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I Have Been Concerned That I Have A Neurological Problem,
Question: I have been concerned that I have a neurological problem, but I do not know where to start or which specialist to see. I have been feeling "off" lately, with problems with proprioception and feelings like I am going to pass out. I have "floaters" in my right eye, and that has been occurring for about a year now. I saw my eye doctor and he said there was nothing alarming. Additionally, I have had R neck stiffness for about a week, with a prickly sensation in my R jaw and R arm. A while back I had discharge from my nipples, so I went to get my levels checked and they were regular. Last, I sometimes have pressure in my throat. Do you have any suggestions? What could this be? Should I have a high level of concern for a tumor?
Brief Answer:
Further work up is needed.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted your clinical details. I agree that you require further evaluation. In view of discharge from nipples and normal hormone tests, I presume PROLACTIN levels were normal. You would require a detailed neurological examination, followed by blood tests for vitamin B12 deficiency. This is because B12 deficiency can cause problems with proprioception and visual disturbances. The chances of a tumor are not high, however, if symptoms persist, a brain scan may have to be done.
I sincerely hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
Further work up is needed.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted your clinical details. I agree that you require further evaluation. In view of discharge from nipples and normal hormone tests, I presume PROLACTIN levels were normal. You would require a detailed neurological examination, followed by blood tests for vitamin B12 deficiency. This is because B12 deficiency can cause problems with proprioception and visual disturbances. The chances of a tumor are not high, however, if symptoms persist, a brain scan may have to be done.
I sincerely hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Okay. So, it is suggested to follow up with a neurologist? Could I start vitamin B12 on my own until I see someone? I appreciate your help. My proprioception gets so bad sometimes that I get butterflies.
Brief Answer:
Yes, you should follow up with a neurologist.
Detailed Answer:
Thank you for getting back.
You can start vitamin B12 supplements until you review with a neurologist.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Yes, you should follow up with a neurologist.
Detailed Answer:
Thank you for getting back.
You can start vitamin B12 supplements until you review with a neurologist.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is there any other conditions that this could be?
Brief Answer:
As of now, no other conditions seem likely.
Detailed Answer:
Thank you for getting back. As of now, possibilities mentioned in the first reply are more likely, and no other conditions seem likely at this stage.
Dr Sudhir Kumar MD DM
As of now, no other conditions seem likely.
Detailed Answer:
Thank you for getting back. As of now, possibilities mentioned in the first reply are more likely, and no other conditions seem likely at this stage.
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I thank you for everything and my mind is put at rest. last question is -
I'm in the military and my hgb and hct were regular during a check up. does this suggest that my b12 is normal? because I thought that would cause anemia.
I'm in the military and my hgb and hct were regular during a check up. does this suggest that my b12 is normal? because I thought that would cause anemia.
Brief Answer:
B12 deficiency can occur without anemia.
Detailed Answer:
Thank you for getting back.
I agree with you that vitamin B12 deficiency usually causes anemia with low hemoglobin and low MCV (mean corpuscular volume). However, vitamin B12 deficiency can occur without anemia and with normal MCV. There are many research papers on this topic, including our own research. You may read one such article at the following link:
https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-015-1437-9
Best wishes,
Dr Sudhir Kumar MD DM
B12 deficiency can occur without anemia.
Detailed Answer:
Thank you for getting back.
I agree with you that vitamin B12 deficiency usually causes anemia with low hemoglobin and low MCV (mean corpuscular volume). However, vitamin B12 deficiency can occur without anemia and with normal MCV. There are many research papers on this topic, including our own research. You may read one such article at the following link:
https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-015-1437-9
Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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