Diagnosed With TMJ And GAD. Getting Headache And Feeling Dizzy. Cause And Cure?

Posted on Sat, 22 Dec 2012

Question: Hi Doctor: My symptoms are dizziness, off-balance feeling, tingling in the legs and hands and throbbing headaches behind the eyes. This has been going on for more than 2 1/2 years. I've been through $10,000 in tests this year and the only thing they found is MGUS, IgG Kappa 0.4. The rest of the blood tests were normal. My hematologist sent me for a full body xray which was normal. I've been to two ENTs including the House Ear Clinic which ran tests and said it's not the ear but "central XXXXXXX I've had an EEG, brain (with contrast), lumbar and cervical MRIs, EMG, heart and leg ultrasound, ankle brachial indices, sleep study test and eye exams. Cervical MRI showed some disc compression but the neurologist said it's not pressing on the spinal canal and unlikely to be causing the symptoms. All the other tests were normal. Also diagnosed with TMJ and GAD (generalized anxiety disorder). I took low does Klonopin and Celexa for years, but stopped them gradually a year ago because I thought they might be contributing to the dizziness. Could MGUS be causing the tingling and numb feelings the legs and hands? How about the dizziness? Thanks so much for your help.

Answered by Dr. Robert Galamaga (15 hours later)

Hello and thanks for your query.

MGUS at the level you currently have would cause virtually no symptoms as all. It would not contribute to dizziness as well assuming that your complete blood count was normal with a normal hemoglobin.

I would make sure you have assessments of your thyroid, vitamin B and vitamin D levels as well as this could cause issues. Also, any electrolyte imbalance such as low potassium or magnesium could contribute to this.

I suspect this may be related to the underlying GAD which can have very strong physical symptoms. There are many new medications available for this and I would encourage a discussion with your doctor or maybe a referral for psychotherapy and to a psychiatrist to discuss continued management.

Again the MGUS is not causing any of your symptoms. It should be monitored yearly in the future.

Thanks again for your query. Please let me know if you have any additional concerns regarding this matter.

Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (13 hours later)

Hi Dr. Galamaga: Thank you for your quick reply. Yes, the blood count was normal. I had the thyroid checked a couple of years ago and it was normal too. The tingling, numbness neuropathy like symptoms, feeling of off-balance and dizziness are experienced by many other people with MGUS that I've found on-line. However, my hematologist said that this is not common and that she could treat it with Prednizone, which didn't work when the orthopedist prescribed it for me. My symptoms are almost MS like, however the brain scan was normal. I'm going for vestibular rehab therapy, even though it's "not the ears" which seems to be helping a little. I'm leery of any benzodiazepine or SSRI due to my prior experience and the fact that they make me very drowsy. Thanks again for your suggestions.

Answered by Dr. Robert Galamaga (7 hours later)

Hello again and thank you for your follow-up.

Again there has been no published research which strongly indicates that MGUS is associated with the type of neuropathy that you have described.

I would encourage you to possibly see a neurologist for a full assessment. If the neurologist is not convinced that you have a primary neurological issue then it might be reasonable to consider medication such as benzodiazepine or serotonin reuptake inhibitors.

I realize this is a very stressful situation for you and I am confident that in time the symptoms will come under good control with continued patience and investigation by your physicians.

Thanks again for sending your question. Please let me know if I can be of any additional assistance.

Dr. Robert

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar