# Neurological problems. CT and MRI scan without contrast clear. but these symptoms...



## Demonicham (Aug 22, 2012)

Hello, my name is Patrick Owers.

For the past 2 and a half months I have been having the worst health complaints I've ever had in my life. It started out as chest pains, so bad to the point that they were stopping me from breathing and making me sweat buckets. went to the doctors and a cardiologist, and I had ECG's, Blood Tests, and a chest X-ray, all came back fine.

Even though that was pretty bad, It was something I could cope with, I had all my mental functions intact, I am generally a smart, witty guy who's very sociable and easy to get on with, and very well spoken.

However a few weeks later, I started having terrible headaches and eye twitches, went to about 5 doctors, all saying I'm fine after about 6 neurological examinations.

As the weeks progressed, I started noticing stuttering in my speech, my muscle twitches spread to every part of my body that had a muscle. these were fasciculations at the time, twitches only visible on part of the skin.' I started getting pricking sensations in my hands and feet, and my leg started to feel stiff and hurt alot. went back to the doctors, referred me to a neurologist, just to be safe.

The neurologist looked me over and did an examination to test my nerve strength. all seemed fine, and he sent me for a CT scan just to be safe.

Had the scan and it came back clear. however, I was told an MRI would be better for the diagnosis of any masses in my brain as CT's without contrast are highly inaccurate.

My symptoms got alot worse, now whole limbs were jerking on their own. Headaches started to get sharper and more intense. muscles were twitching constantly. I have trouble reading long sentences and paragraphs and pronouncing words, and I will replace words with similarly spelt words or completely different words that won't make sense. I felt incredibly dizzy. and I was falling all over the place when I walked.

So I finally flipped and got an MRI done privately. (which was just the Wednesday a week ago) and I got the results of that and that came back clear.

But now, I'm stumped, these symptoms are obviously caused by something neurological in nature, and doctors are convinced that its anxiety. I've had bouts of anxiety before but I've had nothing like this. It's interfering with every aspect of my life and doesn't go away with any kind of medication or antidepressant, I've been on citalopram, amitriptyline, Mirtazapine. and all of these had no effect on my symptoms.

To this date my symptoms are as follows:-



Headaches, sharp and around the temple area, but can sometimes cover the back of my head.
Sharp pains in the neck. 
Muscle twitches and jerks, can have times where they get worse and excessive to times where they are only a few every hour or so. 
Numbness in my foot and hands, sometimes pain in thumbs and toes. 
Cold sensations in my hands, lips, ears, feet, chest and forehead.
A hot burning sensation in the top of my head.
Facial muscles twitch whenever I use them. like when I grimace, my face will have a twitching fit.
Feeling sick in the mornings.
Ears ringing (lasts for a few seconds but can also be accompanied by complete loss of hearing in that ear for a few seconds.
Visual disturbances (such as halos in vision, stripes in vision. uncoordinated eye movements, blurred patches in vision, like the blurred vision you get identical to getting something in your eye, is relieved by rubbing the eye. but happens in both eyes.)
One side of my body will twitch and tingle. usually happens in my sleep, but gives me such a fright.

Can all of these symptoms really be health anxiety, like all the doctors have said? It's affecting my speech, my understanding of words and word processing skills. to the point where I can't interact with people out of embarrassment. with this pattern of symptoms, I would've thought the conclusion would be a neurological deficit, but according to the neurologist and 20 doctors, apparently not.

I have uni in three weeks and in this mental condition, it will almost certainly affect my grades.and my future. so I need to know what's happening as this isn't something that's going to go away overnight.

Any similar experiences or knowledge of nervous system disorders you could share please? I'm in tatters right now.


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## lonelyjew (Jan 20, 2010)

Wow. There's so much going on that I can see why they are leaning towards this being psychological. The thing is, your symptoms are so wide spread and nonspecific that it is very difficult to pinpoint anything. There is no single place in your brain that would give you all of these symptoms, on both sides of your body no less, and only transiently...

The only thing I could possibly imagine causing such variable, transient, with variable but global foci, would be some sort of cerebral vascular issue. The only disease I can think of that actually fits your symptoms pretty well is reversible cerebral vasoconstriction syndrome, but this is a rare disorder, so even though it does fit well, don't automatically assume that this is the only possibility out there.

Here's a basic review of RCVS:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020907/

If it hasn't been mentioned by your docs yet, then you could print it out to discuss it with them.

edit*
So I just did a bit of internet stalking and saw you posted on this earlier, and figured I'd mention one thing if I didn't say it well enough already, since you seemed to be worried about it, and that is that *this does not sound like a brain tumor at all*. The thing about the brain is that each part handles something specific, and while there are certainly areas where there is a lot going on, that could say cause numbness and muscular issues, they are not many, they probably wouldn't be bilateral (hitting both sides of your body), and I doubt there is any one place a tumor could be that would hit every neurological symptom you're describing. More importantly, with a tumor you wouldn't have transient symptoms that just go away, or such variability with each attack.


