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Constant tension headache, dizziness, plateaued nerve problem. Blood work normal with low RBC. Any thoughts?

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Practicing since : 2001
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Hi. I don't know if this is a neurological question or based on something else underlying. I am a 43 year old white female. A month ago I had a bladder infection and was given Cipro for three days. The infection cleared. In a few days after the infection, I noticed a mild headache. Soon after, that was join by some mild lightheadedness. After a week, I started feeling some 'malaise' (some chills, generally feeling bad). I would feel unwell in the a.m. and then often perk up in the afternoon. Approximately two weeks ago, i started noticing random nerve firings (arms, legs - no seeming pattern). These started to ramp up. now I will feel them often in both arms and legs and elsewhere (back sometimes, eye). Nothing has been debilitating pain wise. But symptoms on the nerve front are: cramping, twitching, pulses, nerve 'firings" (shooting), general shakiness of hands, now muscle weakness in the thighs and upper arms (at the top of the stairs, I feel a slight burn and fatigue as though I've worked out for hours). I've had a general blood work up. CBC was good. RBC slightly low at 3.55. In May of last year, it was 3.75. The normal low here is 3.8, so I'm just this of concern? I have also had work in teh area of rheumatoid - all normal. I had two non specific tests - ESR and CRP - this week and they turned out at normal levels.

So the main things troubling me right now include this fairly constant 'tension headache' (rarely does it hurt, but it comes on often enough), the dizziness (feeling off balance mostly...not sure how to describe it), and this nerve stuff (sort of plateaued right now).

I had a very low grade fever for a few nights this week, but chills will come and go too. I can feel a bit sick in the morning (general malaise), but in general my energy after first thing in the morning is good. I wouldn't say I've lost much appetite (a bit, but not significant). And I don't feel fatigued as a primary symptom.

Posted Wed, 4 Jul 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 12 hours later
Hello and thank you for sending your question.

Your question is a good one and I will work on providing you with some information and recommendations regarding the symptoms you are experiencing.

Regarding the headache, I do agree with you that you are suffering from mild form of tension type headache probably triggered by the infection. As the pain in very mild and non-disabling I would advise you to use a mild pain killer or a local applicant for headache if it starts hurting you.

Regarding the dizziness, I feel its a very nonspecific symptoms and could be due to various causes. Most common cause for dizziness is vertigo which is often due to problems in the inner ear. Other causes like low blood pressure, Anaemia (low-RBC) and infections which involve the labrynth.

Considering your nerve problems, dizziness, headache and low grade fever I would like to consider viral or some form of ongoing infection in you. Most such infectious syndrome are self-limiting and require only symptomatic treatment like rest, pain killer for nerve and body pains and good hydration.

My recommendation would be for you to see your physician if symptoms persists beyond 3-5 days for re-evaluation and consultation. I want to reassure you this looks to me like a self-limiting disease and is not something that is life-threatening.

I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.


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