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Avatar universal

What is happening to me?

I was Dx'd w/typhus 2 1/2 mo. ago.Then tested pos. for ebv IgG. Tingling sensation to neck and sensative scalp to touch.Hx of migraines & GERD.I have headaches, dizziness,nausea,fatigue,eyes feel dry and sore.They move when I close my eye lids up & down like REM.My brain can't seem to handle too much stimuli.I'm forgetting what I wanted when I call my kids, mentally very slow and forgetful.I can hear my heartbeat in my head and throat.Blood pressure has always been normal.Now I notice an increase when standing pulse increase at same time.Normal range when sitting 110/70 p67 then standing 140/96 p94.My skin is blotchy,my body hurts,temps have been 99-100 on average.my veins are visible to my entire body and they hurt?My vision has also been affected floaters & blurred.I am 39 and used to have a very active life style. Too tired to do much of anything these days.At night my muscles to my right leg hurt and twitch then I can't sleep.Had an L/P done-normal,cbc-normal  
ct scan normal, cmv-neg,ebv vca IgG-pos 9.17. My pcp doesn't seem concerned just tells me to rest.I wasn't like this 2 1/2 mo. ago. I'm fustrated and worried because This is the unkown zone to me.I have had the same Dr. for 20 years and to be honest have never really needed him.Any suggestions would be appreciated.Thanks in advance.

2 Responses
Avatar universal
Some of your symptoms do sound neurological, but many of them may be related to a rheumatological problem.  A rheumatological workup to look for autoimmune diseases such as Sjogren's which presents with dry eyes and mouth or Lupus may be helpful. Not exactly sure what to make of the EBV IgG level as it is not helpful in diagnosing an acute infection (as opposed to IgM). It just means that you were exposed to it at one time in your life. However, there are some reports in the literature linking very high EBV titers (would have to know your lab's particular normal values) to an illness called chronic fatigue syndrome. Also make sure your thyroid level is ok, too. As your PCP has had the opportunity to examine you and take your full clinical history, he would be the one to talk to about who would be more appropriate to consult: rheumatology or neurology. But I think a second opinion with a specialist could help you figure things out. Good luck.
Avatar universal
Hi Sy,

Here is some info that may relate to your symptoms...
At the very least, you deserve to have polymyalgia rheumatica
and Temporal Arteritis ruled out.

You may even have an hidden infection like Mycoplasma which is not detectable by lab culture.   I am also posting some info
on this type of infection to explain it better than I can.

I wish you well... Ron
------------------------------------------------
POLYMYALGIA RHEUMATICA and
                   TEMPORAL ARTERITIS

                          Gabe Mirkin, M.D.

If you develop severe muscle pain and weakness, primarily in your shoulder or pelvic muscles, check with your doctor. You may have a highly treatable condition called polymyalgia rheumatica. Polymyalgia rheumatica usually affects people over 60 years of
age who were previously healthy. The pain in their shoulder or pelvic muscles is so great that they often can't sleep nights and that they are afraid to move their muscles days. Doctors order a blood test called a sed rate, and if it is very high, they suspect polymyalgia rheumatica.

If a person suffers severe headaches, doctors should suspect migraine or a much more serious condition, called TEMPORAL ARTERITIS, that can cause permanent blindness.
They often biopsy arteries near the skull to diagnose that condition. The only effective treatment is cortisone-type drugs like prednisone, which usually clear the horribly crippling muscle and joint pain within a few days. Then doctors try to reduce the dose of prednisone to the smallest doses that suppress muscle pain. Most people with this condition must continue to take prednisone for a year or two and then the condition
often goes away as mysteriously as it came.

Many doctors feel that this condition is caused by some kind of infection, even though they have never been able to associate any specific germ with this condition previously.
Recent research shows that polymyalgia rheumatica may be caused by infection with parainfluenza virus (1). There is no research on this, but treatment then could be immune gamma globulin injections. Some doctors treat polymyalgia with long-term
antibiotics, such as doxycycline, in addition to the prednisone.

