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Neurology (Expert Forum)
neurological or respiratory problem?
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neurological or respiratory problem?
by john100, Jan 08, 2006 12:00AM
symptoms mimic chronic CO poisoning, but sensor never detects level above 10 ppm
1. constant deep, dull, boring headache with frontal muscle tension and muscle stiffness/weakness felt (if I raise my eyebrows and hold it for 5 seconds the muscles stay intensly contracted, marked feeling of pressure in skull when I activate cranial muscles on the top and forehead.)
HEAVY HEADED FEELING, a weight on the head, brain is being pulled down into neck
2. shortness of breath which is actually WORSE when resting, and improves with activity or exercise....feeling that throat is swelling shut and air is being restricted, feeling of choking, AIR HUNGER (cant get a refreshing breath deep enough), lungs dont feel "elastic" enough
3. constantly dry and blocked nose, with a feeling of pressure or swelling deep behind the nose. swolen turbinates very persistant, nasal lining was bloodred when this started
4. Vertigo
CT BRAIN, MRI, MRA, MRV, EXTENISIVE BLOOD TESTS (including ANA, LYME, LUPUS, TSH), RADIONUCLEOTIDE BONE SCAN, CHEST XRAY, PULMONARY FUNCTIONS, ARTERIAL BLOODGAS, ECHOCARDIOGRAM, EKG, EEG, ENG...
ALL TESTS NEGATIVE!
I should mention that I used to get frequent syncope but it completely stopped at the same time when I started feeling this way. I also get frequent acid reflux.
should i get a spinal tap or other additional testing? i've been very sick with this for well over 10 months now. I am 5'10, 240 lbs, and 28 yrs old,
If I was YOUR patient what would you suggest?
Please, please help!thanks!
1. constant deep, dull, boring headache with frontal muscle tension and muscle stiffness/weakness felt (if I raise my eyebrows and hold it for 5 seconds the muscles stay intensly contracted, marked feeling of pressure in skull when I activate cranial muscles on the top and forehead.)
HEAVY HEADED FEELING, a weight on the head, brain is being pulled down into neck
2. shortness of breath which is actually WORSE when resting, and improves with activity or exercise....feeling that throat is swelling shut and air is being restricted, feeling of choking, AIR HUNGER (cant get a refreshing breath deep enough), lungs dont feel "elastic" enough
3. constantly dry and blocked nose, with a feeling of pressure or swelling deep behind the nose. swolen turbinates very persistant, nasal lining was bloodred when this started
4. Vertigo
CT BRAIN, MRI, MRA, MRV, EXTENISIVE BLOOD TESTS (including ANA, LYME, LUPUS, TSH), RADIONUCLEOTIDE BONE SCAN, CHEST XRAY, PULMONARY FUNCTIONS, ARTERIAL BLOODGAS, ECHOCARDIOGRAM, EKG, EEG, ENG...
ALL TESTS NEGATIVE!
I should mention that I used to get frequent syncope but it completely stopped at the same time when I started feeling this way. I also get frequent acid reflux.
should i get a spinal tap or other additional testing? i've been very sick with this for well over 10 months now. I am 5'10, 240 lbs, and 28 yrs old,
If I was YOUR patient what would you suggest?
Please, please help!thanks!
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jan 13, 2006 12:00AM
You have obviously had a lot of testing already that should ruleout many serious medical conditions
Headache and vertigo can be caused by pulmonary disease, for instance if there is chronic carbon dioxide retention from not being able to exhale enough carbon dioxide - this should have been apparent on you blood gas though.
If you also have symptoms of daytime fatigue or sleepiness, you may have obstructuve sleep apnea. I see that you are overweight, and this is a realtively common condition. A polysomnogram or sleep study would be able to diagnose this, and there is effective treatment, including losing weight.
If you have not seen a neurologist for chronic headache management you should as the issue after diagnosis is effective treatment of your headaches and followup. I cannot substitute for a formal medical opinion though. Losing weight is highly reccommended though, and will almost surely relieve the symptoms.
Good luck
Headache and vertigo can be caused by pulmonary disease, for instance if there is chronic carbon dioxide retention from not being able to exhale enough carbon dioxide - this should have been apparent on you blood gas though.
If you also have symptoms of daytime fatigue or sleepiness, you may have obstructuve sleep apnea. I see that you are overweight, and this is a realtively common condition. A polysomnogram or sleep study would be able to diagnose this, and there is effective treatment, including losing weight.
If you have not seen a neurologist for chronic headache management you should as the issue after diagnosis is effective treatment of your headaches and followup. I cannot substitute for a formal medical opinion though. Losing weight is highly reccommended though, and will almost surely relieve the symptoms.
Good luck
thank you kindly for you help
John