Tinglings on my skull

[boute]

Hello,

I saw my ENT last week because I can feel pain in my throat, my ear and I have tingling on the left part of my skull with itches on both sides of my skull with headaches sometimes. He already diagnosed me in March 2008 with a geniculate herpes zoster (the one which gives chicken pox and shingles) and told me that those symptoms could be related to this virus. So last week when I went back to his office he told me that the virus is probably active again.
Last year, at the same period of time my PCP referred me to a neurologist who diagnosed a MS (multiple foci of white matter signal abnormality (multiple foci of hyperintensity are demonstrated on FLAIR and T2 pulse sequences involving periventricular and hemispheric white matter. There are lesions demonstrates at the collosal septal interface without discrete lesion seen in the corpus collosum. No areas of restricted diffusion demonstrated. No space occupying mass lesions, extra-axial collections or hemorrhage is noted… The visualized segments of the internal carotid and vertebrobasilar systems demonstrate signal void, consistent with their patency).
My ENT told me that brain inflammation of the white tissu could be the result of the presence of the virus in my nervous system and not the result of MS.

I would like to get your opinion about this.
Thank you for your help.

[boute]

Thank you very much for those information. My ENT prescribed me acyclovir but it doesn't really make a difference regarding the symptoms I have. Anyway, I made an appointment with my neurologist on May 26. I guess he will ask for an other MRI. I am turning 43 and I am healthy (vegetarian, daily yoga practice, no drinking, no smoking) but I have always had a pretty high level of cholesterol due to an hereditary factor (my dad had that but a very healthy heart).
This time my ENT didn't do any further exam, he just guessed that it is the same virus than last time I saw him.
Is that true that this kind of virus takes place in the nervous system all life long and can come and go anytime?
What really bothers me are thos tingling on the left part of my skull, the top of my ear which becomes red sometimes. I can feel sporadic tingling (just one shot) on my left jaw and left part of my chin as well. That is very strange.
Anyway, the MRI will tell if those white spots are still here. But last time I saw my neurologist (last year), he told me that the herpes zoyster located in my nose had nothing to do with the white spots. He didn't even want to hear anything about this… which sounded weird to me. I had a cervical spine MRI and a thoracic spine MRI which came back both negative, even my blood test came back normal.
Let's see what the next MRI will have to reveal but I don't really have the symptoms of the MS.

Thanks again for your help. I truly appreciate.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history and review your MRI, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

In general, it is correct that if the virus that causes zoster, the chicken pox virus or what is medically known as the varicella virus, involves the arteries of the brain, MRI abnormalities and other neurologic problems can result. Clues to this would be symptoms not referrable to a specific nerve distribution. Meaning if you were diagnosed with zoster of the geniculate ganglion, and you are having symptoms that could not be localized to the area supplied by the geniculate ganglion, then there would be concern that you have, for example, meningitis or vasculitis (inflammation of the arteries of the brain) due to this virus. If there was concern for this, the diagnosis would be made by (1) MRI (2) a lumbar puncture, so that the spinal fluid can be analyzed for the virus using specific lab tests (3) sometimes an angiogram, to visualize the vessels that supply the brain. If this condition, central nervous system varicella infection, is diagnosed, treatment would need to be with IV anti-viral medications (acyclovir).

However, there are several causes to so-called white spots on the brain, MS is one, vasculitis (due to chicken pox virus or other infections or autoimmune disorders), migraine, and most commonly what is termed small vessel disease, or ", literally meaning diseased small vessels that supply blood flow to the brain. This is not an uncommon process in the brain and increases with age. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by years of plaque build-up. This is most often due to a combination of several factors including the following: high blood pressure, diabetes, smoking, and high cholesterol. If these factors are well controlled, the damage to the brain can be stabilized and further damage prevented.

I strongly recommend continued follow-up with your neurologist if there is suspicion that your MRI abnormalities could be due to the zoster virus (varicella virus).

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.