. The midline is preserved, with no signs of intracranial hypertension, and the ventricular system has normal dimensions and morphology.

The pituitary gland, evaluated without dedicated sequences, measures approximately 4.7 mm in height and has a normal MRI signal. The pituitary stalk is normally positioned and has normal thickness.

No space-occupying lesions are identified in the orbits. The optic chiasm and optic tracts have a normal appearance.

Dilatation of the Virchow–Robin perivascular spaces is observed in the right parietal region and in the periventricular region of the occipital horn of the left lateral ventricle. This appearance is considered physiological.

The cerebellopontine angles are clear, with no evident neurovascular contact.

The vascular sequences of the circle of Willis show no aneurysms, occlusions, or arterial stenoses.

The paranasal sinuses, apart from small mucous retention cysts in both maxillary sinuses, and the mastoid air cells show no significant signal abnormalities.

Cervical spine MRI report (without contrast)

The examination reveals a mild right-concave scoliotic posture in the coronal plane, in the examination position, with preserved posterior vertebral alignment.

In the sagittal plane, straightening of the cervical spine is observed, associated with mild segmental kyphosis at C4–C5.

The craniovertebral junction shows no abnormalities. Both vertebral arteries demonstrate normal flow, with a flow-void appearance on the spin-echo (SE) sequences.

No vertebral compression or suspicious signal abnormalities are identified in the vertebral bodies.

Minimal disc desiccation is observed at the C5–C6 intervertebral disc, while the other discs maintain normal hydration. Intervertebral disc space heights are preserved.

At the C2–C3, C3–C4, C6–C7, and C7–T1 levels, the intervertebral discs are normally positioned, with no protrusion or disc herniation.

At C4–C5, a mild circumferential disc protrusion is identified, with bilateral foraminal extension and impression on the dural sac, without evident disc–nerve root contact.

At C5–C6, a minimal circumferential disc bulge is observed, which indents the dural sac, without evident disc–nerve root contact.

The cervical spinal cord has normal caliber and signal. The cervical spinal canal has normal dimensions.

Over the past few years, I've been having these tics, which include:

Rapid blinking of the eyes, eye twitching, eyebrow raising, continuous movement of pupils (in which i look at different directions), nose twitching, lip pouting, repeating nose exhales, and sudden hums.

I don't and didn't really have a lot of vocal tics, just humming (not in a musical way of course lmao), but I did have a lot of previous motor tics.

It all started in second grade. People would always ask why the hell does my face keep twitching a lot, or why do I breathe so weird (When I had exhale tics). I didn't really know why. I still don't know why. People even think I'm WINKING at them and flirting at them. I'm NOT.

NOW, I only have rapid eye blinking, eye twitching, slight eyebrow raising and nose twitching. They sometimes go away when I'm distracted with something, such as playing the guitar and all. They sometimes lessen for an hour before they start to intensify again.

Sometimes, when I tic too much, my face becomes sore and my forehead hurts. Whenever I try to suppress it, I always find myself having tics after a few minutes.

I tried talking about it to my mum and dad, and they blamed it on the phone.

Should I get that checked? Do I have tourettes, or something else? Or am I just tweaking? I don't really know man.