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What Causes Chronic Headaches That Are Severe At Times, Stumbling Gait, Memory Impairment And Confusion At Times?
Question: I am a diabetes nurse. I have been seeing a p75 year old atient for Diabetes Type 2. Over the past 8 weeks he has developed chronic, severe at times, headaches. He also present with stumbling gait, difficulty rising from a chair, memory impairment at times, confusion at times. He has complained of double vision and blurred vision. He is getting weaker. He has had multiple testing done (MRI, CAT scan, lab work) which are normal. He had an EMG done recently but I don't have the results. His Physician has been working diligently to find an answer and treat the patient's symptoms. Prior to this he was in good health and managed independently and normally. Now he needs assistance with dressing, bathing, toileting and can no longer drive.
In the past 3 months he has started and stopped eating raw honey. I am aware that raw honey is supposed to be safe for adults but could tbotulismlbarhorst@wilson health.org be a possibility? His MD has requested a botulism toxin test but is having a difficult time finding anywhere that performs the test in Ohio.
Do have any other suggestions? Or where to look for an answer?
In the past 3 months he has started and stopped eating raw honey. I am aware that raw honey is supposed to be safe for adults but could tbotulismlbarhorst@wilson health.org be a possibility? His MD has requested a botulism toxin test but is having a difficult time finding anywhere that performs the test in Ohio.
Do have any other suggestions? Or where to look for an answer?
Brief Answer:
Botulism unlikely
Detailed Answer:
Hi,
Regarding the botulism hypothesis I don't think that is likely at all. The progression in time doesn't fit as it is an acute condition with symptoms progressing and reaching their peak within days, not weeks as in this case. In addition to that botulism involves nerves not the central nervous system so symptoms like headache and memory impairment are not explained by it.
As to what else could it be. Well, it's not easy to say since you say that all tests come out normal. It would be important to know what type of MRI did he have, whether he had a contrast exam or not. Such a subacute progression would point towards an infective (Lyme, tuberculosis etc.) or inflammatory condition (sarcoidosis, primary CNS vasculitis etc.) for which a contrast exam and cerebrospinal fluid tests are necessary.
I remain at your disposal for other questions.
Regards
Botulism unlikely
Detailed Answer:
Hi,
Regarding the botulism hypothesis I don't think that is likely at all. The progression in time doesn't fit as it is an acute condition with symptoms progressing and reaching their peak within days, not weeks as in this case. In addition to that botulism involves nerves not the central nervous system so symptoms like headache and memory impairment are not explained by it.
As to what else could it be. Well, it's not easy to say since you say that all tests come out normal. It would be important to know what type of MRI did he have, whether he had a contrast exam or not. Such a subacute progression would point towards an infective (Lyme, tuberculosis etc.) or inflammatory condition (sarcoidosis, primary CNS vasculitis etc.) for which a contrast exam and cerebrospinal fluid tests are necessary.
I remain at your disposal for other questions.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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