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## Demonicham (Aug 22, 2012)

Right now, I just need some form of symptom relief, especially cognitive wise. These symptoms cannot be ignored. they need immediate rectification. I understand that it could be stress, therefore, the antidepressants should be helping, but they aren't. and the headaches and symptoms are progressing, meaning something has been left unchecked.

A cluster of symptoms like this, I would say points to something neurological in nature but tests and scans showed nothing and I am at the point where I don't care if it is a serious condition, so long as they find it and treat it so I can start getting better and get my brain and mental functions back to normal.


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## lonelyjew (Jan 20, 2010)

Did you read about the condition I posted? I'm sorry if I didn't explain it well, and the paper I linked to it is somewhat technical. Your brain's blood vessels are pretty amazing in that they actively loosen or tighten up in order to make sure enough oxygen and nutrients get to your brain. The reason this is important is because your brain uses tons of both and so it needs lots of both of them constantly. The reason you die from a heart attack or being choked so quickly is because if you cut off this supply of oxygen and nutrients, the brain cells malfunction and die quickly.

Now, in RCVS, the problem is believed to be a malfunction of these blood vessels, which makes them tighten up, and block the blood supply to parts of the brain. Where this constriction(s) occurs will decide the part of the brain that will be affected (the specific symptoms), and the severity of the constriction, and how long it is sustained, will decide how bad the symptoms are, and how long they last. This sort of constriction is associated with migraines/headaches and transient stroke-like neurological effects. 

The symptoms you describe would fit into this disease for the most part, but they also fall into conversion disorder, which is a psychological disorder in which your psychological stress manifests into physical and/or neurological symptoms. Mind you, these symptoms are neurological in nature, but the difference is what is causing the neurological abnormality. The thing is though, that conversion disorder can only be diagnosed when you've excluded medical conditions that could cause the same thing, so again, if this RCVS hasn't been brought up, you should at least mention it just in case.

Lastly, how long have you been on anti depressants? Drugs like SSRIs take a few weeks to work and actually can make your anxiety worse until then. If you just started on them, try to wait it out a bit longer, but if it's been a while, and they aren't working at all, then you'd either need a different dose/drug for the anxiety.


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## Demonicham (Aug 22, 2012)

I've finished a course of amitriptyline, I started on citalopram but I had some kind of bad reaction to them so I had to stop them. and I've been on Mirtazapine for about 2 weeks now. none of them have had any kind of benefit to my symptoms, and now my visual disturbances are getting worse, flashing lights in my vision, objects moving when they aren't after keeping my eyes closed for long periods of time. also a period of completely blurred vision for a few minutes upon opening my eyes after sleep.


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## lonelyjew (Jan 20, 2010)

I realize this all very scary, and it is something that I and others who aren't experiencing what you are can't appreciate the gravity of the impact it is having on you. Neurological issues can be, well, scary, not just because of the bizarre symptoms, but because they can be very hard to diagnose. I wish I could simply give you an answer that would bring you comfort or a solution that would fix these problems, but I can't. I'm neither a doctor who has the specialized expertise to seriously advise you on this, nor would I be able to even if I was without actually having you in my care.

The best advice I can honestly give you is to see a psychiatrist and to try to relieve the anxiety/stress caused by your disorder, and not to try to get rid of this stress to stop the neurological symptoms. Your symptoms may or may not be psychological in nature, but I personally think that it would be far better for you to simply ignore this and simply work on feeling better emotionally. It may be hard to do, but if you can come to terms with what's going on, that it may not be a quick/easy fix, and that in spite of how scary this is, that you'll do your best to live the most happy life possible, even if your symptoms don't improve, your quality of life will. 

What I mean to say is that these symptoms are not in your control, but your happiness and outlook on life is, and so focus on that. In the very least, having strategies to cope with the fear and uncertainty would be greatly beneficial in simply dealing with this, and having a person to vent your feelings to will make you feel better as well. Who knows, maybe it'll go away if you can pull this off, but I wouldn't let that be your motivation. Even if this does not go away (let's hope it does), it does not mean you shouldn't be able to live a happy and worthwhile life. There are many people out there who have been stuck down by debilitating injuries and disorders, and the ones who've decided to keep living life to the fullest they can, and who try to appreciate what they do still have, live a far higher and more productive quality of life than those who define themselves by the limitations of their disabilities. 

Lastly, I don't know how much choice you have in your medical care, but try to find doctors who are open minded and who are interested in your case. Again, this very well could be a psycho-somatic, stress related, disease, but your doctors should be open to other possibilities should treating it as a psychological issue not work. Like I said, if they haven't talked to you about RCVS, it might be worthwhile to at least print out that link I sent you and ask them what they think. I could be way off, but even if I am, maybe it will at least get them thinking outside the box at other possibilities. 

