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Pauline
Pauline, Doctor (MD)
Category: Health
Satisfied Customers: 8631
Experience:  Medical Doctor & Registered Pharmacist. Worked as Community pharmacist for 17 years.
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I was recently hospitalized for vertigo for 5 days. I had many

Resolved Question:

I was recently hospitalized for vertigo for 5 days. I had many headaches and nausea. I, too, am an RN. The doctors did an MRI of the brain which showed lesion to the left frontal side of the brain, they say it has nothing to do with the dizziness. They also did a lumbar puncture. The nuerologist stated that it was a traumatic lumbar puncture where he hit a vessel and most of the CSF was pink instead of clear. He made a statement that left me wondering, he said that my pressure was on the normal high end (20). I am not sure what this mean, could it be that I have intracranial hypertension, if so what are the signs and symptoms, I was medicated with antiseizure medication for my headaches. What about my lesions, what part does this affect. My history is depression, scoliosis, migraines.
Submitted: 5 years ago.
Category: Health
Expert:  Pauline replied 5 years ago.

Pauline :

Intracranial hypertension can have non specific symptoms such as headache, vomiting (usually no nausea) and also some visual disturbance, reduced consciousness and then more serious changes to heart rate and breathing rate with higher levels of hypertension.

Customer:

I had double vision, short term memory loss. No vomiting, weakness to the left upper and lower extremity

Pauline :

The important factor was that your level was under 25. If there had been signs of elevated intracranial hypertension then the LP would not have been done.

Customer:

My heart rate is usually high, 80's at rest and 150's when ambulating\

Pauline :

Your heart rate would have decreased with significant hypertension.

Customer:

No, I have high heart rate and low BP

Pauline :

You do have a mixed picture of symptoms which do not completely fit the left sided lesion seen on MRI

Customer:

Left sided lesions means what?

Pauline :

Left sided lesions usually mean right sided symptoms.

Customer:

Nothing seems to make sense

Pauline :

You will need follow up with a neurosurgeon to determine what is the nature of the lesion in the left frontal lobe. However nausea, and dizziness may have been a viral inner ear infection...there are several possible causes of your symptoms. The LP was done to exclude infection and a type pof bleeding in the brain.

Pauline :

If LP was essentially negative then this was a good thing.

Customer:

Not all the results are in. Every time I see the neurologist it seems like a waste of time.

Customer:

I have had 5 MRI in 18 months, they all show the lesions but no explainations

Pauline :

Do you have multiple lesions? And is this the gray matter or white matter?

Customer:

Multiple white matter lesion, they were trying to rule out ms

Customer:

Because I suffer from major depression this takes a toll on me emotionally.

Pauline :

I can appreciate that this is frustrating but with multiple lesions then MS has to be considered. You may need a repeat LP so that they can obtain a 'non-traumatic' LP and look for oligoclonal bands.

Customer:

The last tube was sent for oligoclonal bands since the CSF was clear

Pauline :

This can be a worrying time but you need to focus on small positive objectives such as trips out, or activities to keep your motivation up. Joining a gym would be good as regular exercise is good ,even if MS is the eventual diagnosis.

Customer:

All the MS tests have come out negative

Pauline :

If MS has been ruled out so far then this is good. Multiple lesions may simply be an age related feature.

Customer:

What's frustrating the most is that I have problems with word finding

Pauline :

Word finding difficulty can sometimes be stress related...if this was due solely to a brain problem then the MRI may have shown a lesion in the centre associated with expressive speech, this is not in the frontal lobe. Some studies have shown people with word finding problems to have more generalised lesions so it is possible that this is the underlying cause for you .

Pauline :

Some therapy to help deal with stress and uncertaintly of your diagnosis may help you deal with this on a day to day basus.

Pauline :

basis.

Customer:

What test other than the visual evoked tests can be performed to r/o ms

Pauline :

You need to prove negative for oligoclonal bands on LP. However there is no test that can 100% rule out MS. You do not mention any problems with limb weakness, other focal neurology, loss of bladder function or gait changes so we can say that MS is less likely at the moment although risk is not zero.

Customer:

I have left sided weakness, double vision

Pauline :

So...is your left sided weakness picked up on neurological examination by the doctor?

Customer:

I work full time but once home I am unable to function. Yes the doctor can see the weakness

Pauline :

And is the weakness continual or does it come and go?

Customer:

continual

Pauline :

A continual problem is not in keeping with MS...which is usually a relapsing and remitting disease with symptoms affecting multiple areas. I am sorry that I cannot give you exact answer to the underlying problem, but your neurologist should also be looking at other possible causes such as nerve compression in the spine.

Customer:

Thank you for your time\

Pauline :

A full neurological examination can usually establish if this is an upper motor neurone lesion (the brain) or lower motor neurone ( the nerve roots)

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