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What causes constant pain in nerve, muscle, confusion, brain fog and balancing issues?

Answered by
Dr.
Dr. Bruno Mascarenhas

Neurologist, Surgical

Practicing since :2000

Answered : 803 Questions

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Posted on Tue, 6 Sep 2016 in Headache and Migraines
Question: My CSF has been tested twice now. Both times, approx. 3 years apart it has been at 59 and the lab high range shows 45. I've had two MRIs of the brain. Just show some abnormal white spots but no demyelation. I'm in constant pain from nerves, severe muscle aches, confusion, brain fog, balance probelems, etc.

I have had all neurological tests regarding NCS, brain untrained, etc.

Help!
doctor
Answered by Dr. Bruno Mascarenhas 1 hour later
Brief Answer:
Please specify what you mean by 59, 45 . Specify the parameters and Units

Detailed Answer:
Dear Madam,

Please specify what you mean by 59, 45 . Specify the parameters and Units so that I can proceed with the query.




Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Bruno Mascarenhas 2 hours later
The lab shows their protein range of 15-45 mg/dL. My protein is at 59 mg/dL. My protein was in the same range 3 years ago as well.

Fluid was clear, glucose is fine.
doctor
Answered by Dr. Bruno Mascarenhas 5 hours later
Brief Answer:
CSF Protein a little Bit Elevated

Detailed Answer:
Dear Madam,

Thanks for Clarifying about CSF Protein.
This is a bit higher than normal.

I need few more information from you
1. Results of Nerve Conduction Tests.
2. Whether any other tests done on CSF
3. Whether Oligoclonal Band Analysis was done on CSF
4. Is the pain from nerves, severe muscle aches, confusion, brain fog, balance problems remaining the same or progressing

Can you please clarify these details

Expecting Your Reply
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Bruno Mascarenhas 18 hours later
I attached a few of my lab and mri reports. I hope this will help a bit.

Thanks! XXXXXXX
doctor
Answered by Dr. Bruno Mascarenhas 22 hours later
Brief Answer:
You have to consult a Neurosurgeon and get further evaluation

Detailed Answer:
Dear Madam,

As per the reports you have uploaded,
You have the following Problems

1. Cervical Spondylosis
2. Disc Bulge at C4-5, C5-6, C6-7 and Central Canal narrowing at C5-6
3. Small vessel Ischemia in Brain

-oOo-

You have the following Symptoms : constant pain from nerves, severe muscle aches, confusion, brain fog, balance problems, etc.

Of these
1. constant pain from nerves, severe muscle aches, balance problems are due to Disc Bulge at C4-5, C5-6, C6-7 and Central Canal narrowing at C5-6
2. confusion, brain fog are due to Small vessel Ischemia in Brain

-oOo-

Among these two
1. Constant pain from nerves, severe muscle aches, balance problems due to Disc Bulge at C4-5, C5-6, C6-7 and Central Canal narrowing at C5-6 have to be corrected surgically.

2. Confusion, brain fog due to Small vessel Ischemia in Brain don't need surgery. They have to be treated with drugs

-oOo-

You have to consult a Neurosurgeon and get further evaluation
You may need a surgery at C5-6. The most common Surgical Approach would be removing the disc and inserting a cage or artificial disc

Hope you found the answer helpful.

If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.

Best Wishes for Speedy Recovery
Let me know if I can assist you further.
Take care.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Bruno Mascarenhas 39 hours later
Where are you seeing I definitely have small vessel disease? Does the MRI show that? Is a person able to have elevated protein in spinal fluid for at least 3 years and absolutely nothing is wrong or does that always signal a problem?

Does small vessel disease have a cure? What is the long term prognosis for that?

I am seeing a neurologist but highly value a second opinion. I have a follow up with him soon and he'll finally tell me what's wrong. I'm just tired of waiting as this has been severely affecting my quality of life.
doctor
Answered by Dr. Bruno Mascarenhas 21 hours later
Brief Answer:
Let me answer your questions one by one

Detailed Answer:
Dear Madam,

Welcome Back

Q1
Where are you seeing I definitely have small vessel disease? Does the MRI show that?
A1
Page 8 of the PDF File you have shared mentions this


Q2
Is a person able to have elevated protein in spinal fluid for at least 3 years and absolutely nothing is wrong or does that always signal a problem?
A2
Disc Bulge at C4-5, C5-6, C6-7 and Central Canal narrowing at C5-6 can cause this slightly elevated Proteins in CSF
This is a problem and you have to surgically correct this

Hope you found the answer helpful.

If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.

Best Wishes for Speedy Recovery
Let me know if I can assist you further.
Take care.

-oOo-

PS 1 : After all your doubts have been cleared, kindly (a) Close this Question (b) Rate my Replies and (c) Give your Feedback.

PS 2 : In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at http://bit.ly/askdrbruno
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Bruno Mascarenhas 7 hours later
So no chance I have MS then? Is that small vessel disease curable?

If I'm understanding correctly, the only way to correct my balance, nerve pain, etc. s having neck surgery. Physical therapy, etc. won't help at this point? If it was so,etching other than a disc budge my proteins would be higher?
doctor
Answered by Dr. Bruno Mascarenhas 11 hours later
Brief Answer:
Let me answer your questions one by one

Detailed Answer:
Dear Madam

Welcome Back

Q1 : If I'm understanding correctly, the only way to correct my balance, nerve pain, etc. s having neck surgery.
A1 : Yes Madam

Q2 : Physical therapy, etc. won't help at this point?
A2 : Yes Madam


Q3 : If it was so,etching other than a disc budge my proteins would be higher?
Q3 : Question Unclear. Please Ask Again Madam
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Bruno Mascarenhas 3 hours later
So physical therapy will not help, correct?

If it was something other than a disc bulge causing the elevated disc bulge would my cerebral fluid protein be a lot higher? I've never heard of neck probelems creating so much

So there is no chance I have multiple sclerosis, correct?
doctor
Answered by Dr. Bruno Mascarenhas 26 hours later
Brief Answer:
Let me answer your questions one by one

Detailed Answer:
Dear Madam

Welcome Back

Q1 : So physical therapy will not help, correct?
A1 : Physical Therapy will be needed. It will help. But, Physical Therapy Alone will not be enough and sufficient

Q2 : If it was something other than a disc bulge causing the elevated disc bulge would my cerebral fluid protein be a lot higher? I've never heard of neck probelems creating so much
A3 : If it was MS, the proteins would be very high

Q3 : So there is no chance I have multiple sclerosis, correct?
A3 : From what you have told till now, the chances for MS are very minimal

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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