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Neurology (Expert Forum)
Unusual neurological symptoms
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Unusual neurological symptoms
by gromit12, Mar 05, 2007 12:00AM
Could my symptoms be due to MS or something neurological?Been having symptoms for10mos. I’m 43 female don’t smoke/drink.Took antidepressants March 05-June 06 but stopped taking them due to side effects:memory problems,drowsy,sleepy,groggy, sedated,difficulty waking up. Symptoms began when I was on antidepressants, but didn’t go away when I stopped: memory problems,confusion,problems concentrating,clumsiness,drop things,dizziness increased sleepiness & fatigue,increased migraine headaches,heart palpitations. Sometimes slur speech, drool, stumble. Take Maxalt 10 mg for migraines. My grandmother had progressive MS. Blood tests-Platelet Count 175 K/uL 8/7/06 & 210 K/uL 3/25/05 (150-400) Vitamin B12 324 pg/mL (247-911) MRI without contrast- No midline shift.The ventricles are normal in size without hydrocephalus.There is no evidence of intracranial mass or infarction.No acute ischemia on the diffusion-weighted scans.No significant white matter disease is present. Spinal MRI with contrast-There is a small central disk protrusion at C5-6 with minor mass effect.Given its small size and location, it is unlikely to cause significant nerve root impingement.A minor posterior disk bulge is noted at C6-7. EEG-normal Visual Evoked Potential-The stimulus at the midpostive peak latency was 91.8 msec left eye and 89.5 msec right eye. MSLT-I could not fall asleep at all during any of the nap periods although I was tired and yawning throughout the day. Nocturnal Polysomnogram-Sleep efficiency was 69.1% Stage 1 sleep 7.1% Stage 2 sleep 55.3% Stage 3 sleep 8.7% Stage 4 sleep 0% REM sleep 28.9%
Doctor's Answer
by Forum-M.D.-SH, Mar 12, 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 (memory problems, confusion, problems concentrating, sleepiness and difficulty getting to sleep) are all symptoms that occur with depression. Your symptoms of slurred speech, drooling and stumbling are non-specific, but are most often seen with overdoses of medications or other substances including (alcohol, xanax/valium/benzodiazapenes, narcotics, etc). There is a varient of migraine headaches called 'confusional migraines' which can cause some of the symptoms that you describe as well. The neurologic workup that you describe is re-assuring that it is unlikely that your symptoms are related to multiple sclerosis (MS) or other ominous neurologic syndromes. I would add a copper/ceruloplasmin, TSH, ANA, ESR/CRP and iron levels to round out your workup (all blood tests). It is possible that the reason that these symptoms occurred while on anti-depressant medication is because that your depression worsened and was not adequately treated by the medication you were on (that is why the symptoms did not go away when you stopped the drugs). I would suggest getting neuro-psych testing, which is a series of cognitive tests that will help distinguish a primary neurologic cognitive problem (such as dementia, etc) from the affect of depression. I would also suggest that you see a psychiatrist for additional depression therapy (often requires counseling, medications and behavioral modification).
I hope this has been helpful.
The symptoms that you describe (memory problems, confusion, problems concentrating, sleepiness and difficulty getting to sleep) are all symptoms that occur with depression. Your symptoms of slurred speech, drooling and stumbling are non-specific, but are most often seen with overdoses of medications or other substances including (alcohol, xanax/valium/benzodiazapenes, narcotics, etc). There is a varient of migraine headaches called 'confusional migraines' which can cause some of the symptoms that you describe as well. The neurologic workup that you describe is re-assuring that it is unlikely that your symptoms are related to multiple sclerosis (MS) or other ominous neurologic syndromes. I would add a copper/ceruloplasmin, TSH, ANA, ESR/CRP and iron levels to round out your workup (all blood tests). It is possible that the reason that these symptoms occurred while on anti-depressant medication is because that your depression worsened and was not adequately treated by the medication you were on (that is why the symptoms did not go away when you stopped the drugs). I would suggest getting neuro-psych testing, which is a series of cognitive tests that will help distinguish a primary neurologic cognitive problem (such as dementia, etc) from the affect of depression. I would also suggest that you see a psychiatrist for additional depression therapy (often requires counseling, medications and behavioral modification).
I hope this has been helpful.
Please be advised that I am not responding to you as a physician and that I am not advising you and that what I write is not meant to be construed as medical advice or a replacement from the forum neurologist, et al.
Your symptoms are sad and familiar to me. I understand the immense confusion, trauma and dis-ease that you are feeling and as you enter into the hazy stage of endless hope that it is something benign, asking constant questions in your mind-and just wondering yourself out of sleep; there is an answer that you need and that is-what is happening to me? For now you will experience a segment of waiting for space and time-and then-more than likely you will have an answer.
Could your symptoms be due to MS? Yes, but due to your scans (despite what some on here think) this, at this point, seems unlikely.
The same old answer applies to you for the present time: your symptoms are variable and are non-specific. They can be accounted for in many neurological conditions as well as many viral infections/illnesses, and as well, the truth though not so popular: tick borne illnesses, e.g. Lyme disease.
Try your best to stay strong until you have a pat answer and try not to worry. I know that this is a difficult time for you.
I hope that I have been helpful.
JCmcc.
With the majority of your symptoms being autonomic, have you questioned the function of the pre-frontal cortical output or thalamic integration? A blind spot map would be interesting. May indicate a suppressed cortex. Could also explain the depression prior as well.
DocRuss
Would you please clarify some things you mentioned in your last post dated 3/7/07.
Do you think my symptoms are due to MS? What do you mean by your comment "what some people on this forum think"? Do you think my scans indicate MS or that they don't indicate MS?
You mentioned that neurological conditions or viral infections/illnesses might be causing my symptoms. Would you be able to tell me what these conditons might be?
Thank you.