The only way to prove that you have temporal arteritis is to cut out a piece of your artery and see the irritation in the inner lining of the blood vessels called arteritis. To prevent sudden blindness, your doctor prescribes prednisone, a cortisone-type drug that reduces swelling. Several recent papers show that damage to the inner linings of arteries in your temples and brain can be caused by infection ( 3,4) with chlamydia, the same bacteria that causes heart attacks (1), parvovirus B19 (2) and parainfluenza type

1 (5). At this time, it may be good medicine for your doctor to prescribe antibiotics such as Zithromax (250 mg a day) or Biaxin (500 mg twice day) for a week along with the usually prednisone.

1) AD Wagner, HC Gerard, T Fresemann, WA Schmidt, E GromnicaIhle, AP Hudson, H Zeidler. Detection of Chlamydia pneumoniae in giant cell vasculitis and correlation with the topographic arrangement of tissue-infiltrating dendritic cells. Arthritis and Rheumatism, 2000, Vol 43, Iss 7, pp 1543-1551.

2) H Elling, AT Olsson, P Elling. Human Parvovirus and giant cell arteritis: A selective arteritic impact? Clinical and Experimental Rheumatology, 2000,Vol 18, Iss 4, Suppl. 20, pp S12-S14.

3) E Nordborg. Epidemiology of biopsy-positive giant cell arteritis: An overview. Clinical and Experimental Rheumatology, 2000, Vol 18, Iss 4, Suppl. 20, pp S15-S17.

4) C Nordborg, E Nordborg, V Petursdottir. The pathogenesis of giant cell arteritis: Morphological aspects. Clinical and Experimental Rheumatology, 2000, Vol 18, Iss 4, Suppl. 20, pp S18-S21.

5) P Duhaut, S Bosshard, C Dumontet. Giant cell arteritis and polymyalgia rheumatica: Role of viral infections. Clinical and Experimental Rheumatology, 2000, Vol 18, Iss 4, Suppl. 20, pp S22-S23. Human parainfluenza type 1 virus.

        Health Reports from The Dr. Gabe Mirkin Show and DrMirkin.com

Transcripts of segments of The Dr. Gabe Mirkin Show are provided as a service to listeners at no charge. Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.

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G144 6/3/99

          MYCOPLASMA, CHLAMYDIA AND
                           UREAPLASMA

                          Gabe Mirkin, M.D.

WHAT THEY ARE: Mycoplasma, chlamydia and ureaplasma are the smallest of free-living organisms. They are unlike all other bacteria because they have no cell walls and therefore must live inside cells. They are unlike viruses because they can live in
cultures outside of cells and can be killed by certain antibiotics. However, they cannot be killed by most antibiotics, as most antibiotics work by damaging a bacteria's cell wall.
They can be killed by antibiotics such as the tetracyclines or erythromycins that do not act on a cell wall.

WHAT DISEASES THEY CAUSE: If you feel sick and your doctor is unable to make a
diagnosis because all laboratory tests and cultures fail to reveal a cause, you could be
infected with any of these bacteria. The only way that you will be cured is for your
doctor to suspect an infection with these germs and for you to take long-acting
erythromycin or tetracyclines for several weeks, months or years. They are the most
common cause of venereal diseases and are a common cause of muscle and joint
pains, burning in the stomach, a chronic cough, and chronic fatigue. They can cause
transverse myelitis (paralysis of the spine) (1); gall stones (2); a chronic sore throat
(3); red itchy eyes, pain on looking at light and blindness (4); arthritis (5,19); brain
and nerve damage with symptoms of lack of coordination, headaches and passing out;
spotting between periods or uterine infections (6); kidney stones (7); testicular pain;
asthma (8); heart attacks (9); strokes (10); cerebral palsy (11); premature birth (12);
high blood pressure (13); nasal polyps (14); stuffy nose in newborns (15); chronic
fatigue (16); belly pain (17); muscle pain (18); confusion, passing out and death (19);
coughing, bloody diarrhea, and anal itching and bleeding.

