Doctors Lounge - Neurology Answers
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Forum Name: Neurology Topics
|Jean67 - Wed Jan 07, 2009 9:53 am|
I am a 41 year old female. For the past few years I have experienced strange occasional blurry vision in my right eye. In the summer I started having tremors, first in my sleep. It was like I would get awakened by a strange shaking feeling across my back and in my left armpit area. It would wake me upo several times a night (and still does). I am getting strange pressure headaches where I have a normal headache, then get this wave of pressure across my forehead which quickly subsides back to a regular headache. I also get numbess & tingling (diagnosed with carpal tunnel) in both arms which also happens during sleep and wakes me. By the fall , the tremors were in my hands during the day. Neurologist said benign essential tremor. Then I started having sinus tachycardia with a high resting heart rate which is controlled with bisoprolol. I had svt since birth until and ablation fixed it in 1996. I have had no tachycardia since the ablation until recently. I also have pulmonmary stenosis (moderate) that gets checked with and echo every year, with no changes.
I have had an mri and ct scan of head-both showed nothing. I have had my adrenal glands checked by a 24 hr. urine analysis and a ct scan of the adrenal glands. I have had numerous thyroid blood tests done, all showing no abnormalities. I have went to a sleep lab but had NO tremors the night I was studied. I am out of tests to be done, my doctor thinks this might be anxiety. I am at a stand still and am trying desperately to figure out what is going on and feel like myself again.
|John Kenyon, CNA - Fri Feb 13, 2009 1:13 am|
Hi there -
This set of symptoms suggests the probablility that more than one thing is going on at once (and there is no rule against that). While you have been diagnosed with carpel tunnel syndrome and may well suffer from some degree of anxiety, neither explains all the symptoms, especially the visual disturbance and tremors. I note you've had an MRI, but I don't see what part of your anatomy was imaged. Was this by any chance MRI of the brain? This would be indicated for sure, because your symptoms could be caused by multiple sclerosis (MS). They also could be caused by idiopathic peripheral neuropathy (IPN), which often behaves much like MS, but isn't generally as difficult to manage. The latter is often diganosed by means of nerve conduction studies and electromyelogram (muscle studies). Both are treatable and manageable, and can range from nuisance to disabling depending on many factors. Then again, it may be neither of these. However, both should be ruled out (or in, as the case may be).
I hope this is helpful. Good luck to you and please follow up with us as needed.
|Jean67 - Sat Feb 14, 2009 10:37 am|
Than you so much for your reply. I did have a CT Scan of the brain first, then an MRI of the brain. Since this post, my doctor had thought that some of my problems maybe related to hormones/peri-menipause? I have also found out that I suffer from moderate sleep apnea, which may explain some of my problems. Your thoughts?
|John Kenyon, CNA - Sun Feb 15, 2009 11:41 am|
You're very welcome.
While I'm certainly no expert on the many fine nuances of menopause (or perimenopause for that matter) I do realize it can cause a number of symptoms that are new, then often lost in the shuffle as the process wears on. However, most of these symptoms involve less concrete complaints (although flushing is fairly distinctive) such as emotional lability and headache. I don't think it would explain all that's going on with you.
Likewise, sleep apnea generally manifests primarily by fatigue and/or inappropriate sleepiness during the day, often rather suddenly. Also sometimes some heartbeat irregularities are noted.
Both could account for inappropriate sinus tachycardia, but the other symptoms still sound, to me, like they are rooted in a peripheral nervous system problem or perhaps dysautonomia (which is often marked by inappropriate heart rate increase as well as the former SVT), which sometimes comes as a bonus with IPN. Happily (if maybe frustrating), the MRI of your brain was apparently unrevealing, so MS is for now ruled out. If there is some dysautonomia and/or IPN causing most of the rest of the symptoms, both perimenopause and moderate sleep apnea would probably just magnify everything and add their own two cents each, making the picture more blurry. Speaking of blurry, the vision disturbances are still the symptom of primary concern, to me anyway, along with "essential benign tremor" (unless it is familial tremor and perhaps your mother has the same issue).
Sometimes we find certain people have an essentially heritable set of vague neurological symptoms marked by dysautonomia and some fairly random neurological complaints. You may fall into this category, and if so the problems would need to be largely addressed symptomatically. Certainly, I would imagine, perimenopause would be not helpful at best, even though it may not be the actual culprit.
These were, indeed, just my thoughts on this. Nothing concrete as yet. Hopefully it's helpful in some way. Please keep us updated.
My best to you.
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