Jan 01, 2009
I am wondering where to go from here. Last April I went to the ER with extreme dizziness, and left arm numbness and tingling down to my fingers. While there, I had a BP of 201/ 186. Although I have a family history of high BP, before this point, I had only had high white coat BP. I started on BP meds in June, and my BP is regulated well.
At the ER I had a CT of the brain which led to an MRI with incidental findings of an arachnoid cyst (~4x5x6 cm) in the left temporal area, a tiny CCM or chronic micro-hemorrhage in left temporal lobe, 3 lesions in the white matter "non-specific foci" low FLAIR hyperintensity (right corona radiata and left inferior parietal lobule) and a small C2 -C3 disc protrusion.
I then asked for an MRI of the cervical spine due to chronic headaches, shoulder and neck pain. I also had an MRI of the lumbar spine, where I already had a known L5-S1 rupture, with new sciatic pain on a different side of the body and burning numbness in the right thigh. The cervical spine MRI showed degenerative findings on every level, mild to severe foraminal and central stenosis at various levels, and a moderate-severe bulge at the C5-C6 level. Also mild straightening of the lordosis.
I opted for PT for the lower back, and ESI for the cervical spine. the first ESI gave about 12 hours of relief (the anesthetic, I assume), and the second gave about 2 weeks of relief. The left arm numbness is gone, and headaches are less frequent.
I also had a stress echo test in June, which was normal. CRP testing was normal.
Meanwhile, I developed charlie-horse like cramping in my legs, arms and neck. My doctor drew 6 vials of blood and tested thyroid, enzymes, kidney, liver, magnesium, creatinine CK, CBC, etc. Everything came back normal except the B12 = 148, where 200 is low. So, I've been on 2000mcg oral B12 supplements since Oct. 6, and we'll test the level again this Friday.
Meanwhile, I've been to GI to find cause of B12 deficiency. (I'm not a vegan, don't drink any alcohol, and am not anemic.) Endoscopy and colonoscopy were normal, and biopsies were negative for H. Pylori. I just had a blood draw for H. Pylori to double check (no H. Pylori). I do not have celiac antibodies (nor any sign in the above tests), and my folate levels are fine.
Lots of the B12 symptoms are disappearing - sore tongue, muscle cramps, fatigue, leg weakness, hand tremor, brain fog, vocabulary recall, concentration, etc. I was never anemic.
The problem is, I am still experiencing bouts of dizziness (hours long, 2 or 3 days per week), and stumbling when I walk. I have been to the ENT department for vestibular and hearing tests, which were all normal. The Dr. there thought it might be related to allergies, but I use loratadine, fluticasone and singulair for allergic rhinitis on a daily basis, and I feel my allergy symptoms are well controlled.
I did go to the ER in November due to dizziness that would have caused me to fall if I had not been washing dishes and able to grab the sink and call for my husband. It came on suddenly, with no warning. The ER doc made the ENT referral.
The neurologist I have seen twice (most recently last week) while admitting that my brain findings are very rare, especially in the same brain, does not think they are related to the dizziness, does not think I have MS (I didn't bring this up with him, but I have to admit I was wondering), does not think the B12 is causing the dizziness, and does not think it's cervicogenic dizziness. He offered to order another brain MRI to make me feel better, but really didn't think it would show anything different, so I left it where if the dizziness continues after my B12 issues are figured out, I might ask for a repeat MRI. He told me I didn't have cancer or a stroke so I should go home and live my life. Still thinking about that statement.
My questions then are - should I get the MRI? Would it make sense to see a spine specialist? Can B12 deficiency cause this dizziness (lightheaded - not spinning) after I've been on supplements for almost 3 months? Any other thoughts?
And, the GI has discontinued testing since there doesn't seem to be anything fatal going on. How important is it to find the cause of a B12 deficiency? I'm only 49.