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What Causes Low BP With Headaches And Tiredness?

Posted on Wed, 17 Sep 2014

Question: My blood pressure is 91/55 with a pulse of 79. I generally run low...about 110 or less over 70. I had slight Pneumocephalus a couple of weeks ago with no known cause and after hospitalization brain ct's have been normal. I am being checked for a possible slow csf sinus leak but that will take awhile to determine. I am taking amoxicillin for possible ear and sinusitis, 50 mg Nortriptylene for depression and fibromyalgia, 0.5 Klonopin as muscle relaxer after a cervical laminoplasty surgery 15 months ago that is still causing me great pain. Yesterday for a new annular tear found at c-7, after a week of prednisone 5 mg, I began to take Motrin 600-800 mg every 8 hours and I accidentally took 5 mg prednisone with that. I also took 1 mg Klonopin for neck pain and the 500 mg amoxicillin. In the evening last night I felt very shaky with gi upset and my pupils were tiny and I was very dizzy. This morning I was also very dizzy and I saw the doctor who got very low BP readings. I was sent home told to drink a lot and ear foods high in salt but my pressure is still low. Tonight I only took 0.5 mg Klonopin no nortriptylene and none last night. Is my pressure dangerously low? I had a bout of orthostatoc hypotension in 2012 that resolved. I am also very tired and have a bad headache.

Answered by Dr. Dr. Naveen Kumar Sharma (26 minutes later)

Brief Answer:
I think you need to get MRI of the brain

Detailed Answer:
Hello,
I have studied you case, and I want to first suggest you to not take Prednisone, as it will increase chances of infection in brain and cause meningitis.
Hypotension in your case can be either due to infection in brain or can be due to cervical spondylits.
So I have following suggestions for you.
1. Drink lot of fluid,with salt.
2. Get MRI of the brain and spine. If there is any sign of infection then infection can be treated aggressively. For neck disc prolapse, use cervical collar so that vertebral artery compression will improve.
3. I would also suggest you to avoid muscle relaxant, as it can cause sedation and Low blood pressure.Discuss all about this your treating doctor.
Please send me MRI report of brain and spine. I hope this answer will be useful for you.
Thanks

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Dr. Naveen Kumar Sharma (13 minutes later)

Thank you doctor. Brain MRI was done at XXXXXXX Presbyterian hospital on August 8 and results were normal. Do you suggest a new one?

Also doctor, cervical spine MRI was done last week and the annular tear at c-7 was found. That's why prednisone was given in order to take down nerve inflammation.

Sorry one more thing doctor...at the ER several days ago white blood count was 12,000 and cause was unknown. My GP repeated labs today and will have results tomorrow. Do I need to go to an ER now?

Answered by Dr. Dr. Naveen Kumar Sharma (27 minutes later)

Brief Answer:
I would suggest you to repeat MRI

Detailed Answer:
Hello,
I would suggest you to repeat MRI of the brain. Also if possible get CSF examination also. It will give us complete picture about the present condition of the brain.
For neck condition at present I would suggest you to take cervical collar only. Do not take lot of medicines as there can be cross reaction.
Blood count is slightly high,I would recommend you to show it to a neurologist as at present our priority is to treat infection in the brain.Kindly do follow up with your GP.
Still If you are having Low blood pressure and dizziness then go to ER where a neurologist will be available as well.
I hope this answer your query. Let me know if there is any other followup query.
Thanks.

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Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju