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Fatigue and lightheadedness and carotid stenosis
History of progressive fatigue for past 5 years, now so bad that I returned to my physician.  I was treated for Depression with Wellbutrin (didn 't work) and SSRI and Adderal (didn't work either.)   Acute episodes (about 1-2 X's per year) accompanied by extreme bad breath and incapacitating fatigue requiring bedrest for 2-3 days.   Over the past 2 year there is an increase in fatigue and I am unable to perform dailly activities.   Light headedness has become more freqent over past 2 years and becoming more acute now, usually every day.  Have seen GP, Cardiologist and Neurologist in past 3-4 months.   Diagnosis of possible stroke 2 years ago (sudden onset numbness left arm and hand and grasping function).  Positive Babinski left foot.  All labs are normal, other than +1 ketones in urine.  Heart normal. Echo and CA++ Scan show 0% chance of cardiac event.     MRI of head/neck shows 70% occlusion right internal carotid. SPEC scan normal.  CT angiography show stenosis.
So, here's the question.  Can the level of fatigue I am experiencing be due to the carotid stenosis and yet not show any brain dysfunction on the MRI, CT or SPEC scan?
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Hi.

I believe that your carotid stenosis has little to do with the progressive fatigue symptoms but this would explain some of the near 'stroke like' symptoms that you developed in the past.  Carotid artery occlusion is more commonly due to systemic problems such as high blood cholesterol or high blood pressure, and if you have these, these should be controlled adequately both through medications and lifestyle modifications.

The pharmacologic side of dealing with depression is only half the story.  What is more important are support groups and peers that are constructive.  I'm emphasizing this since I think that by the way you described your symptoms, depression is a major contributor.

Regards.
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