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Suggest Treatment For Excessive Sweating, Fatigue, Headaches And Dizziness

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Posted on Wed, 19 Aug 2015
Question: I have excessive sweating, fatigue, and have headaches with some dizziness for years. what did this mean? FINDINGS: Mild prominence of the extra-axial spaces of the supratentorial brain possible degree of mild cortical atrophy. Ventricles are in the midline without mass effect, edema, hydrocephalus or midline shift. Supratentorial white matter changes are present which may relate to chronic end vessel ischemic change and/or history of demyelinating process or Lyme's disease or vasculitis.No restricted diffusion. No midline structural abnormality. No XXXXXXX cerebellar tonsillar ectopia. Flow voids of the circle of Willis are present. Apparent ectatic vessels of the circle of Willis, correlate if patient has a history of hypertension. Nasopharyngeal soft tissues are symmetric. Bilateral globes are intact without proptosis. Opacifications of the bilateral ethmoid air cells. Mild circumferential mucous thickening both right and left maxillary sinus and more pronounced mild circumferential the study and bilateral sphenoid sinuses. Circumferential mucosal thickening of hypoplastic right frontal sinus and partial opacification both right and left frontal recess. Impression:Small supratentorial periventricular and subcortical nonspecific leuko-dystrophic plaques approximately 9 or 10 in number, recommend post gadolinium images of the brain and MRA circle of Willis given patient's history that there is ectasia regarding vessel circle of Willis Correlate if symptoms are referable to cervical radiculopathy as well. i have no history of hypertension or Lyme's disease, I was electrocuted several years ago at 60 kW 240 v 50 hz and I've had a few near blast experiences with explosives and artillery firing
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below

Detailed Answer:
I read your question carefully and I understand your concern.

The first abnormality that report evidences is the white matter changes. Those lesions are most probably old so at times their origin is hard to determine, they are sort of small scars, remnants of a past injury. The report gives several possibilities.
The first vessel ischemic change is unlikely for your age unless you suffer from some other condition which may affect blood vessels (diabetes, hypertension, autoimmune connective tissue disease etc).
Lyme disease also in the absence of other symptoms, any history of tick bite or cutaneous manifestation in the past is unlikely.
The diagnosis of MS is to be considered in any young individual with white matter lesion. The location of the changes is not typical for MS but still I think as the report suggests, an MRI exam with contrast use (to evidence if any of the lesions might be new) as well as a spinal tap is necessary.
Vasculitis means inflammation of blood vessel. May be in the setting of a systemic autoimmune disease, involving other systems, or it can affect only central nervous system. For that some blood tests for inflammation and autoimmune antibodies are necessary, as well as the above mentioned contrast MRI.

The other finding, the circle of Willis ectasia, that means that the arteries of the circle of willis (a circle formed by vessels connecting the main cerebral arteries) have a higher calibre than usual. That could be simply a born condition, since you do not suffer hypertension that is excluded. The contrast MRI however will give a better view of the circle of willis and evaluate it, it shouldn't cause any symptoms though if no other blood vessel abnormalities are present.

As for your history of electrocution, there are some reports of white matter changes after electrical injuries. However studies involving many patients in this regard are lacking. So it can be another explanation for the matter changes (not the circle of willis), but should be left as a conclusion only after the contrast MRI and blood studies I mentioned have excluded other causes.

The other findings in your sinuses are nothing major, can show some predispositions for sinusitis.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For Excessive Sweating, Fatigue, Headaches And Dizziness

Brief Answer: Read below Detailed Answer: I read your question carefully and I understand your concern. The first abnormality that report evidences is the white matter changes. Those lesions are most probably old so at times their origin is hard to determine, they are sort of small scars, remnants of a past injury. The report gives several possibilities. The first vessel ischemic change is unlikely for your age unless you suffer from some other condition which may affect blood vessels (diabetes, hypertension, autoimmune connective tissue disease etc). Lyme disease also in the absence of other symptoms, any history of tick bite or cutaneous manifestation in the past is unlikely. The diagnosis of MS is to be considered in any young individual with white matter lesion. The location of the changes is not typical for MS but still I think as the report suggests, an MRI exam with contrast use (to evidence if any of the lesions might be new) as well as a spinal tap is necessary. Vasculitis means inflammation of blood vessel. May be in the setting of a systemic autoimmune disease, involving other systems, or it can affect only central nervous system. For that some blood tests for inflammation and autoimmune antibodies are necessary, as well as the above mentioned contrast MRI. The other finding, the circle of Willis ectasia, that means that the arteries of the circle of willis (a circle formed by vessels connecting the main cerebral arteries) have a higher calibre than usual. That could be simply a born condition, since you do not suffer hypertension that is excluded. The contrast MRI however will give a better view of the circle of willis and evaluate it, it shouldn't cause any symptoms though if no other blood vessel abnormalities are present. As for your history of electrocution, there are some reports of white matter changes after electrical injuries. However studies involving many patients in this regard are lacking. So it can be another explanation for the matter changes (not the circle of willis), but should be left as a conclusion only after the contrast MRI and blood studies I mentioned have excluded other causes. The other findings in your sinuses are nothing major, can show some predispositions for sinusitis. I remain at your disposal for further questions.