WHY THEY ARE SO DIFFICULT TO DIAGNOSE AND TREAT: Most doctors will not prescribe antibiotics to patients without a laboratory test that indicates a specific infection. No dependable test is available to rule in or out mycoplasma, chlamydia or
ureaplasma infections. Most antibiotics will not kill these organisms and those that do have to be taken for many months and years. Furthermore, many infected people do not take medication long enough to be cured, or they may have a close contact with an
infected person and become reinfected. Once these infections are allowed to persist for months or years, they are extraordinarily difficult to cure and often require treatment for many months. One venereal-disease patient in four takes medication as prescribed (20) and almost all women who still had chlamydia one month after treatment were reinfected by new or old partners (21). Usually your first symptoms from chlamydia,
ureaplasma and mycoplasma are burning on urination, a feeling that you have to urinate all the time, terrible discomfort when the bladder is full and vaginal itching, odor or discharge. Other first symptoms include itchy eyes, a cough or a burning in your
nose. You can be infected when an infected person coughs in your face, or you touch nasal or eye secretions from an infected person and put your finger in your nose or eye. Your chances for a cure are high if you are treated when you have only local
symptoms; but after many months, the infection can spread to other parts of your body and make you sick or damage nerves, joints and muscles. If you feel sick and your doctor is unable to make a diagnosis because all laboratory tests and cultures fail
to reveal a cause, you could be infected with mycoplasma, chlamydia or ureaplasma and can be cured only by taking long-acting erythromycin or tetracyclines for many months.

HOW I TREAT: I often prescribe 500 mg of azithromycin twice a week and/or doxycycline 100 mg twice a day. You may require treatment for months or years, if your symptoms have gone on for many months or years: muscle and joint pains, a chronic cough, burning on urination, severe fatigue or signs of nerve damage. Many physicians disagree with these recommendations, so check with your doctor before you consider these treatments. For more information on some of the diseases and conditions that may be caused by these bacteria, see my reports on asthma, heart
attacks, infertility, venereal disease, arthritis, and fibromyalgia.

1) M Abelehorn, W Franck, U Busch, H Nitschko, R Roos, J Heesemann. Transverse myelitis
associated with Mycoplasma pneumoniae infection. Clinical Infectious Diseases 26: 4 (APR
1998):909-912.

2) N Figura, F Cetta, M Angelico, G Montalto, D Cetta, L Pacenti, C Vindigni, D Vaira, F Festuccia, A Desantis, G Rattan, R Giannace, S Campagna, C Gennari. Most Helicobacter pylori-infected patients have specific antibodies, and some also have H-pylori antigens and genomic material in the bile: Is it a risk factor for gallstone formation? Digestive Diseases and Sciences 43: 4 (APR 1998):854-862.

3) G Falck, I Engstrand, A Gad, J Gnarpe, H Gnarpe, A Laurila. Demonstration of Chlamydia pneumoniae in patients with chronic pharyngitis. Scandinavian Journal of Infectious Diseases 29:
6(1997):585-589.

4) K Numazaki, S Chiba, K Aoki, K Suzuki, S Ohno. Detection of serum antibodies to Chlamydia pneumoniae in patients with endogenous uveitis and acute conjunctivitis. Clinical Infectious
Diseases 25: 4 (OCT 1997):928-929.

5) JSH Gaston, KHO Deane, RM Jecock, JH Pearce. Identification of 2 Chlamydia trachomatis antigens recognized by synovial fluid T cells from patients with Chlamydia induced reactive arthritis. Journal of Rheumatology 23: 1 (JAN 1996):130-136.

6) IA Tait, SJ Duthie, D Taylorrobinson. Silent upper genital tract chlamydial infection and disease in women. International Journal of STD & AIDS 8: 5 (MAY 1997):329-331.

7) A Yuce, M Yucesoy, K Yucesoy, T Canda, M Fadiloglu, A Gure, N Yulug. Ureaplasma urealyticum induced urinary tract stones in rats. Urological Research 24: 6 (DEC 1996):345-348.

8) JAMA 1997(Dec 17);278(23):2051-2.

9) S Halme, H Syrjala, A Bloigu, P Saikku, M Leinonen, J Airaksinen, HM Surcel. Lymphocyte responses to Chlamydia antigens in patients with coronary heart disease. European Heart
Journal 18: 7 (JUL 1997):1095-1101.

10) Jackson, LA Campbell, CC Kuo, DI Rodriguez, A Lee, JT Grayston. Isolation of Chlamydia pneumoniae from a carotid endarterectomy specimen. Journal of Infectious Diseases 176: 1 (JUL 1997):292-295.

