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Neurology (Expert Forum)
Arnold Chiari Diagnosis-Doctor please help!
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Arnold Chiari Diagnosis-Doctor please help!
by twitching12, Aug 10, 2003 12:00AM
I was diagnosed with Arnold Chiari 1 10mm, after 3 yrs of searching for diagnosis. Here's the problem. My neurologist has never worked on a Chiari patient before and he believes my symptoms are caused by something else unknown, autoimmune disease. He wants me to do the Lumbar puncture for a diagnostic test. I have heard the LP can cause damage to Chiari. Is this true?
My symptoms are: neck pain, fatigue, vertigo, various sensory sensations. Also, I have been experiencing feeling very hot, usually after a hot shower, cannot cool down. It feels like mild-flu. Upon slight exertion I also feel hot/feverish inside, mostly in the mornings. Thyroid tested, full panel, nothing shows. I am age 41 female, but this feels more like the flu than hot flashes other women talk about.
Only blood test abnormal was the CRP. I do have an appointment with a neurosurgeon, regarding the LP test and Chiari, but it may be weeks before I see him. (We only have 1 on my insurance). What questions should I ask him? Thanks so much for your help with this rather rare disorder.
My symptoms are: neck pain, fatigue, vertigo, various sensory sensations. Also, I have been experiencing feeling very hot, usually after a hot shower, cannot cool down. It feels like mild-flu. Upon slight exertion I also feel hot/feverish inside, mostly in the mornings. Thyroid tested, full panel, nothing shows. I am age 41 female, but this feels more like the flu than hot flashes other women talk about.
Only blood test abnormal was the CRP. I do have an appointment with a neurosurgeon, regarding the LP test and Chiari, but it may be weeks before I see him. (We only have 1 on my insurance). What questions should I ask him? Thanks so much for your help with this rather rare disorder.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Aug 13, 2003 12:00AM
The Chiari I malformation is fairly common. Many individuals have these malformations and have no neurologic symptoms. Therefore, it becomes important to ensure that no other problems are occuring. Some of the symptoms you described could be caused by a Chiari malformation. Lumbar punctures can be performed in patients with these malformations as long as they are not severe. Therefore, I would have to see your films prior to determining if you could have a LP.
I am assuming that the remainder of your brain scan was normal. You stated that your CRP level is elavated. I assume other markers such as ESR, ANA, ACE, and RF have been checked, and are normal. Also, have you had a MRI of your cervical spine.
You should ask your neurologist and neurosurgeon if other disorders have been completed excluded, and is the chiari severe enough to cause your symptoms. If you are not satisfied with this evaluation, a second opinion with another neurologist would be appropriate.
I am assuming that the remainder of your brain scan was normal. You stated that your CRP level is elavated. I assume other markers such as ESR, ANA, ACE, and RF have been checked, and are normal. Also, have you had a MRI of your cervical spine.
You should ask your neurologist and neurosurgeon if other disorders have been completed excluded, and is the chiari severe enough to cause your symptoms. If you are not satisfied with this evaluation, a second opinion with another neurologist would be appropriate.
