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Light headed and confused with headache. Also have rashes and hive. Blood work, sinuses, CT scan normal. Reason?

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Neurologist
Practicing since : 2001
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i am feeling light headed confused for already weeks have a headache right side around temple with pain going towards nose and area above right eye and right side of mounth and have rashes of hives coming and going every day and sometimes weak feeling in right arm no balance problems it comes in attacks during the whole day coming and going have had ct scan of head and sinuses all ok checked hart with diagram ok blood test ok dont no what to do anymore feel terrible
Posted Thu, 19 Apr 2012 in Headache and Migraines
 
 
Answered by Dr. Shiva Kumar R 28 minutes later
Hello,
Thanks for posting your query.

From the details provided, it looks like you have dizziness, confusion, headache, rash on right side of the face and probable weakness of the right arm. Considering the overall features, the possibilities that should be considered are either an infective process or vasculitis (a disorder due to the involvement of the blood vessels). A computerised tomography scan (CT scan) is a poor investigating tool for the above causes.

So I personally feel that you need to consult your neurologist for a good clinical examination and consultation as early as possible to rule out causes like meningitis, chicken pox and vasculitis and also chickenpox. You may need further investigations like a magnetic resonance imaging scan (MRI scan) of the brain, a spinal tap ( also called a lumbar puncture) and a work up for vasculitis.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Shiva Kumar R
Neurologist & Epileptologist
Above answer was peer-reviewed by
 
Follow-up: Light headed and confused with headache. Also have rashes and hive. Blood work, sinuses, CT scan normal. Reason? 59 minutes later
not totally agreeing witht this it is already ongoing issue for a 1.5 years the rash i have is a hives rash coming going together with a itch dont have fever or any other symptoms fitting chiken pox or menginitis i think my doctor has laready ruled out this for vasculitis had a complete pet scan in late 2010 after colon surgery to remove a polyp following conclusion of brain focus of calcification seen at anterior falx no idea what this means (same symptoms) all arteries were looking good at complete pet scan head tot toe had collon o scopy end of 2011 noting found but still light headed etc. so there is no other cause please help my
 
 
Answered by Dr. Shiva Kumar R 33 minutes later
Hello,
Thanks for the providing the details about the duration of the illness and the previous investigation reports. I do agree with you that meningitis and other infections cannot be of such long duration. As there is no evidence for vasculitis and other infectious causes, the possibility of demyelination needs consideration. Rarely, psychological causes can present in similar way.

Calcification in the falx is a normal finding in many and needs no evaluation. A positron emission tomography scan (PET scan) is ordered to see if there are any hot spots in the body when one has suspicion for malignancy. However, itdoes not provide details of the brain structures as seen on the MRI.

So, I still feel that a magnetic resonance imaging scan (MRI scan) of the brain would be required to rule out treatable causes. Based on the findings, a spinal tap and other relevant investigations would be required.

Let me know if I have missed out any other concern in your question.

Wishing you good health.

Regards,

Dr Shiva Kumar R
Neurologist & Epileptologist
Above answer was peer-reviewed by
 
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