Near fainting spells

[jumpinjiminy]

The cardiologist has ruled out cardiac reasons for the near fainting spells. They seem to be more frequent and intense during the fevers. Could it be nerve damage related? I've been getting adequate fluid intake, so don't think that's part of it. What other possibilities are there?

Also, he was able to rule out heart valve vegetations, clots and infection. None of them are related to what's happening in the nervous system.

[jumpinjiminy]

Hoping for some answers for you, grandmaval.

[beema36]

Good! Maybe u will start getting some.answers.
Beema

[msgrandmaval]

Neuro office just called and even though they don't have the results of the Lumbar Puncture yet and I haven't worn the neuro monitor yet, he wants to see me on Fri morning for a follow-up. I suspect it is about this Tilt Table test and some meds for these spells. Who knows what else he has gotten back that we need to talk about. At least we are moving forward. Just waiting is so hard. I will let you know how it goes and what he says.

[msgrandmaval]

@Beema36, thank you for your response. I just feel like I am trying to tread water and keep getting my head pulled under! I think I have a little bit of it figured out, then something else comes up w/ all these tests. We are waiting on test results from the Lumbar Puncture and the neuro monitor to show up for my 72 hrs of wearing that...I feel like a cat on a hot tin roof, LOL.

[beema36]

Msgrandmaval, I.have ms.diagnosis and I.have these spells diagnosed Aaron autonomic dysfunction.

[msgrandmaval]

I am just going to jump in here, I'm new to the forums, waiting my final dx, but w/ brain lesions and a history of weird symptoms over the last 16 yrs, I do believe it is going to be ms. Neuro is also checking for EVERYTHING else cardio and neuro related. I had a tilt table test yest. (Have been having fainting spells, 1 while driving) I did ok on the first part of the test, but when they stressed my system (nitro spray orally) my bp dropped way down, heart rate up. I have been having these spells most of this yr. Drs were not really taking me serious, until I did one in their office, then they rushed me to ER! I guess what I am asking is, how many of you are having or have had these spells that already have a dx of MS? Thank you, I do not feel so alone now, just seeing all these posts.

[Lulu54]

Yes, I do have a type of frozen extremities,  but fortunately it has been quiet lately.  I don't get the waxy white skin that is typical of raynauds. Mine is more a extreme temperature difference - like ice cold skin.  Right now my right hand is significantly colder than my left.

Yes, raynauds is vasospasm issue.  
-L

[jumpinjiminy]

Lulu, I'm sorry to hear about the heart problems you're having. Do you have Raynaud's too? That's a sort of vasospasm type issue, isn't it? I have that too. And I get headaches that feel like brain freezes and have been wondering if they're all related.

[jumpinjiminy]

Beema, I'm sorry to hear the horrible problems you are experiencing with this issue. It sounds like it can get to be very debilitating.

I'm currently doing a holter monitor for 15 days but haven't caught any significant episodes of this. It only happens once in a while, and today I took a break from monitoring because my skin is breaking out from the sticky pads. There isn't a place left to put them that doesn't have a rash and itch. It's only been five days. :-(  And of course, the biggest near faint happened today, don't ya know.

I've just had the five year echo for the MVP, which showed changes and prompted a visit to the cardio who then ordered the TEE and holter monitor. He hasn't found much, but he's ruled out some of the other possibilities. At least with that done, we can safely assume this is not a sub-acute endocarditis. It's good to have the infectious disease off the table, because I think that will open up some possible treatment options in the near future.

[jumpinjiminy]

That all sounds really scary. I wouldn't be surprised to have some vagus nerve issues, seeing as how almost all of my cranial nerves are showing signs of irritation right now. It's not a very common thing for me, but has been over these last couple of months.

[beema36]

Mary-the limitation includes both standing and walking. Normally it happens to people who.stand still for some time but with me.it has also happened when walking. It's very frustrating. I hope u can find something to help u. Have u has all the tests and maybe wore a holtor monitor to.see what hour hearts doing when u get the symptoms? I just reread your post and see u have had cardiac workup. Have u had a tilt table test yet?
What meds ru on and do.they help? I keep hoping the drs will find something to help me function better.
Beema

[twopack]

Thanks Beema.  I completely missed mentioning the autonomic connection. Duh.

