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Neurology (Expert Forum)
Have you seen my symptoms?
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Have you seen my symptoms?
by Kali, Apr 12, 2002 12:00AM
I am a 61 year old right handed man with a Ph.D. in engineering, experiencing cognitive changes with spatial relations for the last year. Have difficulty with simple calculations, frequent confusion, and difficulty with familiar task - tying a neck tie, hanging clothes on a hanger. Also experience visual hallucinations and some double vision. Have had tests: MRI, lumbar puncture, spec scan, EEG and neurpsychological evaluation. The first 4 showed nothing very unusual - neuropsych tests showed I was in the 98th percentile for verbal skills & 2nd to 9th percentile on all skills requiring visual analysis, visuomoter abilities & timed tasks. My IQ was intact & my memory was "average for my age" Have consulted with a number of physicians who reported that "they have never seen anything like this before". Lyme disease is a possibility since I had Lyme in 1999 & was treated with oral antibiotics. In 2000 I had a left drop foot & was given extensive testing with a diagnosis of a pinched nerve which resolved itself without medication. Am currently on IV Ceftriaxone for 28 days on chance that symptoms are due to Lyme. Selected test results: Spinal fluid slightly elevated protean of 47. MRI-a few scattered non-specific white matter signal hyperintensities seen within cerebal white matter a nonspecific finding. Spect scan-slightly inhomogeneous perfusion of entire cerebrum. Diminished occipital activity bilaterally but perfectly symmetric. EEG - abnormal record.. diffuse background slowing, intermittent theta discharges right temporal region-possible structural abnormality.
Doctor's Answer
by CCF-Neuro-M.D.-JT, Apr 17, 2002 12:00AM
Sorry to hear about your symptoms. Visuospatial problems, cognitive changes and hallucinations in a previously high-functioning individual are concerning for a progressive dementia caused by neurodegenerative diseases such as Lewy Body disease (usually has some parkinsonian features also), Pick's disease, ALzheimer's , etc... or infection such as herpes simplex virus or prion disease. Prions are abnormal proteins that have been linked to diseases such as mad cow disease and Creuzfeldt Jakob disease in which there is a rapidly progressive dementia (yours sounds too slow). This as well as herpes can be checked with spinal fluid samples. Finally there are paraneoplastic disorders that can cause behavioral and cognitive abnormalities in the setting of a hidden cancer through an autoimmune process, but again the progression of your disease is slower than that reported with paraneoplastic disease.
What is particularly concerning is your abnormal EEG that showed the diffuse slowing and ?possible Rt sided lesion inthe temporal lobe (could be non specific change). This again points to a dementia like picture. It sounds like all the right tests have been done so far, but I would repeat the EEG to look at the degree of slowing present and the right temporal region again. Observation and serial neurological exams will be important in making the correct diagnosis. PET scans to look at metabolism in different parts of your brain may also be of help. Consider a behavioural neurologist for a second opinion. There are excellendt specialists at U Penn, UCLA,and U Florida if you are in the region. Otherwise followup with a neurologist that you trust. Best of luck
What is particularly concerning is your abnormal EEG that showed the diffuse slowing and ?possible Rt sided lesion inthe temporal lobe (could be non specific change). This again points to a dementia like picture. It sounds like all the right tests have been done so far, but I would repeat the EEG to look at the degree of slowing present and the right temporal region again. Observation and serial neurological exams will be important in making the correct diagnosis. PET scans to look at metabolism in different parts of your brain may also be of help. Consider a behavioural neurologist for a second opinion. There are excellendt specialists at U Penn, UCLA,and U Florida if you are in the region. Otherwise followup with a neurologist that you trust. Best of luck
Member Comments (8)
by harleygirl, Apr 12, 2002 12:00AM
where do i go to post a question. everything that keeps coming up to me is post a comment. I would greatly appreciate your help.I have a couple of questions i would like to ask.. Thank you very much.....
by JSK, Apr 12, 2002 12:00AM
To: harleygirl
Good Luck posting a question. It seems this forum only allows two questions a day, which is at the top of the main topics page. Might want to try around midnight and every hour after. Early bird gets the worm.
by searching, Apr 13, 2002 12:00AM
Psst.... I've had the most luck posting (a new question) at around 9 AM EST. But, shhh... don't tell anyone. ;)
by Enhanced Lesions on White Matter, Apr 15, 2002 12:00AM
To: Kayi
I have MS and I think that anyone going through a problem cognitive function knows how disturbing it can be. You need to make sure your b12 levels were testing. Also go see a neurologist that specializes in white matter disease and possible stroke. MS at your age is not to common from what I have read (you may have been a lucky one where the MS disease lay dorment and then arrives as progressive) There is no much info on MS here on this site and www.mswatch.com that can help you figure out the symptoms. Good luck and get the blood test
by RJWren, Jun 03, 2002 12:00AM
I haven't been able to post a question or find a previous question that answers my question completely. So, I thought I would see if anyone has experienced my husbands symptoms. He is 37 and always been in great shape/health. Recently, he has been waking up in the night with both hands completely numb. His cholesterol was checked last year and was a little high "240" and he experiences upper back pain. The only thing that has changed in his life is riding a motorcycle. This also causes his hands to bother him. Could this be related? And, what kind of Dr. should he see?
by JSK, Jun 14, 2002 12:00AM
To: RJWren
I've had that happening since I was a teenager (over 30 years now). Pinched nerves, maybe in the neck, maybe related to riding. Could be the way he's sleeping, etc. I've woken up hundreds of time & just have to move my hands until I can feel them.
by JZ, Jun 17, 2002 12:00AM
I am experiencing a burning feeling in certain areas of my arm, head and sometimes my neck area. I have been going through a lot and my mom gave me a nerve pill last night and i slept all night(unusual) and didn't hae that feeling. However, today it feels like it is returning. My arm i will lay a cold towel over it and it will go away. Brief medical history...Tubal 12/2002 and went off BCP right afterward. Any suggestions!!!
