Numerous weird symptoms over 5mths

[Sonaya]

I am a 38yr female, with high cholesterol.  Apart from this on no medications & have no other medical illnesses. 5 Mths ago I went to ER for what were thought TIA/stroke like symptoms. Came on suddenly, loss of hearing in one ear, double vision and eye bluring, massive head pain like I have never experienced before, unstable on feet, left sided facial numbness, confusion and vagueness with inability to get my words out. Had a full work up of bloods, MRI without contrast of brain & lumbar puncture all normal.  CT of head normal. Dopplar studies of carotid artery all normal. CT of sinuses found 5mm minor opacification of the left maxillary. But nothing to worry about.  4wks later had another turn more violent than the last & now happening more frequently since then my "attacks" have taken on more symptoms of numbness, tingling, pins & needles all on my left side.  Hand, arm, shoulder, back, leg.  With this comes muscle weakness and pain. Sometimes the muscle pains are extremely bad, heat seems to help.  Sometimes I dont get any head pain at all just the blurry vision and sometimes for 30 secs complete blindness in one eye. Muscle twitching and radiating heat, burning like spots and profuse sweating, with a stiff neck now and spinal pain going straight down the middle from base of my neck to base of my bottom.  This is something new.  Sometimes noticed watching tv triggers these "attacks" but sometimes they dont'.  I have also more recently had left sided chest pain with radiating heat going up my shoulder blade, down my left arm, up my neck and around to my back, with profuse sweating and short of breathe, not overly active, thought maybe angina so had a stress test today, came back normal. Sometimes  get head pressure buildup so bad clear liquid comes out of my left nostril.  MRI of spine done recently, don't have results yet. GERD & panic attacks have been ruled out. This is affecting my life daily that I have had to stop work. Thanking you in advance.

[Sonaya]

Thank you for your comments, I am getting tested for lupus, thyroid, rheumatoid arthritis and awaiting tests and I see my specialist in 2 wks with my physician.  My own doctor has since advised it looks like I have Familial Hemiplegic Migraine with cerebellar, ataxia and a type of seizures.

I would like to ask another question about an attack I had last night that was so out of character and the symptoms took on a new turn.  It has me really worried.

I got the aura symptom first of visual disturbances, blurred vision, fatigue, muscle weakness.  I had been feeling not myself all day and thought maybe the migraine was going to come on.  I went to lay down for a little while then got up , my eyes were really blurring and heavy and although I had no pain in my head it was a type of pressure.  My husband came home with some dinner and he got the wrong food and I just lost it, flew of the handle, got myself into a state for no reason, was very angry, abusive and it was like I was someone else, all this time I felt like I was in a trance like state, I would stop and just sit and gaze and say nothing and all this time I felt like my brain was going to come out of my head that it was going to explode and yet there was no pain just pressure and problems with my eyes.  After I stopped yelling I went again into a trance like state where I just sat and gazed and then my left arm went numb, left side of face numbness, muscle pains, I had trouble breathing, and my whole body went into like a bit of a spasm. I couldnt think straight, was vague, all similar symptoms like before but this flying of the handle over something so petty and silly, I scared my family with this behaviour and I scared myself, it was so out of character that I just cant explain what happend. This whole thing last about 1hr and then I came good.
Would  you call this a type of seizure related to the FHM that I have recently been diagnosed with even though I didnt really have a headache?

[Kevin Pho, MD]

I agree with all the workup thus far, and it has been comprehensive.   Various neurologic disorders, including MS, should be considered.  The MRIs, LPs and CT scans would exclude the major possibilities.  Another test to consider would be evoked potentials.

You can also look for metabolic diseases like B12, thyroid dysfunction or diabetes.   Peripheral neuropathy can be evaluated with nerve conduction studies.

These options can be discussed with your personal physician.  I would consider a neurology consult, preferably at a major academic medical center where some of the specialized tests can be obtained.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com