Fatigue Carotid stenosis

[Chris511]

History of progressive fatigue for past 5 years, now so bad that I returned to my physician.  I was treated for Depression with Wellbutrin (didn 't work) and SSRI and Adderal (didn't work either.)   Acute episodes (about 1-2 X's per year) accompanied by extreme bad breath and incapacitating fatigue requiring bedrest for 2-3 days.   Over the past 2 year there is an increase in fatigue and I am unable to perform dailly activities.   Light headedness has become more freqent over past 2 years and becoming more acute now, usually every day.  Have seen GP, Cardiologist and Neurologist in past 3-4 months.   Diagnosis of possible stroke 2 years ago (sudden onset numbness left arm and hand and grasping function).  Positive Babinski left foot.  All labs are normal, other than +1 ketones in urine.  Heart normal. Echo and CA++ Scan show 0% chance of cardiac event.     MRI of head/neck shows 70% occlusion right internal carotid. SPEC scan normal.  CT angiography show stenosis.
So, here's the question.  Can the level of fatigue I am experiencing be due to the carotid stenosis and yet not show any brain dysfunction on the MRI, CT or SPEC scan?

[Piedacita]

I was diagnosed with carotid stenosis about 40 per cent of the artery, i am so worry about it, and, i want to know how dangerous  its 40 per cent narrowing would be and which  threatment is better. I am feeling so fatigued after excersicing and I had a brain stroke last year during the cerebral arteriography, it caused to me force lost from the right side of the trunk, disartria and propioception alteration.  Now I am doing therapy, but just until now I had the doopler carotid image, then the next week I wil consult the physician. Please tell me what you know about. Thanks

[PaulMD]

Hi.

The level of occlusion of your carotid arteries may have produced the stroke like symptoms you had in the past, possibly a transient ischemic attack (TIA).  However, this is not likely to fully explain your present symptoms of progressive fatigue.  TIA's would also not show anything on scans (MRI, CT or SPECT), unless a full blown stroke was completed.

I believe that you and your doctors should take a multidimensional approach in the treatment of your depression.  Drugs like the SSRI's are only one aspect of the treatment and it is important to have a sociological approach to it (like peer groups or support groups).  Depression can indeed cause sensation of severe fatigue that is very hard to explain.

Regards and God bless.