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Suggest Treatment For Intracranial Hypotension
Question: 10 weeks ago (out of the blue) I started feeling really lightheaded and heart racing. I went to hospital and have had all sort of tests. They found out I was anemic (but levels are good now) and still issues. I have had the following tests and all are normal:
Lyme test, Thyroid test including TH3 and TH4, Nuclear stress test, Chest x-rays, Chest ultrasound, Heart ultrasound, Brain MRI MRA and CT scan with contrast, Multiple EKG's, Holter monitor for 30 days, Tilt Table Test, Uterine biopsies, internal ultrasound, Upper GI Endoscopy with biopsies, Colonoscopy, Ultrasound on carotid arteries, leg ultrasound, CT scan on abdomen and chest with contrast. I have been to a neurologist, cardiologist, GI Specialist, Gynecologist and ENT who says it is not an inner ear disorder.
Over the 10 weeks I am lightheaded, dizzy every day. Never when I am laying down, sometimes when sitting but mostly when I stand. My heart seems to race but seems in response to lightheaded feeling. Over the past 4 weeks I am now getting "lightheaded" feeling sometimes in knees and/or feet. Never at the same time as the head but always in both knees and/or both feet. I am also experiencing some arm weakness at times.
Prior to this I had not been to a doctor in 3 1/2 years other than my yearly exam and mammogram. This is completely disrupted my life as I can't drive and haven't been able to work. I am willing to try anything to get back to normal. PLEASE HELP!!
The gender is incorrect. I am a female.
Lyme test, Thyroid test including TH3 and TH4, Nuclear stress test, Chest x-rays, Chest ultrasound, Heart ultrasound, Brain MRI MRA and CT scan with contrast, Multiple EKG's, Holter monitor for 30 days, Tilt Table Test, Uterine biopsies, internal ultrasound, Upper GI Endoscopy with biopsies, Colonoscopy, Ultrasound on carotid arteries, leg ultrasound, CT scan on abdomen and chest with contrast. I have been to a neurologist, cardiologist, GI Specialist, Gynecologist and ENT who says it is not an inner ear disorder.
Over the 10 weeks I am lightheaded, dizzy every day. Never when I am laying down, sometimes when sitting but mostly when I stand. My heart seems to race but seems in response to lightheaded feeling. Over the past 4 weeks I am now getting "lightheaded" feeling sometimes in knees and/or feet. Never at the same time as the head but always in both knees and/or both feet. I am also experiencing some arm weakness at times.
Prior to this I had not been to a doctor in 3 1/2 years other than my yearly exam and mammogram. This is completely disrupted my life as I can't drive and haven't been able to work. I am willing to try anything to get back to normal. PLEASE HELP!!
The gender is incorrect. I am a female.
Brief Answer:
Brain MRI should be reviewed.
Detailed Answer:
Hi, I have gone through your question and understand your concerns.
As you already know, your case seems very complicated.
One thing that may be missed in your case is the proper evaluation of a possible intracranial hypotension, a rare condition where symptoms of headache, dizziness and lightheadedness worsen in upright position.
This needs to be reevaluated reviewing your MRI with gadolinium.
Signs in favor to this condition in MRI with contrast ( gadolinium) include narrowing of ventricular system and contrast enhancing of brain coverings ( meninges).
I suggest you to discuss with your Neurologist this possibility as cause of your symptoms.
Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Brain MRI should be reviewed.
Detailed Answer:
Hi, I have gone through your question and understand your concerns.
As you already know, your case seems very complicated.
One thing that may be missed in your case is the proper evaluation of a possible intracranial hypotension, a rare condition where symptoms of headache, dizziness and lightheadedness worsen in upright position.
This needs to be reevaluated reviewing your MRI with gadolinium.
Signs in favor to this condition in MRI with contrast ( gadolinium) include narrowing of ventricular system and contrast enhancing of brain coverings ( meninges).
I suggest you to discuss with your Neurologist this possibility as cause of your symptoms.
Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Above answer was peer-reviewed by :
Dr. Raju A.T
I have had multiple types of brain scans with contrast and shown nothing. I also typically do not have a headache with these episodes.
Brief Answer:
Better have a second opinion.
Detailed Answer:
Hi again.
Common conditions that cause dizziness and lightheadedness include ENT diseases (Benign positional vertigo, Meniere disease, middle and inner ear infection), but your ENT excludes them.
Other conditions include postural hypotension or lowering of blood pressure when standing from sitting or laying, but you say the tilt table test was negative.
Anemia also causes those symptoms, but when corrected symptoms should subside.
Impaired cerebrospinal fluid circulation may cause those symptoms too, so, in my opinion, having a second opinion about ENT evaluation and head MRI does not harm.
Hope this helps. Wishing you good health.
Better have a second opinion.
Detailed Answer:
Hi again.
Common conditions that cause dizziness and lightheadedness include ENT diseases (Benign positional vertigo, Meniere disease, middle and inner ear infection), but your ENT excludes them.
Other conditions include postural hypotension or lowering of blood pressure when standing from sitting or laying, but you say the tilt table test was negative.
Anemia also causes those symptoms, but when corrected symptoms should subside.
Impaired cerebrospinal fluid circulation may cause those symptoms too, so, in my opinion, having a second opinion about ENT evaluation and head MRI does not harm.
Hope this helps. Wishing you good health.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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