Please help......scared!

[AATiday]

Hello,

I have the following very bothersome symptoms and am wondering if you can help ease my mind? I know you cannot diagnose me, but maybe just ease my mind?  I am 29 years old, a female.

*  Migraine headaches since 2002.  Had an MRI done in 2007 that said "there is a very minimal pattern of T2 flair periventricular hyperintenisty".  A LB was done to rule out MS and other things.  The Dr said the "spot" was from my migraines.  He never checked it again.  The migraines are once a week and originate at the base of my neck, on the left hand side.

*  Bodywide intermittent muscle twitching for 16 months.  No muscle weakness.  Worse in the feet and at night.  Sometimes its more like a buzzing sensation, other times slight twitching, other times big thumps.

*  Very occasional limb jerking.  Saw my neuro again about this and the twitching.  He did an EEG which came back normal.  Did not do another MRI or an EMG.

*  A problem with my vision for the past 14 months.  When I sit down or relax, I go off into a stare and everything goes blurry.  It clears up as soon as  I blink.  I saw 3 eye Drs last year who just changed my prescription and it didnt help.  Last month I went to a new eye Dr who said my eyes are misaligned (strabismus?) and weak and that I should do eye excersises.  She is doing a visual field test next week to check for brain tumors, which is why I am so freaked out.

*  Contstant post nasal drip and blocked Eustachian tubes for six months.  There may be slight swelling in my face, possibly due to this?  (or maybe I am over reacting and looking too closely after reading things on the internet?)

*  Pressure in my head and face when I bend over.

Please help and let me know if you feel that these symptoms point to a brain tumor.  I dont get to go back for my Visual Field test results until July 14th and the wait is killing me.

Thanks so much for this service.   It is wonderful.  Have a wonderful weekend.

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

It sounds like you are suffering from bad headaches, which have been diagnosed as migraines. Your MRI findings are most likely as a result of the migraines. If you have migraines >2 times a month (which it sounds like you do), specific migraine medications are indicated for you. In treating frequent migraines, the treatment should include two types of medications: preventative therapy and abortive therapy. Preventative therapy is a medication that would be taken every day regardless of whether or not a headache is prevent. This type of medication is used to prevent headaches from occurring, and there are several types including but not limited to beta blockers such as propranolol, calcium channel blockers such as verapamil, and others including topamax, depakote, elavil, etc. A lot of these medications were invented for other uses and are used not only for headache but also epilepsy and depression. They have proven very effective in preventing headaches. The second medication is abortive, meaning it is used when a headache is coming on. The medication used depends on the nature of a headache. If it is a migraine type headache, a group of medications called triptans can be used. And so on. However, with frequent use of abortive medications including triptans, tylenol, advil, and others, medication overuse headache occurs. This requires a specific treatment in which the over-used medications are slowly stopped and replaced with more long-acting medications. Tylenol with caffiene, and similar medications, can cause medication overuse headache if used too frequently. Lyrica, which is used for fibromyalgia, can be used for chronic headaches too.

Regarding your muscle twitches, this is most likely benign fasciculation syndrome, which I will abbreviate as BFSa condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. If the diagnosis is confirmed and other causes are excluded (through the physical examination, and history taken by your neurologist, and sometimes an EMG), it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low.

Your vision symptoms sound benign; just some unfocusing which is common and can occur in normal people. The fact that it goes away as soon as you blink is very reassuring. Straibsmus is as you said a mal-alignment of your eyes, but it can be present from birth, and does not necessarily indicate a brain tumor. The visual field testing may be helpful in excluding the presence of elevated pressures in the fluid that surrounds the brain, such as in a condition that causes headaches called benign intracranial hypertension.

Continued follow-up with your neurologist and eye doctor is recommended.


Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[sandy1750]

I have no medical knowledge but I am  67 years old and I have suffered the same as you in my younger days.  I think the pain is definately migraine as I suffered very badly and it is possible to think you have a brain tumor. I had immigram self injections and after about 10 years they disappeared. I have had the twitching in my legs and feet and this is called restless legs.  I take amytriptylene for it. Please try not to worry, I know this is easier said than done but I had to do and I found gentle yoga helps. Hope you feel better soon

[AATiday]

Thank you Dr. Chahine for that reassuring information.  It has made me feel much better.  

I was wondering if I could just ask one more quick question?  You stated that you feel my vision symptoms are benign, just some unfocusing.  But, I forgot to write that it is happening very often, somewhere in the neighborhood of 100 times per day.  Being this frequent, do you still feel that its benign?

Thanks again for everything.  Happy 4th of July!

[crystalhanzelka]

Could this also be pseudotumor cerebri.  I have this.  Research online.  It is where the spinal fluid builds up and cause cause blindness.  The only definitive way to diagnose this is an LP to measure opening pressure.  Hope this helps!