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I am a 33yo white female, with no abnormal medical history until recently.  Over the past 13 years or so, I have had many diffuse symptoms which wax and wane and don't make any sense.  My biggest complaint is memory difficulties, to the point of not being able to work as a residential designer.  

I am being seen at a well respected teaching hospital. Working memory and Logical memory have been pin-pointed as deficient in psych-elvals, Right finger tap test was slower than right (I am right handed), I have an abnormal MRI (3 non specific lesions in white matter  - but no change in second MRI taken a year later)Lumbar Punct: clear & pressure norm.    Blood work up, cardio-stress test and echo(?) show no abnormalities (including Mitral Valve Prolapse).  I have had mild numbness on the right side which lasted about 2.5 - 3 years then gradually over months has come back.  I have had several disturbing episodes that I would like your thoughts on (in order of appearance):

1. Awoke in the middle of the night with chest pain; has happened before, lasts for 5 -15 mins, with no consequence.  This one was different; I had an intense pain on the left that radiated in an unmistakable curved path from the center of the chest pain down in an inverted "U".  The chest pain lasted about 15 min, but for the next 2 - 3 weeks it became increasingly difficult to sleep unless I was elevated. A week after symptoms subsided (yes, I know stupid) I went to the local ER (not the teaching hospital) and they found nothing.

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

It has taken me a while to sort through your post! In general, one can expect a quicker and more informative response from shorter questions, in the internet setting.

I cannot give you a clinical diagnosis over the internet, but I will try to informally answer some of your questions

1) the symptoms in 3) sound like an unrelated UTI

2) the chest pain does not sound neurological so should be dealt with accordingly in a non-neurological fashion

3) Brain fog and memory difficulties can sometimes be more accurately be analysed by standardised tests such as neuropsychological testing. A review of you medications for side effects is essential also.

4) re pins and needles in the foot - I would not worry too much about this - you are most likely within normal range for pins and needles

5) an EEG may be benefical in terms of the brain fog and panic snesation to investigae for seizures, although the likliehood of this is low

6) have the flashing light and visual lines evaluated by an ophthalmologist, my inital impression is that it sounds retinal rather than neurological

General laboratory screeing for ie diabetes, electrolyte disorders, thyroid dysfunction, should be done if not already

Otherwise as in your  MRI report and tests, there is no hard evidence for a neurological disease, keep attending your doctors, time I suspect will support this statement. Good luck

[prm]

2. May 04 Several weeks after above chest pain; mild slurring of speech, dribbling when drinking, and difficulty swallowing (food and drink "going down the wrong pipe" several times a week to several times a day) lasting from 2mos - 7mos - speech problems lasting the longest.

3. Aug 04 Intense shock like pain going from the groin, shooting to the mid thorasic region.  This pain took my breath away, and I couldn't speak for a minute or 2.  (I had had similar pains, not as intense) for probably 10 years with no consequence.)  The next day at around 2pm I realized I hadn

[prm]

Rheumatologist did full work up for Lupus including CNS Lupus - that's not it.  She also said that she really didn't think it was fibromyalgia.

Also, I have had other symptoms such as ringing in the ears and vertigo (not disabling - but significant).  I also had chronic pain which kept getting worse. But I was put on nortryptiline 25mg at first.  It was intended for sleep, but my chronic pain which had NOT been alleviated by NSAIDs went almost completely away with in an hour of taking the first nortryptiline.  Played with the dose, balancing out at a dose of 35 mg/day.  Then a few months later parathesias, ringing, started to come back.  Upped to 40mg, 50mg was too much (I found the drug even in these small doses made me easily angered).  Stayed that way for about a month then gradually went off.  Ringing in the ears has returned, (quite loud at times) but I am not taking the nortryp for that!

Other odd symptoms:
May 04 For weeks I could not clean my ears they were constantly clogged, like being under water, or severe elevation change.  If I q-tipped them I couldn

[prm]

Correction:  Right finger tap test was slower than left (Rt handed)

And I have an increasing number of muscle spasms in the right trunk,leg and arm.

