Have Nystagmus, Swollen Lymph Node On Neck. Got Fainted. EKG, Blood Test Done. Any Suggestion?

Posted on Thu, 18 Apr 2013

Question: Hello. I am a 29 yr old, active mother of 3. For a few years now I have had episodes that come and go of severe fatigue, body aches, head aches and dizziness. My blood pressure runs low, averaging about 90/60. I was told that is not a problem, though orthostatic hypotension may be why I have fainted. I also have nystagmus, chronic swollen lymph nodes in the the left side of my neck and just a general feeling that something is going on. I have had a CT scan, an MRI that showed white spots in grey matter but was told that isn't significant, blood tests and met with a neurologist. I was referred to a cardiologist after fainting and having an EKG that showed minor right axis deviation, but the neurologist said that would not cause my symptoms. The episodes last from a few days, to a few weeks, and seem to be getting more frequent while lasting a bit longer each time. I have tried yoga, tried Dr's, tried clean eating, running, stretching, sleeping, bought a new mattress and pillows...I am running out of ideas. I just want to feel better. Any suggestions? I have an appt. with my primary care, who is the only Dr that seems to take me seriously in 2 weeks. If you have any ideas please let me know so I can ask about them, or if they are lifestyle changes, test them out. I live overseas on a military base, so meeting with any specialists is really difficult and involves driving across Europe. I will be going back to the neurologist for follow up, just looking for info/suggestions. Thanks!

Answered by Dr. Balaji Chinnasami (54 minutes later)

Hello,

Thanks for your query.

I am really concerned that you are suffering from illness. Some of the few causes you may ask your doctor to rule out anemia, hypothyroidism, hypotension, chronic fatigue syndrome, depression.

Since lymph nodes are enlarged, have you done any blood tests like complete blood count, ESR to rule out systemic diseases like Sarcoidosis. If your treating physician is MD XXXXXXX medicine, he will be able to evaluate all possible causes of your symptoms. Once major illnesses have been ruled out, I would suggest that you consider the impact of stress on your lifestyle. Getting a psychiatrist opinion will go a long way in complete evaluation.

Don't worry. Be relaxed. Keep doing all the good things like yoga, exercise etc. It will definitely help in the long run.

I am happy to help you if you have any further queries.

Balaji Chinnasami

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Balaji Chinnasami (44 minutes later)

Seeing a psychiatrist is already checked off, that was one of the first suggestions. They have done a full CBC a few times, and the blood work seems to be good. My Dr. has mentioned possible MS a few times but the neurologist didn't seem to think that was likely. I feel like I am chasing dead ends. I am doing everything I am told and not finding answers, but more importantly, not feeling better. This has been going on for a few years now. I was originally diagnosed with an adverse reaction to the anthrax vaccine and told the problems would clear up within a few months, after they didn't go away it has been test after test, with little things here and there, but no major findings/relief. I am not sure if they have done a ESR blood test and will ask. I know they tested for lyme but that was negative.
Oh and if it helps at all, there are a ton of random/strange symptoms. My right ear is constantly tickling inside, with random pain. I get hives from cold weather, tingling in my hands and feet. Also, we (my Dr and I) decided that while I was not feeling overly stressed/anxious to try Zoloft to see if it reduced my symptoms. I have been on it for 6 months now with no change.

Thank you!

Answered by Dr. Balaji Chinnasami (12 hours later)

Dear Madam,
I am glad that you replied with more information.

First question to be answered is - Is something really worse disease you are suffering?

From your history I would say, it is definitely not a serious illness. Normal, EKG normal, all blood tests normal. No serious disease happens without causing changes in these blood tests or imaging. In addition, it has not progressed rapidly in the last few years.

After careful exclusion of all major illness, which I feel your doctors have evaluated very well- I would like to suggest that this might be probably "Chronic Fatigue syndrome"

Fatigue that is not due to other causes, that keeps recurring, that feels worse after physical activity, associated with dizziness, muscle pain causing body pain, swollen lymph nodes fits into Chronic fatigue syndrome.

Cognitive behavioral therapy, graded exercise therapy, activity management, analgesics, lifestyle advice like pacing-balancing periods of activity with rest, avoid stressful situations, avoid alcohol, caffeine, spend time relaxing.

It may last for years but usually many either get relieved or starts adjusting to it by following above advices.

Don't worry you will be alright. Just discuss with him about this possibility.

Dr. Balaji Chinnasami

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E