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Neurology (Expert Forum)
Do I need a 2nd opinion?
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
Do I need a 2nd opinion?
by Vicky_1952_1952, Dec 17, 2002 12:00AM
I've had repeated bouts of SUDDEN onset headache and vomiting. 1-2x wkly since Sept-02 Severe enough to be hosp 3x(dehydration) PCP sent me to Gastro speciaist had endoscopy...all normal..PCP sent me to Neurologist..had MRI, MRA, EEG Blood/urine ..all normal cept elevated liver enz. Other symptoms are ear fullness, hearing loss, balance difficulties. Neuro DX polyneurophathy from initail exam. Neuro did not personnally view MRI just read report(I asked) and his nurse called with "normal" results. 1. Do I need 2nd opionion or just wait this out? 2.Does MRI always show tumors or Multiple Sclerosis?
Doctor's Answer
by CCF-Neuro-M.D.-JT, Dec 20, 2002 12:00AM
1.A second opinion at a major academic center may be helpful, and should be considered as your symptoms appear to be quite dramatic, requiring 3 hospital admissions.
2.10% patients with MS have an initial normal MRI. But tumors are usually picked up on an MRI.
Inner ear/vestibular problems are certainly a possibility given your symptoms of hearing loss, ear fullness, and balance problems. This can be evaluated with a formal ENT exam and in a dizzy clinic such as the one we have here run by Dr.Oas. Atypical migraine is also a possiblity. The polyneuropathy in itself does not explain your symptoms. But there is a condition called acute intermittent porphyria which can manifest as GI, neurologic, and psychiatric symptoms. It's a genetic defect affecting the liver's ability to make a component of blood, causing a buildup of certain chemicals in the body that somehow affects those systems I mentioned. You can get a polyneuropathy, abdominal pain with vomiting, and psychiatric changes as well as other symptoms. There's also a change in urine color. An attack can be triggered by certain medications such as estrogen, barbituates, and even alcohol. This can be diagnosed with blood and urine studies and treatment is usually supportive or in some cases with hematin and glucose. Talk to your docs about this possibility as they have had the opportunity to examine you and review your clinical history in detail. Good luck.
2.10% patients with MS have an initial normal MRI. But tumors are usually picked up on an MRI.
Inner ear/vestibular problems are certainly a possibility given your symptoms of hearing loss, ear fullness, and balance problems. This can be evaluated with a formal ENT exam and in a dizzy clinic such as the one we have here run by Dr.Oas. Atypical migraine is also a possiblity. The polyneuropathy in itself does not explain your symptoms. But there is a condition called acute intermittent porphyria which can manifest as GI, neurologic, and psychiatric symptoms. It's a genetic defect affecting the liver's ability to make a component of blood, causing a buildup of certain chemicals in the body that somehow affects those systems I mentioned. You can get a polyneuropathy, abdominal pain with vomiting, and psychiatric changes as well as other symptoms. There's also a change in urine color. An attack can be triggered by certain medications such as estrogen, barbituates, and even alcohol. This can be diagnosed with blood and urine studies and treatment is usually supportive or in some cases with hematin and glucose. Talk to your docs about this possibility as they have had the opportunity to examine you and review your clinical history in detail. Good luck.
IS THIS MORE LIKELY A MIDDLE EAR PROBLEM or NERVE PROBLEM IN MY FEET?
You are making a better diagnosis than your doctor..
Inner ear infections or a condition called Benign Positional Vertigo can confuse the messages going to the brain.
When the messages from the eye do not agree with those being
received from the ear's balance system, nausea, vomiting and
falling over when the eyes are closed is often a result.
Since the tiny chamber where balance is controlled is supposed to have fluid in it (and it is tiny particles within this fluid
that cause the problem) they are often missed even with an MRI.
You might have to see and Ear Nose and Throat (ENT)specialist who
will make a diagnosis and try some head manipulation to
clear the debris from the balance fluid.
One sure sign of BPV is dizzyness wen lying down and simply rolling over in bed with the lights out.
Here is a report to read which will prove that I am not making anything up.
Take care.. Ron
--------------------------------------------------------
DIZZINESS WHEN CHANGING POSITION
Report #7072; 3/15/97
Some people feel dizzy and nauseous when they change positions. Exciting new research shows that many will have a condition called benign positional vertigo that can be cured by
surgery or special exercises.
If you feel dizzy or nausea when you change position, move from lying to sitting, turn when asleep or bending over, check with your doctor who will probably order tests for nerve damage: an MRI to look for a tumor, HbA1C for diabetes, Vitamin B12 for pernicious anemia, Lyme