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Neurology (Expert Forum)
Tingling Numbess Pressure in head
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Tingling Numbess Pressure in head
by Manysymptons, Jan 02, 2007 12:00AM
First of all, wow, I got in!
For over two years now, I have had numerous symptoms ranging from tinging in legs/arms, numbess in legs, pressure in head (not a dizzy feeling, just pressure), sporadic twitching in different areas, hard to enunciate at times, tongue tingling, sometimes I wake up and feel beaten up, like I worked out, pulling sensation in neck and under ears. I have had an eeg, emg, ncv, mri of head, cat scan of head, mra, chest x-ray, mri of chest, 2 stress tests, 2 ekgs, wore a heart moniter, blood work continuously, mri of sinuses, ent motion test, x-ray of lumbar hearing test, eyes checked twice, dentist check, I have seen a 2 neurologists, ent, gastrologist, been to the hospital three times in last year for numbness in legs, pressure in head. The only thing they have found so far, thank God, is low b-12 (165), have brought it up to 2000 (!!) with sublinquals and shots, and I dip into low sugar (slightly). I am 5'5 and 125 pounds, 36 years old. This is effecting my life, work, marriage, play. Spend alot of time sleeping just to avoid pressure in head. Please help with any advice. Thank you in advance.
For over two years now, I have had numerous symptoms ranging from tinging in legs/arms, numbess in legs, pressure in head (not a dizzy feeling, just pressure), sporadic twitching in different areas, hard to enunciate at times, tongue tingling, sometimes I wake up and feel beaten up, like I worked out, pulling sensation in neck and under ears. I have had an eeg, emg, ncv, mri of head, cat scan of head, mra, chest x-ray, mri of chest, 2 stress tests, 2 ekgs, wore a heart moniter, blood work continuously, mri of sinuses, ent motion test, x-ray of lumbar hearing test, eyes checked twice, dentist check, I have seen a 2 neurologists, ent, gastrologist, been to the hospital three times in last year for numbness in legs, pressure in head. The only thing they have found so far, thank God, is low b-12 (165), have brought it up to 2000 (!!) with sublinquals and shots, and I dip into low sugar (slightly). I am 5'5 and 125 pounds, 36 years old. This is effecting my life, work, marriage, play. Spend alot of time sleeping just to avoid pressure in head. Please help with any advice. Thank you in advance.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jan 25, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms that you describe are not specific for any one disorder, but are most likely related to chronic daily headache and possibly depression/anxiety. There is a lot of data that I do not have, and it sounds like you have had an extensive workup that 'did not find anything'( which doctors should never be comfortable with that statement-without seeing exactly what tests were done, what the results were and examining the films for themselves). A low B12 is concerning (although yours is not low to the poitn were we would expect to find severe or irreversible disease) and can cause some of the numbness/tingling sensations that you describe. Along with a B12 level, I would suggest that your MMA (Methyl Malonic Acid), Homocysteine, intrinsic factor level and parietal cell antibodies are checked as well to evaluate the cause of your B12 deficiency. The feeling of being beaten up/worked out in the morning is concerning for possible nocturnal seizures. An EEG (electroencephalogram or 'brain wave test') is a snap shot (usually only 20 minutes) that can record 'footprints' of seizures/epilepsy, but if you do not have a spell while connected to the EEG, then a seizure disorder cannot be ruled out. Asking your spouse if he/she has seen any spells/convulsions during the night may be helpful. If this happens on a repeated basis then you may need to have an admission of overnight EEG monitoring to capture on of these events. Another possibility would be a REM sleep behavior disorder (these people act out their dreams). The head pressure sounds like chronic daily headache, but may also be a transformed migraine (I would need more history). You have probably heard of our typical treatments if you have been to 2 neurologist already, including elavil(amitryptiline) at night, topamax, zanaflex (tizanidine), nadolol, etc. These medications once started will reduce or eliminate your headaches within 3-4 weeks. There are several ways that prevent this from working. The number one reason people in your situation have refractory headaches (headpressure) is analgesic overuse headaches (also called rebound headaches). Taking common analgesics such as tylenol, motrin, narcotics, ultram etc more than 3 days per week can Give you headaches. These 'rebound headaches' are very difficult to treat and do not respond to our typical methods until the analgesic overuse is stopped (no more than 2 times per week). The second is anxiety/depression. When people are depressed then their pain is amplified and will not improve (despite therapy) until the depression/anxiety is addressed. For this reason many refractory headache patients are given an antidepressant on a trial basis in attempt to improve their headache control.
