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Dr. Stan
Dr. Stan, Medical Physician and Surgeon
Category: Medical
Satisfied Customers: 2701
Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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Experiencing tightness (inflammation ) entire right side of

Customer Question

Experiencing tightness (inflammation?) entire right side of body. Several dr visits with no answer toward cause - hoping to identify cause, 2nd opinion, or questions to ask dr on next visit. Symptoms initially presented 6mo as right-side right-sided paresthesias transitioning over this time period to 'tightness' sensation with pain:
1. Above and to right of right eye back across scalp - strongly accentuated by raising eyebrows
2. Right cheekbone - accentuated by 'big' smile
3. Right side of neck from back of jaw/ear area running down along esophagus to collarbone (feels like a 'rope') - strongly accentuated by turning head to left'
4. Right shoulder blade area running down back, in the front, just below shoulder running down right side of nipple to lower ribcage. Strongly accentuated by inhaling deeply - feels like chest is tight and lung cannot fully inflate
5. Mild down outside shoulder outside of arm and forearm
6. Significant discomfort beginning beltline running down both front and back of leg concentrated mostly (front) above knee, calf, shin
7. Right side of throat feels mildly "sore"

Symptoms exclusive to right side of body. No real answers to date as to what could be cause. Am concerned for cancer, liver damage (alcohol hx), infection of some kind, or???
Submitted: 5 years ago.
Category: Medical
Expert:  Dr. Stan replied 5 years ago.

Welcome to Just Answer:

Based on the description of your symptoms, it appears that you had a stroke syndrome affecting the right side of the body. If is possible that the such stroke syndrome is related to an autoimmune inflammatory connective tissue or collagen vascular conditions such as seen in vasculitis conditions like polyarthritis nodosa, wegener's, lupus, rheumatic arthritis, Behcet's, and others. Other conditions such as migrating thrombophlebitis affecting the brain should be considered. I suggest that your doctor closely evaluate with tests including ANA, ESR, C-reactive protein, anti-sdDNA and anti-Sm antibodies, p-ANCA and c-ANCA, anti-scl-70 and MRA or CT brain angiography. In the meantime, it is likely that treatment with prednisone or other anti-inflammatory agents would significant reduce your symptoms.

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Customer: replied 5 years ago.
Apologies, I read your response very quickly. Clarification on 'stroke syndrome' - does that mean it was not actually a stroke or that it may have been? Stroke was in fact the initial concern of Dr, but one week after initial symptoms onset (occurred overnight) I had an MRI done and it was apparently "normal". Stroke was never mentioned again. Is it being suggested that I request my Dr to revisit the possibility that a stroke occurred? I have no significant motor skill issues so between that and MRI results presumed stroke was off the board as root cause. I do get very brief and infrequent bouts of dizziness. (Most often occurs during landing for air travel - I fly very often for business). Again apologies for the follow-up but took a while to digest the reply. Will send a bonus for your time. Thanks!
Expert:  Dr. Stan replied 5 years ago.
Thank you so much: Sorry for the delay in reply.

There are inflammatory or abnormal blood vessel conditions that can affect small and medium blood vessels, including those in the brain to cause changes in blood flow, with symptoms that resemble stroke - resulting from bouts of blood flow interruptions especially during exacerbations. MR or CT angiography along with other autoimmune inflammatory condition testing as mentioned above can be used to support such consideration. I suggest that the doctor re-visit the possibility that this may be related to persisting vascular abnormality in the brain which tend to worsened with changes in altitudinal pressure, affecting blood flow and causing symptoms that resemble stroke. In the addition, I suggest that your doctor consider including PET scan study in the diagnostic portion to assess the blood flow in the different parts of the brain.