Confused and need help

[Frustated § headaches]

How it all started was. I was at work and developed a headache. I stressed out a little and I felt my BP rise and I got a severe headache, along with dizziness and blurred vision.  My doctor put me on altace and checked blood. 1 week later symptoms were still their and was sent for an MRI. Symptoms are headaches, lightheadedness, dizziness, blurred vision and fatigue. I feel a pounding in the center of my head. Like my heart beat. Sometimes I can just sit there and I can get a heart rate by listening. Visual problems usually happen with my head in rotation. The fatigue can happen even when I unload the dishwasher. It feels like I just ran a marathon. Also have nasty mood swings. Discussion was an incidental finding. A well circumscribed 3mm region of fluid signal intensity in the anterior portion of the pituitary gland. It does not demonstrate significant enhancement on the post contrast sequence and this could reflect an incidental pituitary cyst. A microadenoma is felt less likely but cannot be entirely excluded.  Some doctor findings were. Lose of senses and balance when I close my eyes. Trouble with heal to toe, straight leg raises and difficult in Romberg position. Endocrine work up was good. Tried antivert first for 10 days, which didn’t help and he sent me to ENT #1. I did pass his tests and when he asked me what my problem was. He then said I have BPPV. He gave me valium and diazide for 1 month with vestibular pt. At PT when head was in motion I was getting the dizziness and headaches started. When I would close my eyes? Someone needed to be behind me at all times. I would have that balance loss, and after the session I had that sense of fatigue and sick feeling. Neurologist stopped PT at this time. ENT #1 then sent me too ENT #2 and he thinks it might be migraines and anxiety and he said the cyst was the neurologist’s problem. He put me on pamalar for 3 months and will do some balancing tests on me. Radiologist said he’s unsure where it’s sitting and at this time radiation might not be the way to go, but come back in a month and maybe we can put our ( doctors ) heads together. All blood work has been good. Neurologist has done ultrasound of kidneys, EEG, MRA for an aneurysm and a nerve conduction and EMG study. All seem to be good. 6 months later I have another MRI. After the procedure was done am I’m waiting for my films. I notice I had really bad blurred vision. I couldn’t read a business card with my glasses on or off, I couldn’t read any certificates on the walls. Big letters on magazines were out of focus. Big objects were fuzzy. Distant objects seemed okay. My watch I couldn’t read at all. Discussion on this MRI was. Images through the pituitary demonstrate a round region of decreased enhancement noted in anterior aspect. This measures appox. 5.7mm in craniocaudal dimension and 5.3mm in the transverse dimension and approx 3.2 in AP dimension. This is bright in signal on T2 weighted images. Again the differential diagnosis is a cyst. Although, included in the differential diagnosis is a pituitary microadenoma. Impression is Pituitary lesion as above unchanged in size since prior exam. This may represent an incidental cyst. A small microadenoma is not entirely excluded. I’m confused and frustrated. Could you shed some light on this matter?

[CCF-Neuro-M.D.-CS]

Your case is complex, and without evaluating you I can not provide an accurate clinical diagnosis. It seems that your major problems are balance, vision, and headaches. These could represent a form of migrane variant, and the Pamelor is designed to prevent headaches from occurring. If your cervical spine has not been imaged, this would be reasonable. It is possible to have a problem in your spine, and have balance problems and headaches. Other blood tests which may be of some help include vitamin B12, markers of inflammation (such as ESR and C-reactive protein), and markers of connective tissue disorders. Without looking at the MRI I cannot be sure, but the cyst is most likely incidental. Perhaps a second opinion with a neurologist at an academic center would be helpful. They can review your test and make further recommendations. Good luck.

[Alex1950]

I had and still have the symptoms that you describe, not as serious, for the past 20 years. Went trough many Dr and meds nothing seemed to work. Two years ago I was tested for lyme, went on meds, pain went away.
Just this past summer the lyme resurfaced, waiting to see the nuro again before treatment restarts.
I was ignorant, about lyme until this past summer.  Until I started going to the lyme web sites. Lymenet.org is the best one that I have found to date (click on Forum, General, and Medical to get some more answers).
It not saying that you have lyme, but an avenue to get to the bottom of your problem(s).