Having neurological symptoms and unsure what to do

[fearfactor]

I am a 34 year old female and have a long history of anxiety disorder, including OCD and health anxiety (just to get that out of the way).  Since about a year ago, I have been having symptoms such as heart palpitations, feelings of vertigo, "brain fog," headaches.  Sometimes the vertigo gets really bad and I feel like I will lose my balance though it's not accompanied by a fainting feeling.  I had an MRI in 2000 due to a severe episode of headaches and vertigo and was told it was just sinus problems.  I also experience fasciculations (especially in the hands and thumb and also in the face) and numb feelings in my hands.  I have optic disc drusen and went to a specialist in opthalmology to be checked for optic neuritis, which I don't have.  I do occasionally have blue flashes before my eyes and sometimes when I am startled or turn my head fast I get flashes.  I do have fairly severe migraine headaches and take beta blockers for them.  I have been prescribed Topamax but don't take it yet because I'm scared of side effects.  I have suspected temporal lobe epilepsy.  I am VERY concerned that I have MS.  I am wondering if I should pursue testing because I realize this could very well be anxiety and/or some nonspecific neurological problem that isn't serious.  The twitching and numbness plus the vertigo are what make me think MS is a possibility.  I had the MRI back in 2000 - if I have MS would it have shown up back then?  I don't want to spend lots of money on tests if it's probably just anxiety.  I am also concerned about the eye issues.  What do you think I should do?  Thanks!

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

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 and story that you describe are most consistent with migraine headaches and/or depression.  Twitching is not a typical symptom of multiple sclerosis, although it can present with vertigo and numbness (but the numbness is usually more focal [not both hands at once]).  Given your symptoms of vertigo an ENG (electro-nystagmogram) might help determine the etiology (central [brain] vs peripheral [ear]).  I would suggest that you have a repeat MRI of the brain and cervical spine with GAD contrast.  I suspect that your visual symptoms are an aura to your migraine headache (do not have to be followed by a headache to be an aura).  The exam by a ophtamologist was a good idea to evaluate for active optic neuritis.  The most sensitive way to examine for past optic neuritis is a visual evoked potential VEP.  Given your history of 'suspected temporal lobe epilepsy' then another medication (besides a beta blocker that may cause fatigue-and make depression worse) that works both for epilepsy and migraine prevention such as topamax, lyrica, neurontin, etc.  The side effects of topamax can largely be avoided by increasing the dose slowly over several weeks. Depression can also cause the feelings of brain fog and can make headache worse.  Paxil is a popular SSRI that can benefit OCD type traits.
I hope this has been helpful.

[alchris]

Hi were you ever tested for any autoimmune disorders or thyroid problems, if not extensive blood work is a good place to start.

[Manhattan]

I get headaches and also get heart palpitations and twtiching all over my body. It's almost like people like us have hyperactive electrical systems. But maybe they are all completely unrelated. I also take Propranolol, a beta blocker to prevent migraines, control pvcs and I found that it's even helped to control my anxiety to an extent. It's a good drug for me, but if it does not work as a preventative medication my headache specialist plans to put me on Topamax. I too am afraid of the side effects, but I have children and I think it is unfair to allow myself to continue with disabling headaches and have them affected as well. I get short tempered when I have headaches and with three young children and no hired help it is not a good situation. The kids bear the brunt of my crankinss when I am in pain. How big of a dosage are you taking of the beta blocker? I take 40 mgs per day. So far, it seems to be helping. Keeping my fingers crossed.

[fearfactor]

alchris - I have not been tested for autoimmune disorders and I am going to have my thyroid check this Thursday.  I have symptoms of both hyper and hypothyroidism.

Right now, I take propranolol, too - I take 10 mg in the morning and 10 mg at night.  It does help with my palpitations and anxiety as well as my headaches but I can't take a lot because it tends to make my heart rate go way too low.  I am hopeful the Topamax will help me, but I'm scared of all the side effects like memory problems and even electrolyte imbalances.  I plan to start Topamax after I take the bar exam next month - don't want to have a bad memory while studying!

[fearfactor]

Hi, I answered your post in the previous one I did to someone else - I meant to include you in the subject line, too!

