Help with Multiple, Varizella Zoster/Mono, Endocrinology, Neurological.

30 year old female. Jan 2008 flu. Feb 2008: Hormonal disruptions, no Menses since March 08) and pains below the left ribs. Strange food reactions. Diagnosis PCOS, which is now a mis-diagnosis). Low Thyroid T3.

• Severe migraine headaches. Pulling sensations down the right side : neck, jaw, face, eye – progressed to arms and legs with noticeable facial droop apparent in right eye. Swelling in face, head, jaw, eye, tongue – noticeable on the right side. Feels like sinus infection, facial bones hurt to touch, fluid in the ears (now believe this is actually nerve being irritated, I also hear a flutter sound) the pain migrates behind the right shoulder blade and collar bone. It all pulls from the neck.

July 08 - Aura Migraine. Typical aura then I collapsed, legs became numb/weak, migraine shooting through right side of my head, numb tingly lips and tongue right side. Coming in and out of fainting. MRI showed multiple lesions on the brain with a differential of MS or Microangiopathic disease, or Migraines?

6 months ago these neurological symptoms spread to the left side, it started with migraines then pulling in the neck. I also have TMJ my whole life on the right.

Jan/2010 - Bilateral Ramsay Hunt Syndrome (vesicles in both ears). Right side fully paralyzed, left side was weak. Pain and weakness in legs and arms. Lumbar tap was Postive Varizella Zoster and Epstein Barr. Antivirals and prednisone for 7 days. 2 months later the shingles came back in both ears now affecting the left side. I can feel the nerves fluttering in both ears and weakness again on both sides.

Positive bubble test on the heart and have a left to right shunt from PFO. Still determining need to close hole.
I’m hoping there is some relation to all of these symptoms – some connection that could point to the root cause of all of this. I’ve had over 8 MRI’s of the head and neck and there are no obstructions, no tumors on the Pituitary or brain. Any help or suggestions would be greatly appreciated.

[Jyoti Kalra, MBBS]

Hi Friend,
Well i can understand the sorrows you must be undergoing, when so many inter-related problems occur.
I hope that the present status (post Jan-2010) is better.
The main problem is that virus can get reactivated any time and hence produces secondary symptoms. We really can't have any control over the E-B / Herpes virus.

We generally use anti-viral medicines in India, but it's effective only when the treatment is started within 24-48 hours of re-activation of the virus. Post that, the medicines don't help much.

As far as PFO is concerned, i would suggest you to have a detailed cardiologist visit and determine the final treatment (like you said- still determining whether the hole needs to be closed or not). Reason being some neurological complications are being reported in the latest literature, in context to the PFO.

I would like to conclude that , please follow the basics in crisis situation. Drink lots of water, keep your diet simple, avoid oily stuffs / starchy items , and do adequate relaxation.
Also follow up in those centers, which have a Multi-Super-Speciality back-ups / teams of doctors.
I would be very glad, if you ask me more doubts, which have left unanswered.
Regards