I hope this has been helpful.
The symptoms that you describe are not specific for any one disorder, but are most likely related to chronic daily headache and possibly depression/anxiety. There is a lot of data that I do not have, and it sounds like you have had an extensive workup that 'did not find anything'( which doctors should never be comfortable with that statement-without seeing exactly what tests were done, what the results were and examining the films for themselves). A low B12 is concerning (although yours is not low to the poitn were we would expect to find severe or irreversible disease) and can cause some of the numbness/tingling sensations that you describe. Along with a B12 level, I would suggest that your MMA (Methyl Malonic Acid), Homocysteine, intrinsic factor level and parietal cell antibodies are checked as well to evaluate the cause of your B12 deficiency. The feeling of being beaten up/worked out in the morning is concerning for possible nocturnal seizures. An EEG (electroencephalogram or 'brain wave test') is a snap shot (usually only 20 minutes) that can record 'footprints' of seizures/epilepsy, but if you do not have a spell while connected to the EEG, then a seizure disorder cannot be ruled out. Asking your spouse if he/she has seen any spells/convulsions during the night may be helpful. If this happens on a repeated basis then you may need to have an admission of overnight EEG monitoring to capture on of these events. Another possibility would be a REM sleep behavior disorder (these people act out their dreams). The head pressure sounds like chronic daily headache, but may also be a transformed migraine (I would need more history). You have probably heard of our typical treatments if you have been to 2 neurologist already, including elavil(amitryptiline) at night, topamax, zanaflex (tizanidine), nadolol, etc. These medications once started will reduce or eliminate your headaches within 3-4 weeks. There are several ways that prevent this from working. The number one reason people in your situation have refractory headaches (headpressure) is analgesic overuse headaches (also called rebound headaches). Taking common analgesics such as tylenol, motrin, narcotics, ultram etc more than 3 days per week can Give you headaches. These 'rebound headaches' are very difficult to treat and do not respond to our typical methods until the analgesic overuse is stopped (no more than 2 times per week). The second is anxiety/depression. When people are depressed then their pain is amplified and will not improve (despite therapy) until the depression/anxiety is addressed. For this reason many refractory headache patients are given an antidepressant on a trial basis in attempt to improve their headache control.
I hope this has been helpful.
You both sound like the hundreds of people whom were finally diagnosed with Lyme Disease, including myself.
Often with Lyme disease all bloodwork, testing etc is all fine, even the test for Lyme itself is notoriously innaccurate....the doctor on this board told me this and also told me my symptoms sounded like Lyme disease.....he was correct. Unforunately they have taken away the thread.
You need to be tested at a reputable lab and see a reputable Lyme Physician.
Even if you dont recall a tick bite there is still a chance.
Please dont hesitate to investigate this as a possibility, it should be included in the differential diagnosis.
Good Luck
Shangs
You both sound like the hundreds of people whom were finally diagnosed with Lyme Disease, including myself.
Often with Lyme disease all bloodwork, testing etc is all fine, even the test for Lyme itself is notoriously innaccurate....the doctor on this board told me this and also told me my symptoms sounded like Lyme disease.....he was correct. Unforunately they have taken away the thread.
You need to be tested at a reputable lab and see a reputable Lyme Physician.
Even if you dont recall a tick bite there is still a chance.
Please dont hesitate to investigate this as a possibility, it should be included in the differential diagnosis.
Good Luck
Shangs
I agree totally with Shanghai. I to have been dx with lyme disease and spent two years trying to figure it out. I did have a lumbar puncture and am glad I did for peace of mind. It is not a fun procedure but can rule out serious disease like MS. If you would like any information on Lyme