11) Grether JK, Nelson KB. Maternal infection and cerebral palsy in infants of normal birth weight. JAMA 1997(July 16);278:207-211.

12) N Kjaergaard, D Hansen, ES Hansen, HC Schoenheyder, N Uldbjerg, H Madsen. Pyospermia and preterm, prelabor, rupture of membranes. Acta Obstetricia et Gynecologica Scandinavica 76:
6(JUL 1997):528-531.

13) PJ Cook, GYH Lip, P Davies, DG Beevers, R Wise, D Honeybourne. Chlamydia pneumoniae antibodies in severe essential hypertension. Hypertension 31: 2 (FEB 1998):589-594.

14) PA Gurr, A Chakraverty, V Callanan, SJ Gurr. The detection of Mycoplasma pneumoniae in nasal polyps. Clinical Otolaryngology 21: 3 (JUN 1996):269-273.

15) 9% of newborns get a stuffy nose taht is casued by mycoplasma and cannot be cultured by routine laboratory methods. NM Iskandar, MB Naguib. Chlamydia trachomatis: An underestimated
cause for rhinitis in neonates. International Journal of Pediatric Otorhinolaryngology. 42: 3 (JAN 1998):233-237.

16) S Wessely. Chronic fatigue syndrome. Journal of the Royal College of Physicians of London. 30: 6 (NOV-DEC 1996):497-504.

17) L Cirasino, A Marccotti, C Barosi, F Massaro, A Silvani. Misdiagnosis of post-traumatic splenic rupture in a patient with acute cold agglutinin disease due to Mycoplasma infection. Scandinavian Journal of Infectious Diseases 29: 5(1997):522-524.

18) Y Aihara, M Mori, T Kobayashi, S Yokota. A pediatric case of polymyositis associated with Mycoplasma pneumoniae infection. Scandinavian Journal of Rheumatology 26: 6 (1997):480-481.

19) Braun et al. Chlamydia pneumoniae- a new causitive agent of reactive arthritis and undifferentiated arthritis. Ann Rheum Dis 1994;53:100-105. 20) Gerard HC et al. Screening of
synovial tissue from reactive arthritis patients for the presence of chlamydia pneumoniae. Arthritis Rheum 1995;38:S394.

19a) TM Korman, JD Turnidge, ML Grayson. Neurological complications of chlamydial infections: Case report and review. Clinical Infectious Diseases 25: 4 (OCT
1997):847-851. cerebellar dysfunction, followed by respiratory failure requiring mechanical ventilation.

20) M Augenbraun, L Bachmann, T Wallace, L Dubouchet, W Mccormack, EW Hook. Compliance with doxycycline therapy in sexually transmitted diseases clinics. Sexually Transmitted Diseases 25:1 (JAN 1998):1-4.

21) SD Hillis, FB Coles, B Litchfield, CM Black, B Mojica, K Schmitt, ME St Louis. Doxycycline and azithromycin for prvention of chlamydial persistence or recurrence one month after treatment in women - A se-effectiveness study in public health settings. Sexually Transmitted Diseases 25: 1 (JAN 1998):5-11.

22) TV Poggio, N Orlando, L Galanternik, S Grinstein. Microbiology of acute arthropathies among children in Argentina: Mycoplasma pneumoniae and hominis and Ureaplasma urealyticum.
Pediatric Infectious Disease Journal 17: 4 (APR 1998):304-308.

23) J Haier, M Nasralla, AR Franco, GL Nicolson. Detection of mycoplasmal infections in blood of patients with rheumatoid arthritis.Rheumatology, 1999, Vol 38, Iss 6, pp 504-509.Nicolson GL, Inst Mol Med, 15162 Triton Lane, Huntington Beach,CA 92649 USA.

24) S Johnson, D Sidebottom, F Bruckner, D Collins. Identification of Mycoplasma fermentans in synovial fluid samples from arthritis patients with inflammatory disease. Journal of Clinical Microbiology, 2000, Vol 38, Iss 1, pp 90-93.

        Health Reports from The Dr. Gabe Mirkin Show and DrMirkin.com

Transcripts of segments of The Dr. Gabe Mirkin Show are provided as a service to listeners at no charge. Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.
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