It must be hard to be so limited in your ability to stand for any lenght of time.  Does that include walking or is it standing still only?

Fortunately, I haven't experienced fainting or near fainting episodes.  The erradic rate and rhythm of the heart does stop me in my tracks.  Unfortunatley, there isn't any specific trigger I can identify for my sympotoms.  If there was, I could turn to my advantage in prevention.

Mary

[beema36]

Vasovagal response is an autonomic.dysfunction. I used to.have the symptoms only occasionally but now have them everyday. I have been told to increase my fluid intake and up my salt intake plus take a betablocker for.the tachycardia.
My symptoms.get worse when I.stand and I will faint if I don't sit or lay down when the presyncope hits. My Dr tells me now not to.stand more than 7 or 8 min as that is all I can do before I.start getting these symptoms. It's very frustrating. I also can not be in heat without the symptoms.
Both my neurologist and electrophysilogist.feel this autonomic dysfunction is secondary to my ms.
I hope u can get a diagnosis and get on some sort of treatment.
Beema

[twopack]

It may well be significant that this happens more often when you have fever.  Increased body temperature (originating from sources within OR outside the body) tend to increase symptoms in nervous system disorders.

The tenth cranial nerve (the vagus) originates in the brain stem and can have a huge effect on many organ functions.  One of the things it can do is bottom out your heart rate and blood pressure pronto, causing a faint.  You might want to find out more about something called a vaso-vagal response (or reflex).  It apparently occurs more frequently in MSers.  

This is the very thing that prompted my PCP to review my chart for past history and initiate the process toward MS diagnosis (which was confirmed one year ago minus 24 hours).  I continue to have problems on and off with my heart rhythm and rate and BP even though much testing shows no cardiac problem.  

I take meds to help control the symptoms but it's often hard to tell how much they are helping.  Treatment is limited to symptom control (which I hope will prevent development of actual cardiac damage like Lulu has experienced) since there is no treatment to repair the damage MS has done to the nerve.

Mary

[jumpinjiminy]

Thanks, Lulu. You're making perfect sense. Thank you for explaining the EP role.

Beema, those all seem to strike at one point or another, and almost all of them when I'm involved in my work, which is physically demanding. It has me a little worried, as that is one of the more positive aspects of my life. I enjoy my work and would rather not have to give it up anytime soon.

Does yours come and go, or is it always present? How do they treat it?

[beema36]

Google autonomic dysfunction and u will.find a wealth of information. Symptoms.depend on.type but some r heat intolerance, shakiness, feeling faint, fainting, vision blurring or.graying out, bp and.heartrate changes etc.

[Lulu54]

The electrophysiologist is the doctor who studies the electrical currents in our heart, for a very simplified explanation.  Sorry I'm missing the bigger words here in my head.  This doctor would correct irregular rhythms, recommend pacemakers if needed, etc.  

We've kicked around AD some, here.  I had a heart attack in 2008 which was finally attributed to a vasospam.  No blockages, no other obvious problems.  To this day I think it was a misfunction due to my MS - though my cardiologist and msologists won't entertain that idea.  AD would explain my problem.

All of our autonomic functions can be affected is there are lesions in the right spot - including our heart and lungs.  Those things that are done by our bodies automatically without our brain having to tell it to do so can be affected.

I hope this makes sense - I'm a bit on the tired side.

be well, Lulu

[jumpinjiminy]

I've never heard of an electrophysiologist. I'm wondering if it's autonomic dysfunction. What other symptoms does it cause, and how common is this? Is it dangerous?

[beema36]

I have ms and I.have fainting spells. My neurologist and.electrophysilogist diagnosed it as autonomic dysfunction which they think is caused from my ms.

[Lulu54]

Since cardiac reasons have been cleared, my next guess would be autonomic dysfunction of some sort - talk to your neurologist about this possibility that your brain is short circuiting.  

good luck with finding answers,
Lulu