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Vertigo and Weakness
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Vertigo and Weakness

I am a 28 year old female.  Almost 3 years ago I had an episode of vertigo, imbalance (+Romberg) and Upper and lower Right extremity weakness resulting in daily falls, which lasted for 4-6 weeks.  I had a normal MRI of brain w/ & w/o gad at that time.  (blood tests Ruled out lyme, syphilis and variety of hormone imbalances.)  

I had a similar set of symptoms 6 months later, vertigo, fatigue, weakness, especially in my right (dominant) hand with decrease of hand strength by 80% over my left hand.  (Ruled out Lupus, RA, and variety of rheumatoid diseases, as well as active EBV/Parvo/Lyme infections.  Normal sed. Rate, normal thyroid, slightly elevated CK, slightly low white count)  Symptoms lasted about 4-6 weeks.  

These symptoms returned this fall.  I now have intermittent vertigo (including +Romberg and pronator drift, no dysmetria), Upper extremity weakness (mild thenar wasting), fatigue and severe neck pain for >8 weeks.  

My reflexes are brisk (3+) with ankle clonus on left side.  I have over the last 10 yrs experienced sciatic pain q 4-5 days (could explain the clonus.)  I have occasional, short term parasthesias in hands, face, legs, as well as short episodes of tinnitus every day. My internist ordered an MRI of head and c-spine w/ and w/o Gad.  I couldn't have the Gad due to insurance.  Is a plain MRI adequate to assess my symptoms? I think my Dr. suspects cervical radiculopathy or a CNS issue?  What else might she reasonably suspect?
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Avatar_n_tn
Clonus is as a result of an upper motor neuron problem (if sustained more than 3-4 beats), and is not connected with a peripheral nerve problem like sciatica

Your symptoms would best localize to the cervical spine or lower brainstem, and the more common causes in your age group would include demyelinating disease (such as MS), masses or growths, a syrinx (hollow area in the spinal cord), or migraine. An MRI with and without Gad of the upper spinal cord and brain could evaluate for these, and a spinal tap could help evaluate for demyelinating disease. Tinnitus can be caused by vascular narrowings, so an MR angiogram can be done at the same time.

Good luck
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Avatar_n_tn
Thank you Carol this is definitely a good thought and still possible.  I was tested using ELISA, Western Blot and PCR 3 years ago and again 2.5 years ago which were all negative.  I was also tested for Erlichiosis which in my area is very prevalent.   Because I am IgG2 and IgG4 and IgA deficient any antibody tests can be affected by this (Though antibody tests which detect IgM will be more sensitive as I will overproduce IgM.)  My husband is an infectious disease specialist and at my first symptoms 3 years ago I went to see his colleagues who ruled out lyme disease.  I think if they were suspicious they would have given me a course of doxy at that time.  I will, however, put it back on the table with my internist again, especially if I am sent for *another* series of blood work.  Thanks for your thoughts and good wishes.
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Avatar_n_tn
I apparently have a bulging cervical disk.  I have not read the report, but the Dr.'s office called me with this info.

Is it possible a bulging cervical disk could cause vertigo and/or other problems with proprioception?  Or migraines which would cause vertigo?
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Avatar_n_tn
My Mother is being treated with Alimta for Lung Cancer - Before taking it she gets a vitamin B-12 injection (one week before treatment) together with 1mg of Folic Acid/Day while on chemo. This is required because the drug evidently works by shutting off the body's ability to naturally produce Folic Acid.

The good news is that Alimta works great on the cancer but the bad news is that it makes her Very Dizzy and unstable on her feet.

The neurologist we visited with diagnosed her with Neuropathy -

Do you think thee might be some connection between Folic Acid / Vitamin B-12 and neuropathy and if so any suggesting to eliinate or reduce the dizziness??? I should also add that her dad developed Pernicious Anemia - and took vitamin B-12 injections from age 60 on.

Thank You!
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Avatar_n_tn
Hello I am 22yrs old and about a year ago I was diagnosed with "vertigo". For about a week I would feel lightheaded when I stood up but paid no attention to it, nothing else was wrong no cold or anything, then on a Friday night at work I became very dizzy and had to have my husband pick me up. He took me to the emergency room where the doctor there gave me a pill (antivert) and sent me home. My symptoms had gotten worse by that Monday and my sister got scared and took me the the ER again. This time they gave me an IV, they said the medication was the same as antivert just through an IV, they did a CT, and everything seemed fine on it so they sent me home and told me it would go away in a week. A week after the hospital trip I was not feeling any better, I ended up going to my family doctor who then sent me to an ENT. The ENT did hearing test and found nothing wrong, so he sent me to Physical Therapy for Vestibular Rehab, this went on for 6weeks. I was having to miss work this whole time because I was a hairdresser and I could not do that while being "dizzy". I finally said I could not afford to be out of work anymore and I started doing the physical therapy at home. I did gradually start to feel a little better but not completely. I have given up doing hair because of my "dizzyness" and I have my good days and my bad days. I now work in an office enviroment so that I could make money. However I am starting to have bad vertigo episodes again and it is even keeping me from doing office work properly. I have seen my family doctor and they have ran several tests and I am not getting any answers as to why I am experiencing this feeling. About 2 weeks ago I even passed out, I have never done that before. I am not able to get an appointment with the ENT  till the end of the month. I have been experiencing some little muscle spasms, no particular muscle just here and there every now and then and I have been felling a numbness or tingling sensation on my right side of my face and my right arm and fingers, could this have something to do with it. What should I do now? Who should I go see? I am young and I have no energy anymore. Please give me any advice you can.
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Avatar_n_tn
Hello I am 22yrs old and about a year ago I was diagnosed with "vertigo". For about a week I would feel lightheaded when I stood up but paid no attention to it, nothing else was wrong no cold or anything, then on a Friday night at work I became very dizzy and had to have my husband pick me up. He took me to the emergency room where the doctor there gave me a pill (antivert) and sent me home. My symptoms had gotten worse by that Monday and my sister got scared and took me the the ER again. This time they gave me an IV, they said the medication was the same as antivert just through an IV, they did a CT, and everything seemed fine on it so they sent me home and told me it would go away in a week. A week after the hospital trip I was not feeling any better, I ended up going to my family doctor who then sent me to an ENT. The ENT did hearing test and found nothing wrong, so he sent me to Physical Therapy for Vestibular Rehab, this went on for 6weeks. I was having to miss work this whole time because I was a hairdresser and I could not do that while being "dizzy". I finally said I could not afford to be out of work anymore and I started doing the physical therapy at home. I did gradually start to feel a little better but not completely. I have given up doing hair because of my "dizzyness" and I have my good days and my bad days. I now work in an office enviroment so that I could make money. However I am starting to have bad vertigo episodes again and it is even keeping me from doing office work properly. I have seen my family doctor and they have ran several tests and I am not getting any answers as to why I am experiencing this feeling. About 2 weeks ago I even passed out, I have never done that before. I am not able to get an appointment with the ENT  till the end of the month. I have been experiencing some little muscle spasms, no particular muscle just here and there every now and then and I have been felling a numbness or tingling sensation on my right side of my face and my right arm and fingers, could this have something to do with it. What should I do now? Who should I go see? I am young and I have no energy anymore. Please give me any advice you can.
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