Suggest Treatment For Severe Headaches, Confusion And Difficulty Walking

Posted on Sat, 27 Dec 2014

Question: I am asking this regarding my 35 yr old daughter.....6 years ago she had a sinus infection...they gave her cipero and she had a bad reaction too it. since then she has had a lot of problems starting with bad headaches, after that it goes to mental confusion and after that she can't walk. she has the happen often with the symptoms in that order. She also has lyme disease. It has been happening more often. these symptoms will last for days and then she will be able to walk fine. She has been to many doctors but no one seems to know what the problem is

Answered by Dr. Noble Zachariah (23 minutes later)

Brief Answer:
More information required.

Detailed Answer:
Hello,

I appreciate your concern for your daughter.
There are a number of possibilities. But the present symptoms are not due to the ciprofloxacin she took 6 years ago.
I would like to have more information on the tests she has undergone.
Did she have a MRI of the brain during one of these episodes? Did it show any plaques?
Has she been cured of Lyme disease because it can have neurological manifestations.?
Let us work through the problem systematically with all information on board.

Dr Noble Zachariah

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

Follow up: Dr. Noble Zachariah (32 minutes later)

I don't know if she was cured or not by the way she also had babesia (don't know the spelling of this). She was on meds for a few years and she thinks she developed allergies to her meds...I am not sure of that because what she says are reactions are the same as her symptoms now. Well actually they are a bit worse when she's on the meds. Her brother had the babesia also but he just lost use of his arms and legs and was cured in a few months (he never had the head aches or mental confusion) She did have an adrenal issue too. I was thinking maybe she also had some autoimmune problem too. (sister w/RA another with grave and some other thyroid disease and I am type 1 diabetes) She thinks its just the babesia (sounds like you think she is right (???) )

Answered by Dr. Noble Zachariah (12 minutes later)

Brief Answer:
Unlikely to be Babesiosis

Detailed Answer:
Babesiosis is a malaria-like parasitic disease.
There is usually fever and some of the other symptoms like Headache
Myalgia, or muscle pain
Anorexia
Nonproductive cough, meaning that mucus is not coughed up
Arthralgias, or a non-inflammatory joint pain (unlike arthritis, which is inflammatory).
Nausea, feeling uneasy in the stomach
Vomiting, or throwing up
Sore throat
Abdominal pain
Conjunctival injection, or pinkeye
Photophobia
Weight loss
Emotional lability
Depression
Hyperesthesia, or becoming more sensitive to stimuli
Splenomegaly, an enlarged spleen
Pharyngeal erythema
Hepatomegaly, an enlarged liver
Jaundice, yellowing of the skin
Retinopathy with splinter hemorrhages
Retinal infarcts
She does not have such features.
My first in the differential diagnosis is Multiple Sclerosis.
If she has not had a MRI, it may be helpful.

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

Follow up: Dr. Noble Zachariah (22 minutes later)

Thanks. When her brother had it, it started with no use of his arms and went to his legs ( he was in a wheel chair for a few months) but his symptoms got progressively worse (he had none of the other symptoms) where hers seem to come and go and he was cured of it and to this day he had no other problems. I do think she did have a MRI a few years back. I do think she said that they saw a spot or something.... but they did not say to come back or that they thought it was anything to do with her condition...... Going back to my son they told him that he had myasthenia gravis (his grandma has it) put him on steroids and he got worse(that was at a very good hospital here... this daughter told him to get a Lyme and coinfection test and he was treated from it then (yes he did go off the steroids and only took the other meds) and was cured in a few months. Would the MRI show MS or does it take a. while to show up on the brain??

Answered by Dr. Noble Zachariah (35 minutes later)

Brief Answer:
More plaques may appear with time

Detailed Answer:
You are welcome.
I think your son had Lyme neuroborreliosis and was successfully treated.
The spot that was seen on your daughter's MRI could have been a plaque lesion - a sign of MS.
With time the plaques may be more and seen more often when there are signs and symptoms.
Has she had her blood Potassium checked during an episode?
Periodic paralysis is another differential.
If you could send me the reports of the tests and imaging studies she has done so far, I would review them.

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

Follow up: Dr. Noble Zachariah (2 days later)

her mri was about 5 or 6 years ago (when she lived in another state) they said the spot was nothing. Yes she did have her blood potassium level check during and episode and it was low...(how low I don't know) I know she started taking supplements for it. I would love to get her records for you but I don't know if that is possible...she has lived in 3 different states. I think they should be here for a long time... What does her potassium level have to do with it???

Answered by Dr. Noble Zachariah (11 minutes later)

Brief Answer:
A rare disorder called Hypokalemic periodic paralysis

Detailed Answer:
Welcome back.
There is a rare disorder called Hypokalemic periodic paralysis . It is autosomal dominant channelopathy ( high incidence in siblings - ? her brother has the same ) , characterized by muscle weakness or paralysis with a matching fall in potassium levels in the blood . In individuals with this mutation, attacks often begin in adolescence and are triggered by strenuous exercise followed by rest, high carbohydrate meals, meals with high sodium content, sudden changes in temperature, and even excitement, noise, flashing lights and induced by cold temperatures. Weakness may be mild and limited to certain muscle groups, or more severe full body paralysis. Attacks may last for a few hours or persist for several days. Recovery is usually sudden when it occurs, due to release of potassium from swollen muscles as they recover. Some patients may fall into an abortive attack or develop chronic muscle weakness later in life.

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

Follow up: Dr. Noble Zachariah (14 minutes later)

She did not have this in her youth...it just started about 6 years ago. Her brother hasn't had this since he was diagnosed with lyme and took the meds for it.. unless you mean that lyme caused the hypokalemic. Does it come along with sever headaches and confusion? Who would one see for that? (what kind of doctor)

Answered by Dr. Noble Zachariah (16 minutes later)

Brief Answer:
Neurologist would be the doctor to be consulted

Detailed Answer:
What I wrote is a general description of hypokalemic periodic paralysis.
All do not follow the typical description. Some features present, some absent.
Since it is a rare disease, it is often missed unless one specifically looks for it.
It may co-exist with other conditions or illnesses.
I think it would be best for her to see a neurologist.
If she sees a neurologist, please let me know his/her opinion.

Have a good day

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

Follow up: Dr. Noble Zachariah (8 minutes later)

Oh!! Thanks very much!! I will let you know.

Answered by Dr. Noble Zachariah (5 minutes later)

Brief Answer:
You are welcome

Detailed Answer:
You are welcome.
Your daughter is lucky to be blessed with a mother like you.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

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