Scalp, face tingling/numbness. Light headedness

’ve been experiencing lightheadedness, panic/anxiety/confusion, cloudiness, dizziness, numbness/tingling limbs while lying down/sleeping.  My face went numb after getting a hot flash while driving last week.  Catscan of head = normal. Catscan of neck abnormal, but neck MRI came back normal.  Followed up w/ neurologist, received general reflex/sensation/strength workup.  Passed normal.  Follwed up w/ general practitioner.  Submitted blood work for Lyme/ANA/Sjogren’s factor.  Drs all think its anxiety.

This morning I woke up in the middle of the night with a numb scalp. Last night I woke up at 3am w/ full facial numbness and tingling/weakness all over my body.  It seems to go away as soon as I sit up.  I went back to bed and woke up a few hours later with only numb lips.  This immediately subsided as soon as I sat up.  I have been getting anxiety attacks and feeling as I am going to pass out.  Worse during sleep/early afternoon.

I did have one episode similar on 05/2008 where I woke up w/ tingling and ended up w/ syncopal episode.  Paramedics documented blood sugar @ 45mg/dl.  Blood sugar has tested normal since.  

My stats: 27, 6'3, 190lb, normal bp, liver function normal, no anemia, no diabetes, (blood workup from ER came back normal)

My history: mild/moderate sleep apnea, ocd/anxiety, ?possible sjogren's? (lip biopsy came back + but not sure this was accurate, waiting on blood work mentioned above to rule it out)

05/2005 - Had a baseline brain MRI because I was complaining of headaches/cloudiness.  Normal MRI.

Family history: mom has NMO/Devic's, aunt has an autoimmune, mom's cousin has rheumatoid.  Dad has diabetes (type 2).

I want to rule out serious issues like nerve compression, cranial nerve lesion, onset of multiple sclerosis, brain clotting/tumors/bleeding, circulation issues, or even lyme disease, before attributing this to anxiety.  Should I get another brain MRI or a spine MRI?  Get a new pillow (I’ve been using an apnea pillow)?

[DrNoopurMD]

Hi,

You have mentioned about some abnormality in the neck CT scan. Do you by any chance remember what it was?
Since on an average your scans and tests have been normal neurological lesions, diabetes have been ruled out.
These symptoms could be due to nerve compression in upper part of neck or they can be due to excessive anxiety. I would suggest you to do some deep breathing exercises everyday eat on time and drink plenty of water. B complex supplements may also help.
Hope this helps!

[trackorbishack]

Thank you for the reply.  

So I still could have compressed a nerve even though the MRI came back normal?  

I've been doing deep breathing, B-complex, inositol this last week.  Seems to help a little but not much with the light headedness/nausea.

I have noticed an increased sensitivity to light/noise, I went to see a movie last night and got tingling in my scalp during all the flashing, and had to stare at the floor for most of the film.  I keep getting weird sensations at the top of my head too.  

Report from CT Scan:




TITLE: CAT 0041 CT CERVICAL SPINE W/O CONTRAST * Mar 5 2009 11:29PM

PROCEDURE REASON: NUMBNESS IN FACE
DIAGNOSIS: NUMBNESS IN FACE ?ALLERGIC REACTION

RESULT: CT CERVICAL SPINE 03/05/09 BC/dj

TECHNIQUE: This exam was performed without contrast enhancement.

FINDINGS: Multiple axial images were obtained. Coronal and sagittal
reconstructions were also obtained. There is reversal of the normal
cervical lordotic curve. There is also lateral cervical curvature convex to
the right. No fractures or dislocations are seen. There is prominent
degenerative spurring at C5-6 intervertebral disk space narrowing anteriorly
at this level. There is mild encroachment upon the right neural foramen at
C5-6. Postoperative changes involving the mandible.

IMPRESSION: Cervical spondylosis at C5-6.

TITLE: CAT 0013 CT BRAIN/HEAD WO CONTRAST* Mar 5 2009 11:29PM

PROCEDURE REASON: NUMBNESS IN FACE
DIAGNOSIS: NUMBNESS IN FACE ?ALLERGIC REACTION

RESULT: CT BRAIN 03/05/09 BC/dj

TECHNIQUE: This exam was performed without contrast enhancement.

FINDINGS: The ventricles are midline and are not dilated. There is no
hemorrhage. No mass lesions are seen. No bony abnormalities are noted.
There is mild mucosal thickening in the ethmoid and sphenoid sinuses. The
mastoids are clear.

