symptomatic empty cellar

[joan]

hi! i have been diagnosed w/empty cellar,compressed pituitary, white matter changes from a previous mri, a heriated mass pressing on nerve root, scar tissue on optic nerve with some per.loss. i also have been having strokelike attacks with blood pressure spikes and racey heart dispite meds. i,ve had so many over the years and more lately that i,m havingtrouble with my right leg and ankle,numbness,pins and needles,clumsiness,and pain in that leg. i have shortness of breath all the time and sometimes i go to the er. i recently had a sleep study done and i had one of these attacks there(a mild one) and the results were i don,t have sleep apnea(i don,t snore) but i do have trouble breathing, so they gave me a cpap ,but because of the rib soreness and shortness of breath after a hour i was out of energy. I have very bad headaches on my right side,aslo temple wasting,and it feels like my head swells. i know this is alot and there,s more ( endocrine stuff and many cyst and tumors) but this is very hard for me because i suffer every day and still no diagnosis. i don,t even know what to ask you, i guess to ask can empty cellar,which most doctors have told me be this symptomatic and would you have any idea where i could go from here?

[Kzzy]

A related discussion, empty silla/smashed peturitary gland was started.

[CCF Neuro[P] MD, RPS]

Dear RSD:

I would not think that your empty sella syndrome has much impact on your symptoms unless your thyroid is compromised, and if so it still would not give you unilateral symptoms in isolation.  You problem really sounds like it may be related to other things and without seeing the MRI of your cervical spine it is difficult not to suspect the compromised cord.  But, I can't tell over the internet, and I would recommend a second opinion from a neurologist or neurosurgeon.

Sincerely,

CCF Neuro MD

[Bobbi D]

I, too, have been diagnosed with an empty sella - discovered in a cervical MRI. The MRI report says "an expanded sella turcica which contains what appears to be on all sequences cerebrospinal fluid." This MRI also showed a bony ridge and central protrusion resulting in moderate cord flattening at C4-5, and a nominal bony ridge effacing the ventral subarachnoid space with no compression at C-4.  The neurological exam indicated I had a positive Babinski reflex, Lhermittes sign and hyperreflexia. The neurologist initially diagnosed me with CNS demylination, but there was no sign of demylination in the brain MRI so MS was ruled out. My symptoms have been tingling and numbness in my left arm, hand, leg and foot (sometimes numbness in the hand and leg), unbelievable fatigue, muscle twitching, stiffness of legs and hands, dizziness (more of an off balance feeling than a room spinning feeling) and now am having trouble with incontinence. These symptoms have come and gone over the past 4 years - not always all at the same time, however for the last six months it seems more often than not. I have been to a rheumotologist to rule out lupus (ANA is normal) and a neurosurgeon to determine if the cord compromise should be surgically repaired - he said no, not severe enough to warrant surgery. My question is (and I apologize for the long windedness) can any of these symptoms be caused by the empty sella syndrome?  The drs have all seemed to write that off as an insignificant finding and I didn't think much about it until I read this posting by Tanya. Thank you.

[CCF Neuro[P] MD, RPS]

Dear Tanya:

Sorry that your having such symptoms.  You have alot of various symptoms which are difficult to put together.  Although you have the empty sella syndrome, what hormonal changes have they told you that you have?  Are you on somesort of replacement of the hormones that are deficient?  The white matter changes, since the pituitary is not a white matter structure per se, what are the reasons for the changes?  Do you have high blood pressure and the changes are due to hypertension, do you have MS, ???  The symptoms in you leg could be from the herniation, but where is the herniation in your spine?  They would not start CPAP unless you had sleep apnea and desaturating, did they say that you had hypopneas?  The CPAP is uncomfortable but usually does not involve the chest and ribs, so I am unsure why these symptoms are happening to you.  Shortness of breath can come from a number of reasons, do you have heart failure?  It sounds like you need to sit down with whoever is managing the overall care and see how these things are related.  Sorry that I wasn't much help.  But you really need to know what is the status of your health overall, how it is related to the pituitary, and what other health issues may be going on.

Sincerely,

CCF Neuro MD