[Mels22]

Ok I would appreciate ANY help at this point as I have been told MANY MANY different things.  I am worried sick.  Let me start by saying I had a baby in May.  I am almost 26 and had always been healthy except for chronic sinusitis and anxiety.  While I was pregnant I started having these weird spot headaches.  I had a neuro consult, an MRI and a CAT scan - just showed chronic sinusitis.  That was back in April '06.  Headaches subsided for a while.  Then in October, they came back full-force and were those strong weird spot headaches - mainly on one side.  My vision also got a little blurry - my contacts bothered me.  Also I noticed a lot of pressure behind my eyes.  I had a eye exam - normal, MRI and CAT scan again - normal except the sinusitus.  Have been taking nasonex and topomax (topamax).  It has been better over the last several months but last Monday they came back with a vengence.  I had a headache all over that was different adn wouldn't respond to topomax (topamax) or anything.  Over the course of last week, I also started to have a sense of fullness and ringing in my right ear - mainly at night.  I could also feel my heartbeat in that ear.  I have also noticed my hearing has worsened.  Well the spot headaches are back and the bandlike pressure behind my eyes - I can't even wear my contacts.  I have also had this terrible neck pain for the past couple months.  My questions are...
1. Could this be an aneurysm or a tumor?
2. Do an MRI and CAT scan rule these out?
3. Do you need an MRA to rule it out?
4. Can an aneurysm grow since my MRI on halloween?
Any help would be appreciated!

[alchris]

Hi

Well first good luck on your exams!!!

When you go for your thyroid exam make sure it is a complete thryoid count where they are testing the thyroid antiboidies as well.  As this inludes all the T levles wich are the thyroid stimulating hormones.  Sometime doctors just do a regular thryoid check which is just one test your test to be accurate needs to include the thyroid antiboides as well.  Wish you well

[fearfactor]

An MRI would definitely show a brain tumor and if you were having those same symptoms in October it would have shown the tumor if there was one.  It sounds like cluster headaches - I had a friend who had them and she described just what you did.  They were very severe at times, and she said it felt like someone was poking her in one spot in her head with an ice-pick or something.  It also hurt really bad behind her eyes.  I know headaches can be AWFUL as I suffer from them, too.  I don't know the treatment for these kind of headaches but I am sure if you see your doctor again they can try to give you something that will help you.  I'm certain it's not a tumor as they would've found that on your previous tests.

[Manhattan]

I do have a friend who took Topamax and it completely stopped her headaches for months. She did finally have to stop taking it because of hair loss but when I asked my headaches specialist about the side effect of hair loss she said that it wasn't common. I've read a lot of comments by people taking it and many say the side effects are minor and it has been a miracle drug for them. All in all, it sounds like the side effects are bearable, but I think it's wise of you to wait until after your exams. You certainly don't want to be feeling funny for that! Not sure how much more Propranolol I could take without it affecting my pulse but 40 mg's spread apart is fine for me. My blood pressure is on the low side so Topamax will have to be my next preventative if this fails. Please let us know how it works for you! Good luck.

[Mels22]

I'm not so much scared of a tumor as I am a brain aneurysm.  Back about 2 1/2 months ago I had the CT scan, MRI/MRA, but my questions are, can an aneurysm develop that quickly?  I have had the constant headaches for about 10 days now.  Plus yesterday it was behind my eyes and today it is in my neck and bottom of my head and all over.  I've also felt in a fog lately.  And sooo tired!  I've been sleeping like 16 hours a night!  Does this sound like an aneurysm and can I have one if my MRI/MRA was clean back then?  Also, I'm having regular and pulsatile tennitis in my right ear.  Plus my ear feels full and my hearing is a LOT less.  My neuro had my take a BAER test today and I will find results of it tomorrow.  Does anyone know what that is for?  I would appreciate any answers!!!
Thank you and good luck to all of you!

[rcs2]

Sorry for your problems.
The auditive test you talked about is an evoked test. It checks if you have any problem in your auditive nerves. I think the dr requested it due to the fact you are having hearing loss. I had this test done, as well as the visual one, to rule out MS.
You can do a google search and will find out a couple of sites about it.
As you are worried about aneurysm or tumor, the tests you have done would have shown something. I had all those tests done as well, but the MRA.
I am not an specialist, but I don't think you have/had an aneurysm. I think when it happens it can easily be dx by a CAT scan. What kind of specialist are you seing? A neuro? Let me know about the results.
I myself know how frustating it can be having stg and not knowing what it is... I have weird symptoms for almost 2 years and nobody has a clue what is causing it. Although by one side it's they didn't find anything really bad, by other it let our mind wondering, sometimes for the worst case scenario...
Also, don't give up trying to post a question to the doctors, at least it will give you some guidance and a second opinio!
All the best for you, and hopefully we will find our answers...

[NightAngel]

I'm glad to hear you're not starting on the Topomax (topamax) till after your exams. Topomax (topamax) is known for causing horrible brain fog. It has some other bad side effects, too.