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Neurology (Expert Forum)
paresthesias, headaches, mood swings
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
paresthesias, headaches, mood swings
by joelski, Jul 16, 2006 12:00AM
Hello, I am a 24 YO Male from MA. Recently I went to the ER because of nummbness all over my body. They did a CT scan (which they said was normal) and a blood test for lyme (which came back negative).
A few days later I had another attack, this time my entire arm and left side went numb and I couldn't move it for several hours, but it later diminished. I have also had mood changes (which is not normal for me) and periodic headaches. I have trouble using my hands and arms at time, and the numbness is most prevalent in my legs. I am still having the same symptoms, and I saw a neurologist who couldn't seem to diagnose anything for this, even after doing an MRI of the brain and neck (with contrast).
Now, I have several concerns that I would desperately like some advice on. First, I was bitten by a tick several months ago. Given that I live in a lyme disease area (eastern Massachusetts), could it be the case that the lyme test was wrong? My doctor says that it is not lyme based on all my symptoms, but I just can't help but wonder if it is. And she didn't think it was MS either, which is relieving; but if it isn't MS or lyme, what is it?
Second, I did have an incident at my previous job a while back where I was hit very hard in the head by someone(I used to work with mentally ill patients). Could it be the case where I recieved some sort of head injury from this? I did have ringing in my ear for several weeks as well as severe headaches and periodic hearing loss after the incident. Maybe this could be related?
I appreciate any insight into my condition.
A few days later I had another attack, this time my entire arm and left side went numb and I couldn't move it for several hours, but it later diminished. I have also had mood changes (which is not normal for me) and periodic headaches. I have trouble using my hands and arms at time, and the numbness is most prevalent in my legs. I am still having the same symptoms, and I saw a neurologist who couldn't seem to diagnose anything for this, even after doing an MRI of the brain and neck (with contrast).
Now, I have several concerns that I would desperately like some advice on. First, I was bitten by a tick several months ago. Given that I live in a lyme disease area (eastern Massachusetts), could it be the case that the lyme test was wrong? My doctor says that it is not lyme based on all my symptoms, but I just can't help but wonder if it is. And she didn't think it was MS either, which is relieving; but if it isn't MS or lyme, what is it?
Second, I did have an incident at my previous job a while back where I was hit very hard in the head by someone(I used to work with mentally ill patients). Could it be the case where I recieved some sort of head injury from this? I did have ringing in my ear for several weeks as well as severe headaches and periodic hearing loss after the incident. Maybe this could be related?
I appreciate any insight into my condition.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jul 17, 2006 12:00AM
First of all keep in mind that I am unable to diagnose you since I am unable to examine you, this forum is for educational purposes. The symptoms that you describe are complex and do not fit nicely into any single disorder, but I can give you a list of possibilities and a diagnostic approach based on the symptoms you have listed.
First, was your concern over lyme disease. Lyme antibodies are often negative during the acute disease, because the Borrelia burgdorferi (spirocete that causes Lyme) is immunosuppresive and thus the test is often negative. I would recommend re-testing and a trial on antibiotics to adress this. Lyme disease can cause a number of the symptoms you described including numbness/tingling, headaches and mood changes (neuro-psychiatric changes). I would recommend a SPECT scan of your brain that looks for vasoconstrictive disease that alters brain function that would not show up on an MRI.
Second, there are a number of things that can cause transient symptoms in neurology among which include stroke/TIA (transient ischemic attack), seizures, migraine headaches, and toxic/metabolic disorders. It is unlikely that yo had a stroke due to your apparently normal MRI, and TIA would be less likely (though not impossible) given your age. Seizures can cause episodes of numbness like you described and transient paralysis, also called a Todds paralysis. Migraine headaches can also be associated with numbness and paralysis in some cases and are referred to as "classical migraine". This is difficult to diagnose, since there is no test, and is often a diagnosis of exclusion. Toxic/Metabolic disorders can also cause these symptoms, such as acute intermittent porphyria, periodic paralysis, and mitochondrial disorders.
To begin your analysis I would ask your neurologist to consider an EEG (for seizures, it may take a prolonged EEG to capture one of your spells), the SPECT scan already mentioned, and blood/urine work to include lyme titers, lactate/pyruvate, ammonia, ceruloplasmin, serum amino acids, urine amino acids, urine organic acids, urine tests for porphyria, ESR, CRP. I hope this has been helpful.
First, was your concern over lyme disease. Lyme antibodies are often negative during the acute disease, because the Borrelia burgdorferi (spirocete that causes Lyme) is immunosuppresive and thus the test is often negative. I would recommend re-testing and a trial on antibiotics to adress this. Lyme disease can cause a number of the symptoms you described including numbness/tingling, headaches and mood changes (neuro-psychiatric changes). I would recommend a SPECT scan of your brain that looks for vasoconstrictive disease that alters brain function that would not show up on an MRI.
Second, there are a number of things that can cause transient symptoms in neurology among which include stroke/TIA (transient ischemic attack), seizures, migraine headaches, and toxic/metabolic disorders. It is unlikely that yo had a stroke due to your apparently normal MRI, and TIA would be less likely (though not impossible) given your age. Seizures can cause episodes of numbness like you described and transient paralysis, also called a Todds paralysis. Migraine headaches can also be associated with numbness and paralysis in some cases and are referred to as "classical migraine". This is difficult to diagnose, since there is no test, and is often a diagnosis of exclusion. Toxic/Metabolic disorders can also cause these symptoms, such as acute intermittent porphyria, periodic paralysis, and mitochondrial disorders.
To begin your analysis I would ask your neurologist to consider an EEG (for seizures, it may take a prolonged EEG to capture one of your spells), the SPECT scan already mentioned, and blood/urine work to include lyme titers, lactate/pyruvate, ammonia, ceruloplasmin, serum amino acids, urine amino acids, urine organic acids, urine tests for porphyria, ESR, CRP. I hope this has been helpful.
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Would you mind telling me what symptoms you had? I'm living with weird neurological symptoms for over 1 year, and all my doctors say they don't know what I have, and that I shouldn't bother looking for another doctor because they will say the same, but they did only a few exams (and all to exclude MS). I just learned you can have Lyme without the rash ...
Thanks
rcs2
I'm learning that we need to be active with our doctors, and know I understand why they hate internet...
I have to confess that even after 3 doctors said I don't have MS I'm still worried, and at this point if I learn I have Lyme it will be blessing (altough I know all the pain behind it, it is still better than MS and would stop my daily pain wondering about what I have and what will be the next symptom).
Also due to the subjectivity of the symptoms (nobody can see them...), it's hard to talk to family, friends, about it, I'm glad I found this website with these wonderful doctors that give their time (while other don't spend time with you paying for the appointment) and people like you supporting and helping each other.
Thanks you all! :)