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Suggest Remedy For Headache, Numbness And Tingling Sensation In Head While Treating Anxiety
Question: I have been having some health issues for the past 2.5 Years It started with an anxiety/panick attack 2.5 Years ago i was coming home from prayer when i noticed sudden gloom like feeling rapid heartbeat hard to understand what was going on i felt like i was dying... anyhow i rested after a couple days was back to normal and went on with my life. Two weeks later it come back this time stronger and left me very weak for 2 months maybe it was just cause i was thinking about it too much anyhow after two months back to work and normal again but after a couple months i was at the gym lifted some heavy weights that dropped on my legs and had some testicular pain and some digestive problems then the anxiety kicked back in im not even sure these attacks are from anxiety till this day so ive been having slight testicular pain ever since anyhow the anxiety attacks kept coming and going i did try some medications but it made it worse and i would hallucinate too much any how after some type i started developing some very bad weakness headaches numbness and tinling sensation on the inside of me head dont know if its my brain i have had severeal blood work ultrasounds of my testicles all clear my testicular pain comes and goes however i constantly feel numbness and tingling and brain fog every single day i have had a normal ct scan but some minor issue on my mri the results said minor cystic encephelomelacia which was followed up by a neurologist who couldnt figure it out so i went in for a neaurosurgical consultaiton which the doctor siad what i have is harmless and isnt causing these symtoms now the symptoms have gotten worse since the past 4 months i feel extreme vertigo sometimes i feel off balance when im walking i feel like im walking on water. I get very tense like when im drivivg for more than 25 minutes i have to pull over. Also other symtopms are i have red and irritatied throat and tonsills a grey furry tounge, itchy and sometimes bleeding anus, digestive problems, and burning sensation while im peeing i have had multiple sex partners although i have been tested 3 times in the past 2.5 years with nothing so i believe its nothing to do with stds. PLEASE READ MY QUESTION CAREFULLY I NEED SOME HOPE IN MY LIFE .
Brief Answer:
All queries explained in detail
Detailed Answer:
Hello and Welcome
I appreciate your concern
Firstly, let us specify the issues/ chief complaints in history in an orderly manner.
1. Anxiety and panic attack 2.5 years back
2. Testicular pain + Digestion issues after weights dropped on legs during Gym.
3. Headache and vertigo
4. Encephalomalacia
5. Anxiety episodes recurring with symptoms worsening for the past 4 months.
6. Throat irritation and inflammation
7. Lower gastrointestinal bleeding and dysuria.
Based on the history you described, Generalized anxiety Disorder is the most likely conclusion for a majority of the symptoms that you experience including the headache, numbness, increased heart rate and even vertigo to some extent . The appropriate way in the management of GAD is to arrange a psychiatrist consult. XXXXXXX mental state exam and detailed history would determine the diagnosis. SSRIs like sertraline or fluoxetine can be advised with initial bridging of benzodiazepines such as alprazolam. The Benzodiazepines are initially added as the SSRIs are potent stimulators of the brain and can worsen anxiety, initially. The benzodiazepines can be stopped after 2 weeks and the SSRI would be continued for 3 months. Reassessment at 1 month should be done to adjust the medication dose. SSRI can be continued for 6 to 12 months as they have a good safety profile.
The testicular pain and digestion issues are unlikely to be related to any trauma to the legs suffered in the gym. If the ultrasound of the testes was normal and no torsion or epidydmitis was suspected then most likely there is no serious cause. PPIs like Pantoprazole can be given for associated GERD (Gastroesophageal Reflux Disease).
Encephalomalacia is basically local softening of the brain tissue as a result of hemorrhage or inflammation. I doubt that you have either of these. If you have no symptoms related to these changes then there is no need to worry.
The vertigo should be worked up. Upon ENT and neurological examination, focus of infection or neurological cause should be looked for. Many people confuse dizziness and presyncope with vertigo. Vertigo is related to neurological cause and dizziness is associated more with cardiac and metabolic issues. Blood pressure and blood sugar , electrolyte readings would help to rule out such metabolic cause.
The throat needs to be examined to look for possible infection. Antibiotics, saline gargles and antihistamines can be prescribed accordingly.
Both the stool and urine routine examination and culture sensitivity testing would be required to see for growth of any bacteria. If the bleeding persists from the anus then local causes such as hemorrhoids, anal fissure, anal mucosa erosions due to hard stool/ constipation should be looked for. A Digital rectal exam would give more details in this regard.
Wishing you best of health
Thanks
Let me know if you have any query.
Please consult your doctor before deciding on any further course of action.
For future follow up / correspondence you may ask me directly at the link given below
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107
Dr. M.S. Khalil
All queries explained in detail
Detailed Answer:
Hello and Welcome
I appreciate your concern
Firstly, let us specify the issues/ chief complaints in history in an orderly manner.
1. Anxiety and panic attack 2.5 years back
2. Testicular pain + Digestion issues after weights dropped on legs during Gym.
3. Headache and vertigo
4. Encephalomalacia
5. Anxiety episodes recurring with symptoms worsening for the past 4 months.
6. Throat irritation and inflammation
7. Lower gastrointestinal bleeding and dysuria.
Based on the history you described, Generalized anxiety Disorder is the most likely conclusion for a majority of the symptoms that you experience including the headache, numbness, increased heart rate and even vertigo to some extent . The appropriate way in the management of GAD is to arrange a psychiatrist consult. XXXXXXX mental state exam and detailed history would determine the diagnosis. SSRIs like sertraline or fluoxetine can be advised with initial bridging of benzodiazepines such as alprazolam. The Benzodiazepines are initially added as the SSRIs are potent stimulators of the brain and can worsen anxiety, initially. The benzodiazepines can be stopped after 2 weeks and the SSRI would be continued for 3 months. Reassessment at 1 month should be done to adjust the medication dose. SSRI can be continued for 6 to 12 months as they have a good safety profile.
The testicular pain and digestion issues are unlikely to be related to any trauma to the legs suffered in the gym. If the ultrasound of the testes was normal and no torsion or epidydmitis was suspected then most likely there is no serious cause. PPIs like Pantoprazole can be given for associated GERD (Gastroesophageal Reflux Disease).
Encephalomalacia is basically local softening of the brain tissue as a result of hemorrhage or inflammation. I doubt that you have either of these. If you have no symptoms related to these changes then there is no need to worry.
The vertigo should be worked up. Upon ENT and neurological examination, focus of infection or neurological cause should be looked for. Many people confuse dizziness and presyncope with vertigo. Vertigo is related to neurological cause and dizziness is associated more with cardiac and metabolic issues. Blood pressure and blood sugar , electrolyte readings would help to rule out such metabolic cause.
The throat needs to be examined to look for possible infection. Antibiotics, saline gargles and antihistamines can be prescribed accordingly.
Both the stool and urine routine examination and culture sensitivity testing would be required to see for growth of any bacteria. If the bleeding persists from the anus then local causes such as hemorrhoids, anal fissure, anal mucosa erosions due to hard stool/ constipation should be looked for. A Digital rectal exam would give more details in this regard.
Wishing you best of health
Thanks
Let me know if you have any query.
Please consult your doctor before deciding on any further course of action.
For future follow up / correspondence you may ask me directly at the link given below
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107
Dr. M.S. Khalil
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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