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Neurology (Expert Forum)
balance problem, numbness is this MS
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balance problem, numbness is this MS
by kazzabing, Oct 12, 2006 12:00AM
I am 33 year old female. 3.5 years ago I was told that I had an episode of demylination symptoms where dizziness parasthesia to face and arm and below the knee and a strange buzzing sensation and a band like headache this lasted for 6 weeks. I was given an MRI and lp and usual blood work all neg. Neuro then told me that it was possible migraine sx. I had another episode about a year from the first with similar symptoms and a new problem with intense sx lasting a minute where my face would feel numb like a wave of dizziness hitting me then it would settle this period lasted a few months. I was put on Amitriptyline and this seemed to dull everything down.
I had about a year of no sx and then became pregnant with second baby so came off amitriptyline. Was well through pregnancy with the odd pressure sensation in my head. Had difficutl labour and then C Section. Felt some episodes of dizziness after baby and doc said this was things settling down after child birth. Baby is now 10mths and for the last two month my dizziness has got alot worse feel off balance on standing/walking some change in sensation to my right side face hand and outer aspect of leg and again weird attacks like a wave thruogh body which makes me very anxious, neck pain also. Back on amitriptyline again and thing seem less severe though balance still a problem. Waiting to see general docs at hospital as GP unsure what is going on, cant see Neuro as referral takes 9mths. What should I do? have had some acupuncture as this helped in the past noted that dizziness much worse after neck manipulation/massage.
I had about a year of no sx and then became pregnant with second baby so came off amitriptyline. Was well through pregnancy with the odd pressure sensation in my head. Had difficutl labour and then C Section. Felt some episodes of dizziness after baby and doc said this was things settling down after child birth. Baby is now 10mths and for the last two month my dizziness has got alot worse feel off balance on standing/walking some change in sensation to my right side face hand and outer aspect of leg and again weird attacks like a wave thruogh body which makes me very anxious, neck pain also. Back on amitriptyline again and thing seem less severe though balance still a problem. Waiting to see general docs at hospital as GP unsure what is going on, cant see Neuro as referral takes 9mths. What should I do? have had some acupuncture as this helped in the past noted that dizziness much worse after neck manipulation/massage.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Oct 20, 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 you describe are consistent with cervicogenic migraine headaches/dizziness (Headaches/dizziness that comes from the neck). This often occurs after a neck insult of some kind such as trauma (car wreck), or an episode of inner ear infection (viral, etc) that damages the vestibular system and leads to neck misalignment. Neck problems then lead to dizziness and headaches. Medications such as elavil (amitriptyline) are very effective at preventing migraine headaches, and would be expected to provide some benefit for you. It is true that inexpert neck massage will exacerbate your symptoms,but a skilled physical therapist that has experience in treating cervicogenic migraines would be very helpful for you. I would also suggest you take a muscle relaxant, such as zanaflex to assist with the physical therapy. Alternatively, some people have "basilar migraines" that do not specifically involve the neck, but get better with preventative medications alone (elavil, topamax, nadolol, etc). When you see your neurologist, they may be able to inject trigger points in your neck that are causing discomfort. Many cervicogenic migraine patients expierence significant temporary relief with Botox injections into their neck muscles. I would also suggest an MRI of the Brain and Cervical spine with contrast to rule out any structural pathology.
I hope this has been helpful.
The symptoms you describe are consistent with cervicogenic migraine headaches/dizziness (Headaches/dizziness that comes from the neck). This often occurs after a neck insult of some kind such as trauma (car wreck), or an episode of inner ear infection (viral, etc) that damages the vestibular system and leads to neck misalignment. Neck problems then lead to dizziness and headaches. Medications such as elavil (amitriptyline) are very effective at preventing migraine headaches, and would be expected to provide some benefit for you. It is true that inexpert neck massage will exacerbate your symptoms,but a skilled physical therapist that has experience in treating cervicogenic migraines would be very helpful for you. I would also suggest you take a muscle relaxant, such as zanaflex to assist with the physical therapy. Alternatively, some people have "basilar migraines" that do not specifically involve the neck, but get better with preventative medications alone (elavil, topamax, nadolol, etc). When you see your neurologist, they may be able to inject trigger points in your neck that are causing discomfort. Many cervicogenic migraine patients expierence significant temporary relief with Botox injections into their neck muscles. I would also suggest an MRI of the Brain and Cervical spine with contrast to rule out any structural pathology.
I hope this has been helpful.