Thanks again, sorry for the hacked nature of the post.

No more, I promise.

[kwag]

Have you ever researched Lyme?  Please google it and read all you can.  Google Sue Massey and Lyme and read it all.  Before you say you don't have Lyme, look into it.  I have lost so much time in the past by not looking into everything.  kw

[prm]

Lyme: I had it years ago and treated it with in days of being bit.  Had the classic bull's eye mark and everything.  I had 4 or more weeks of antibiotics so, I am about as good as its going to get for that case.  I will always test pos for lymes since having it.  Thanks for the comment.

[nosol]

Hi,

I would suggest going to a Neurologist in an academic center and getting the following:  

1.  Another MRI + gadolinium (to check for recurrence or change in those white matter spots) of Brain and possibly spine as well.  This is needed to rule out Multiple Sclerosis or related disorders.

2.  EEG (electroencephalogram) to check for any possible seizure activity.   Mild nonconvulsive seizures may be responsible for some (not all) of your symptoms and should be evaluated

3.  Spinal tap for oligoclonal bands / myelin basic protein (again to rule out MS)  and I also agree w/ the Lyme suggestion from another post.

Good luck.

[patsy10]

I really think you should consider the fact that you may not have gotten rid of the Lyme.  Your symptoms are profoundly classic of neuro Lyme.  People are told 4 weeks is enough antibiotic and that is not necessarily the case.  Lyme would explain all of your symtoms (symptoms).

I would see a doctor specializing in Lyme disease.

[MICH2604]

hello,

Please check out lymenet...do a search and you will see lots of people just like you...if you do nothing else check out the site.

Please go see a doctor specializing in Lyme disease.  you have many of the symptoms that i have.  I also have had every test done imaginable. Trips to the ER in so much pain, and they have found NOTHING!  4 weeks of antibiotic is not enough, you need a lot more then that.

[prm]

Thanks for your thoughts everyone.

I should clarify the MRIs  Both done at well respected Teaching hospital.  Both head and Cspine done, both with gad contasts, taken a year apart.

I have had symptoms before lymes, Its looking unlikely.

[kwag]

4 weeks on antiobiotic treatment for lyme is not adequate.  After being treated successfully, a person does not have the symptoms ( or is at least as close to symptom free as they can be)and tests neg.  You can get lyme from fleas, and humans and elsewhere.  Your family probably has it as well.  There's a reason so many of us are telling you that what you have is classic for Lyme.

[Citizen T]

One of the hallmark signs of advanced Lyme is joint pain.   Elbow, knees, etc.     Keep this in mind before becoming hysterical.   It wouldn't hurt to do a Lyme antibody blood screen and if, and only if you're allready doing a lumbar puncture, check the csf fluid for Lyme as well.  good luck

[prm]

CSF showed no lyme.

I am glad you are all pointing out that I forgot to mention that above.  

I am aware Lyme can be very different from person to person, and very slow to develop, even after extensive treatment in some cases.  But with out evidence of lyme in the CSF - It is extremely unlikely to be the cause.

Thanks though.

[prm]

And I forgot to mention I had a neg Evoked Potentials test

[prm]

It has taken me a while to sort through your post! In general, one can expect a quicker and more informative response from shorter questions, in the internet setting.  
***Yeah, I am really sorry about the blitzkrieg but I had been waiting months to post

[redhed]

hey prm.  um, i hate to beat the dead tick here, but you have almost every symptom that's been making my life miserable, and i was just diagnosed with lyme.  i mean, we could be twins.  i went on the tetracycline, and i'm already seeing an eradication of pain and symptoms.  heart has started to level out, fatigue is melting away.  joint pain is just less and less.  balance is so much better. mental cognition greatly improved.  knees not swollen all up.  i've been cycling in and out of this for about 6 months now.  floaters got bad, then eased off.  swollen neck glands normal finally.  i'm thinking you just maybe should try the antibiotics for awhile and see.

my doctor, who has had lyme herself, told me i may need to stay on this treatment for up to 6 months, maybe longer.  i just think you stopped to soon.  hey, why not try it, couldn't hurt, right?