CSF leak from left nose, ear filling & head pressure please help

[Sonaya]

5mths ago I was at the emergency dept with stroke like symptoms with a whole pile of test negative for anything serious at the time. MRI of brain without contrast, Lumbar puncture etc etc.  Stroke was ruled out and it was diagnosed as either inner ear vestibulitis or complicated migraine. No major dizzyness only once or twice with the attacks and Ive had approx 8 now.  Since then I have had clear liquid running from the left nose.  I can feel it happening, the pressure builds up in my head, over my left eye and left ear fills up and becomes blocked and then the pain and pressure in my nose and then t his clear liquid comes out.  I have some nerve related symptoms also, sensations, tingling, pins and needles, radiating heat spots, all on left side.  When I lie down my head pressure seems a little better.  But I was wondering if this clear liquid could be CSF leakage.  I had a fairly traumatic lumbar puncture with 4 attempts for the sample.  Every other test has been normal including two cat scans for sinuses.  I have never suffered hayfever or anything like this before.  I have posted in the nuerology section and nobody seems to want to answer my questions.
Could this be CSF leakage ?  How can this be tested without having another lumbar?

[Rossana_Babor]

Additional information about me, I was also diagnosed to have white spots in my brain thru MRI, it was said to be tissues and described as cholesterol free. And they said it's benign and I am afraid it will become malignant.

I would like to know more about the "cholesterol free" situation. What does it imply?

Once again thank you.

Respectfully

Rossana Babor

[Rossana_Babor]

I am suffering from CSF and is currently experiencing massive pain. It already has blocked my ear and fluid doesn't come out. Before, it used to get out through my nose but now it doesn't. When I experince the pain my left eye feels bulging.

Please help me through your medical advices.

Thank you very much.
God Bless.

Rossana Babor,54
Philippines

[Sonaya]

A Big thank you so much for your advice.  YOu dont know how much I appreciate your response.  Ive had my MRI of the spine the other day but no results yet, tried to get them, but they wont give out until I see my physician.  Found a 3mth old radiology report for CT sinuses which I have posted  for help with enterpreting but it does not seem to worry my doctors so it must not be a big deal. My symptoms have lapsed over into cardiology- thankfully thats ruled out, neurology, still debating, and ENT yet to explore but now thanks to you I will make sure that gets looked into also.
I want to thank you once again for your time. Bless you.

[Nancy T]

Wow, how great to have a neurotologist looking in here! Thanks, and welcome!!

Nancy T.

[Eric P Wilkinson, MD]

Hi Sonaya, to rule out a spontaneous CSF leak from either the sphenoid sinus (in the middle of your head) or the tegmen (roof of the middle ear and mastoid) you need to have the nasal fluid collected, preferably 2-3 cc, and have it tested for Beta-2 transferrin.  This protein is only found in CSF, perilymph (inner ear) and the aqueous humor of the eye.  If that test is positive, you have a CSF leak.  You would then need imaging to detect its source.

You should see an ENT and describe your symptoms, and (hopefully) be able to provide a significant fluid sample in the office.

If there isn't that much fluid, there are other tests to detect a slow CSF leak.  These include CT cisternography and nuclear medicine radioactive pledget tests.  An ENT can order these.

Hope this helps.  Good luck!

[Sonaya]

Very Interesting Cluster headaches do have similar symptoms to mine.  Thanks for the tip.

Julie thank you so much for the link, it was of great help.

I have been good for a few days then last few days not so good. Just comes on out of the blue & thats it Im out of action.  MRI is tomorrow, doubt I will get results straight away but shall see how we go.

Hope you are feeling ok too.

Sonaya

[Nancy T]

Hmm, I know I've heard of something that includes runny nose on one side. Cluster headaches? Try looking that up and see what you think.