IMPRESSION:
1. Mild mucosal thickening in ethmoid and sphenoid sinuses.
2. No intracranial abnormalities.


MRI:




TITLE: MRI 0086 MRI SPINE CERVICAL WO CONTRAST Mar 6 2009 7:11AM

PROCEDURE REASON: NUMBNESS
DIAGNOSIS: RECHECK NUMBNESS



TITLE: MRI 0086 MRI SPINE CERVICAL WO CONTRAST Mar 6 2009 7:11AM

PROCEDURE REASON: NUMBNESS
DIAGNOSIS: RECHECK NUMBNESS

RESULT: MRI OF CERVICAL SPINE WITHOUT INTRAVENOUS CONTRAST 3/6/09, AC/cah.

HISTORY: Numbness.

COMPARISON: Cervical spine CT from 3/5/09.

TECHNIQUE: Routine MRI protocol for cervical spine without intravenous
contrast administration.

FINDINGS: Image quality is suboptimal due to patient motion during several
pulse sequences. There is stable reversal of cervical lordosis with apex at
C5-6 disk space. Articulation at the atlantooccipital and craniocervical
junctions, including atlantoaxial interval, are within normal limits.
Vertebral heights minimally lost at C5 and C6 levels unchanged from the
recent CT study. Remaining vertebral heights are maintained. No focal
spondylolysis nor significant spondylolisthesis is identified.
Degenerative disk disease detected most notably at C4-5 and C5-6 level.
Central canal remains widely patent without evident cord compression nor
significant central canal stenosis. Cervical cord is normal in morphologic
appearance without focal expansile or atrophic process. No significant cord
signal abnormality is detected to suggest myelopathic change.

At C2-3 level, disk height is maintained. Central canal neural foramina
bilaterally are patent.

At C3-4 level, disk height is maintained. Central canal and right neural
foramen are patent. Minimal left sided neural foraminal stenosis detected
secondary to bony arthropathy.

At C4-5 level, there is mild disk height loss with degenerative disk
desiccation. Minimal posterior disk protrusion is detected which effaces
the ventral thecal margin slightly more to the right of midline. There is
no cord impact from the protruding disk. Central canal remains patent.
Minimal left neural foraminal stenosis is detected while the right neural
foramen is patent.

At C5-6 level, there is mild to moderate disk height loss with mild
posterior disk protrusion. Focal signal abnormality in the posterior
protruding disk may suggest annulus fibrosis tear. Protruding disk also
effaces the ventral thecal margin eccentrically more to the right of the
midline and contribute to mild central canal stenosis at this level.
Protruding disk additionally extend toward the right lateral recess and
combine with mild bony arthropathy to provide moderate right neural
foraminal stenosis. Degenerative changes also contribute to mild left
neural foraminal stenosis.

At C6-7 level, there is minimal disk height loss with minimal posterior disk
protrusion which effaces the ventral thecal margin. Central canal remains
patent. Right neural foramen is also patent. Bony arthropathy provides
mild to moderate left neural foraminal stenosis.

At C7-T1 level, central canal neural foramen bilaterally are widely patent.


IMPRESSION:1. Limited study due to patient motion. Stable appearance of
cervical spine since the recent CT study.
2. Degenerative change is noted at C4-5 and C5-6 disk levels
contributing to mild central canal stenosis at C5-6 level.
3. Varying degrees of neural foraminal stenosis detected most notably in
the right C5-6 level as described on the recent CT.
4. No evidence of cord compression.

Findings discussed with Dr. Kolm in the emergency room.

[Christine121476]

My husband had a c4 disk replaced with a plastic one and the c5 fused disk back in August.  He is in severe pain.  He has pain in the back of his head where his occipital nerve is then it swells and comes around the front of the left side of his face and he is in severe pain.  He is far from a pill popper and doesnt take anything until he absolutely needs to.  He is currently on Fentanyl pain patches, which is the generic form of morphine.  The neurologist also would like to do a botox treatment on my husband, but the vile is $700.00 per bottle and is not covered by my insurance for medicinal reasons, not physical appearance.  Any ideas as to wheat we can do.  He is depressed.  I am depressed and we have two very small children who are noticing the effects of daddy's discomfort.  Dont kow what to do to help him.  Anyone have any ideas??  If he says like this, he will never return to work again.  He can not drive.  He is losing his ability to focus while drivig through the pain and workes almost two hrs from home.....Any help or suggestions would be gratly appreciated.