Could these symptoms be side effects of stroke or depression?

1 answer | Last updated: Mar 23, 2011
Silky asked...

Could these symtpoms be side effects of stroke or depression? Two years ago I had a TIA and 2 wks later a major stroke. I suffer from severe depression and am seeing a doctor. But I don't think my other 3 doctors understand me. I have tingling in my arms and it feels like the sensation winds up so tight and after a few minutes it releases itself. What makes this happen? Why do I also have severe  pain in my leg and on top of my foot? I have trouble seeing sometimes and my hands shake uncontrolably without any warning- it's noticable and embarassing. I communicate these symptoms to my 3 doctors but they medicate only. Do you have answers for me?

Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

The symptoms you are describing are not all too uncommon after a stroke.  When the connections between the brain and the peripheral nerves is interrupted, there are often disturbing symptoms that follow.  I compare this to the "phantom" limb pain that amputees will have.  If you have ever seen a Civil War movie, there is usaully a segment where one of the wounded will complain of pain that is coming from an amputated limb - so called "phantom" pain.  It is your body's way of dealing with the fact that the nerve fibers have been interrupted.  The most frequent symptoms I hear about are burning pains or electric shock pains.  These can often be treated with medicines that work to "dial-down" these overactive nerves.  The three medicines that I have the most success with are amitriptyline, gabapentin, or pregabalin.  As you suffer from depression, and amitriptyline can be used as a anti-depressive agent, this one might be your first choice.  Another anti-depressant that can help with pain is duloxetine.

With regards to the shaking, this could either arise from an increase in spinal tone, or even posibly small seizures.  This requires the evaluation of a Neurologist.  In fact, all these issues require a hands-on evaluation by a Neurologist - and possibly even a Stroke Neurologist.  There is a common misconception that Neurological problems cannot be treated - this is a false myth likely based on a lack of good Neurologic medications many years ago.  This is no longer true, and my hunch is that many of your problems can be alleviated by the proper treatment.

Good luck!