Oh, and if you don't mind, would you be keep us updated? I'm a med student and it's an unfortunate fact that the types of medical disorders one would really hope to not have, are the ones that happen to be the most interesting. It's also good to hear your perspective in how you feel about your disease and your treatment (both medical and how you are treated as a patient).

Best of luck.


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## Demonicham (Aug 22, 2012)

Yeah, I'm trying my best to cope and deal with these symptoms and telling myself it's all in my head, but the symptoms are just too unsettling to ignore completely. there'll always be a part of my mind focusing on them. Yeah, thanks. I'm one of the unlucky few who happens to get a problem that's hard to diagnose. I just want answers and I thought the MRI would've given me them but obviously not.

Despite all these symptoms, I may just keep going but if these symptoms get any worse, then I would need to seek help medically. it's already at the stage where it's very very difficult to manage, affecting my ability to read, write and process words in general.


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## Demonicham (Aug 22, 2012)

Just an update.

So far, none of my symptoms are responding to treatment on the health anxiety diagnosis I've been given. my muscle twitches are getting more violent and abnormal. my heads starting to make strange jerks involuntarily. my ears will ring for a few seconds once every few hours. my heads getting a burning pain and I keep getting like a cold tingling in my elbows.

My cognitive abilities are getting worse, making silly mistakes that I normally wouldn't, having difficulty spelling and typing on my keyboard and on my phone. forgetting simple tasks such as how to prepare basic meals and forgetting how to do simple things on my computer. my speech is getting worse, my understanding of speech and general phrases is getting worse. nothing is responding to treatment and my symptoms are progressing. this is a clear sign that something has been left unchecked and is progressing at a steady rate.

I am tempted to go private again and see a neurologist and get an EEG. or an EMG if one is available in my area. as I will get my loan and I will have the funds to have these tests carried out. however, my university life and work is going to be greatly affected by these debilitating symptoms. I can't take it anymore, had it been stress, I'm sure it would've responded to medication/treatment by now. 

I know it's not a brain tumour, which is nice, but that isn't going to make my symptoms go away if there is something there, just the knowledge of not having cancer isn't going to cure this. that is, unless, the scan missed something, which is why I asked for contrast in the first place.

I am also considering getting an MRI neurography done, to have a look at my nerves and see if theres a blockage or pressure in my head anywhere. or an MRA. like you said RCVS is a possibility, and it needs to be ruled out. I need to narrow it down to what it has to be. instead of just assuming what it could be and waiting until life threatening symptoms appear before being certain on something life threatening.

Opinions?


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## lonelyjew (Jan 20, 2010)

Demonicham said:


> Just an update.
> 
> So far, none of my symptoms are responding to treatment on the health anxiety diagnosis I've been given. my muscle twitches are getting more violent and abnormal. my heads starting to make strange jerks involuntarily. my ears will ring for a few seconds once every few hours. my heads getting a burning pain and I keep getting like a cold tingling in my elbows.
> 
> ...


Can you go into detail on how your symptoms present? Are they transient, or are they chronic (if some are one, and some the other, can you specify?)? If they're transient, how long do they last for? Do they come on and/or disappear suddenly or do they gradually get worse/better? How often do they occur? Very importantly, what is the order in which they present? Do some come on first, then are followed by others? Is there a regularity/predictability, or is it random? Do the sensory and motor symptoms start out in one region and then spread? Are they worse at a certain part of the day/night? Do certain things seem to make your symptoms worse/better?

I realize that's a lot, and I wasn't going to ask for a detailed history, but it would be a lot easier for me to think about this if I had a clear idea of how your symptoms are presenting.

Also, I didn't ask earlier because I assumed that your doctors would have looked into the more obvious diseases, but did they talk to you at all about the possibility of this being migraine related (specifically basilar type), or epilepsy?


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## resquegurl (Dec 17, 2012)

*I've had similar problems*

My problems started Nov 1st 2012. My story is long but an abbreviated version is very similar to yours. The tingling, muscle spasms, stuttering and thought impairment all started suddenly. I've been hospitalized and tested and everything has come back clean. I see a neurologist tomorrow. The neurologist I saw in the hospital gave me three ideas of what it may be; seizures, migraines or Wilson's disease. The doctor tomorrow will hopefully be able to tell me more. I was put on celexa like you and had a bad reaction also. But I feel your pain and know what you're going through! Its very embarrassing to be out in public when this is happening. They put me on clonazepam 0.5 mg three times a day and it stopped my symptoms. But I had to scale back because I became so depressed I scared myself. The depression could just have been situational because I felt like I was going crazy because I couldn't control my body. I want you to know you're not alone and if you find out anything I would love to know and the same goes for me. Good luck my friend and be patient


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