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Neurology (Expert Forum)
what now?
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.
what now?
by bklk, Dec 19, 2004 12:00AM
Hello,
I was DX’d via LP with viral meningitis in Sept. That presented as isolated severe headache that worsened with activity, after two weeks of sore throat.
LP showed 23 WBC-90%lymphocytes.
2 subsequent taps showed 10 then 0 cells.
Headaches remain and have developed left trigeminal nerve pain and left arm paresthesia now.
2 MRI w contralst normal except for a small arachnoid cyst in the quarigeminal cistern plate
MRA normal
Tested for lyme, syphilis, HIV, West Nile, etc. B12, many other all normal so far.
I did have a 40-50% improvement for about 3 weeks recently but a lot of things were all tried at once including cessation of all meds for rebound, 3 weeks antibiotics 4,000mg for sinus infection, and a 7 day trial of acyclovir for the chance of it? And 80mg Prednisone taper. They all ended about the same time or within days and symptoms returned?? Rebound is most unlikely as I am still off all drugs a month now. Return to Prednisone was tried but has not had the same affect.
Why on earth would the headaches slowly progress to face and arm after cessation of the CSF pleocytosis nearly three months on now?
I have had a tachycardia which is very unusual for me as I am vegan, thin, athletic with a resting heart rate usually low. Could cardio or endocrine all correlate with the early CSF findings, low grade infection somewere? I get lots of transforaminal injections for leg pain after spine surgery, last one 8/28, could an abscess down there or another parameningeal infection show a lymphocyte predominance in CSF and thus the response to antibiotics or are mononuclear cells the rule?
My initial blood work at the ER showed only a lymphopenia of .48 scale of 1.0-4.0 and high barely high monocytes and neutrophils.
By early November, the lymphocytes normalized to 1.22 and the other WBC returned to mid scale.
Would a viral reaction resolve very slow like this or could this point to something else that correlates with these persistent symptoms?
Could these blood findings point to an entity you could see responding to antibiotics/antivirals?
It is not possible for DX I know, but what would be your next avenue of investigation, something to suggest to my Dr.s, I’m spent.
Thanks!
I was DX’d via LP with viral meningitis in Sept. That presented as isolated severe headache that worsened with activity, after two weeks of sore throat.
LP showed 23 WBC-90%lymphocytes.
2 subsequent taps showed 10 then 0 cells.
Headaches remain and have developed left trigeminal nerve pain and left arm paresthesia now.
2 MRI w contralst normal except for a small arachnoid cyst in the quarigeminal cistern plate
MRA normal
Tested for lyme, syphilis, HIV, West Nile, etc. B12, many other all normal so far.
I did have a 40-50% improvement for about 3 weeks recently but a lot of things were all tried at once including cessation of all meds for rebound, 3 weeks antibiotics 4,000mg for sinus infection, and a 7 day trial of acyclovir for the chance of it? And 80mg Prednisone taper. They all ended about the same time or within days and symptoms returned?? Rebound is most unlikely as I am still off all drugs a month now. Return to Prednisone was tried but has not had the same affect.
Why on earth would the headaches slowly progress to face and arm after cessation of the CSF pleocytosis nearly three months on now?
I have had a tachycardia which is very unusual for me as I am vegan, thin, athletic with a resting heart rate usually low. Could cardio or endocrine all correlate with the early CSF findings, low grade infection somewere? I get lots of transforaminal injections for leg pain after spine surgery, last one 8/28, could an abscess down there or another parameningeal infection show a lymphocyte predominance in CSF and thus the response to antibiotics or are mononuclear cells the rule?
My initial blood work at the ER showed only a lymphopenia of .48 scale of 1.0-4.0 and high barely high monocytes and neutrophils.
By early November, the lymphocytes normalized to 1.22 and the other WBC returned to mid scale.
Would a viral reaction resolve very slow like this or could this point to something else that correlates with these persistent symptoms?
Could these blood findings point to an entity you could see responding to antibiotics/antivirals?
It is not possible for DX I know, but what would be your next avenue of investigation, something to suggest to my Dr.s, I’m spent.
Thanks!
Doctor's Answer
by CCF-Neuro-M.D.-CS, Dec 20, 2004 12:00AM
Your case is very complex and would best be handled with a second opinion at a large academic medical center. They will be able to review your history, examination, and tests and make the proper recommendations. Viral meningitis can result in neurologic symptoms which can persist for months. Headaches can be part of that. A spinal abscess would typically present with different symptoms, and would typicaly have no change on a LP, unless it involves the meninges, and then would typically have a neurtrophil count elevation.
One possible test which you may not have had is a MRI of the cerebral veins. In new onset daily headaches there have been a few reports of partially blocked cerebral veins as a cause for the headaches. ALthough unlikely, chronic fungal infections may need to be excluded as well. Again without the ability to review your case personally I cannot provide much information. Good luck.
One possible test which you may not have had is a MRI of the cerebral veins. In new onset daily headaches there have been a few reports of partially blocked cerebral veins as a cause for the headaches. ALthough unlikely, chronic fungal infections may need to be excluded as well. Again without the ability to review your case personally I cannot provide much information. Good luck.
Member Comments (2)
by pwdrskiers, Dec 23, 2004 12:00AM
If you are having problems with nervous system (peripheral or central) and they are getting worse while on an antibiotic, check to make sure its not the antibiotic making you sick.
