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Neurology (Expert Forum)
Non specific neurological symptoms
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Non specific neurological symptoms
by rcs2, Nov 08, 2006 12:00AM
4 months ago I posted a question here thanks for answering http://www.medhelp.org/perl6/neuro/messages/34286.html
After that post I changed my BP medicine to a b-blocker I changed neuros I'm seeing a doctor from a respectable university
At one point I dont really know and my cardio and neuro neither what symptom is related to the medicine and what is not
After all that I got really worse, couldnt concentrate headaches lasted for minutes like a sharp pain Also I could confirm that I was having paresthesias on my legs and belly I had a sensation that my scalp was burning neck was stiff
Negative results for HIV Lyme and a second MRI w/wo contrast of my brain and cervical spine was "beautiful" according to my neuro (this was done 1 year after the first MRI)
I have to confess that at one point I thought I had neuro Lyme, I even saw an specialist and he said he didnt think I had Lyme, he thought it was a virus
I got better After 1 1/2 year I'm still having the weird feeling on the left side of my face and scalp, and my neuro said most likely it will never go away. But I feel myself again
She said that after start seeing me, she had about 50 patients that described the very same symptoms. She thinks it might be a different form of Bell's Palsy, the virus attacking a different nerve. Of course we are not sure, I'm a researcher and microbiologist, so we chat a lot
So, let say it's a virus. Should be of any help try a anti-virus (like Valtrex)? One of my doctors said to me to take it (I didn't) Would you reccomend me any exam? Now I live with a ghost that I might get worse again Tks
After that post I changed my BP medicine to a b-blocker I changed neuros I'm seeing a doctor from a respectable university
At one point I dont really know and my cardio and neuro neither what symptom is related to the medicine and what is not
After all that I got really worse, couldnt concentrate headaches lasted for minutes like a sharp pain Also I could confirm that I was having paresthesias on my legs and belly I had a sensation that my scalp was burning neck was stiff
Negative results for HIV Lyme and a second MRI w/wo contrast of my brain and cervical spine was "beautiful" according to my neuro (this was done 1 year after the first MRI)
I have to confess that at one point I thought I had neuro Lyme, I even saw an specialist and he said he didnt think I had Lyme, he thought it was a virus
I got better After 1 1/2 year I'm still having the weird feeling on the left side of my face and scalp, and my neuro said most likely it will never go away. But I feel myself again
She said that after start seeing me, she had about 50 patients that described the very same symptoms. She thinks it might be a different form of Bell's Palsy, the virus attacking a different nerve. Of course we are not sure, I'm a researcher and microbiologist, so we chat a lot
So, let say it's a virus. Should be of any help try a anti-virus (like Valtrex)? One of my doctors said to me to take it (I didn't) Would you reccomend me any exam? Now I live with a ghost that I might get worse again Tks
Doctor's Answer
by CCF-Neuro-M.D.-SH, Nov 22, 2006 12:00AM
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 that you describe could be possibly related to a virus, but could also be a varient of migraine headaches or other etiology. Viral infections can "hide" deep within nerves (for example herpes often remains in the inactive stage in the trigeminal nerve) until some event triggers them and they erupt (in the case of herpes it can cause a fever blister, shingles or even encephalitis). Bells palsy is caused by inflammation of the facial nerve (not specifically caused by any known virus) that causes one sided facial weakness, but not often sensory symptoms (except for some pain at the angle of the jaw). Given that you had headache, stiff neck and sensory symtoms in multiple areas of your body, it could not be explained by a virus affecting a single nerve. During the acute event a lumbar puncture would have been very helpful, since it could show increased white blood cell count (mostly lymphocytes) increased protein and inflammation in the CSF (increased IgG index) with a viral process. Some headache syndromes can also manifest with weakness (hemiplegic migraine), confusion (common) and various sensory complaints. There is also a headache syndrome call paroxysmal hemicrania continua that involves a constant headache (with or wothout sensory symptoms/tingling) on one side of the head. This type of headache often responds to indocin (indomethacin). Anti-virals such a valtrex are used for 2 purposes in patients with herpes infections. One is to prevent outbreaks when any outbreak in not acceptable (for example, genitial herpes) and the other is to treat acute infections (for example as soon as a fever blister starts). In your case, it does not sound like you are in the middle of an acute infection, and it is unclear wheter this was a virus or not. Thus, I think that anti-virals would not be likely to help at this point. If your MRI was not done with contrast, you should have one with Gadolinium contrast. Viral infections of nerves cause enhancement with contrast on MRI (some cancers such as lymphoma can also cause nerve enhancement). I would recommend a trial on Indocin and a headache preventative medication such as elavil, topamax, etc (taken daily). I would also recommend that you get a lumbar puncture if your symptoms do not continue to improve or get worse.
I hope this has been helpful.
The symptoms that you describe could be possibly related to a virus, but could also be a varient of migraine headaches or other etiology. Viral infections can "hide" deep within nerves (for example herpes often remains in the inactive stage in the trigeminal nerve) until some event triggers them and they erupt (in the case of herpes it can cause a fever blister, shingles or even encephalitis). Bells palsy is caused by inflammation of the facial nerve (not specifically caused by any known virus) that causes one sided facial weakness, but not often sensory symptoms (except for some pain at the angle of the jaw). Given that you had headache, stiff neck and sensory symtoms in multiple areas of your body, it could not be explained by a virus affecting a single nerve. During the acute event a lumbar puncture would have been very helpful, since it could show increased white blood cell count (mostly lymphocytes) increased protein and inflammation in the CSF (increased IgG index) with a viral process. Some headache syndromes can also manifest with weakness (hemiplegic migraine), confusion (common) and various sensory complaints. There is also a headache syndrome call paroxysmal hemicrania continua that involves a constant headache (with or wothout sensory symptoms/tingling) on one side of the head. This type of headache often responds to indocin (indomethacin). Anti-virals such a valtrex are used for 2 purposes in patients with herpes infections. One is to prevent outbreaks when any outbreak in not acceptable (for example, genitial herpes) and the other is to treat acute infections (for example as soon as a fever blister starts). In your case, it does not sound like you are in the middle of an acute infection, and it is unclear wheter this was a virus or not. Thus, I think that anti-virals would not be likely to help at this point. If your MRI was not done with contrast, you should have one with Gadolinium contrast. Viral infections of nerves cause enhancement with contrast on MRI (some cancers such as lymphoma can also cause nerve enhancement). I would recommend a trial on Indocin and a headache preventative medication such as elavil, topamax, etc (taken daily). I would also recommend that you get a lumbar puncture if your symptoms do not continue to improve or get worse.
I hope this has been helpful.
My doctor said that you never can discard the MS possibility, but it's highly unlikely. Also, about the Valtrex, I don't have general herped and never had a cold sore, he asked me to take the medicine to see if it would improve my symptoms.
Sorry for the way I wrote my post, there is never enough space...
Thank you so much
Sorry for keeping add symptoms...
Thank you so much
rcs2