What causes headache, dizziness, facial numbness and tingling sensation throughout the body?

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Posted on Wed, 23 Aug 2017 in Brain and Spine
Question: Read my previous questions. M/33. Update. Had upper and lower emg, nerve conduction study, qarst, small fiber punch biopys. All normal.

I still am having daily severe dizziness, facial numbness that moves around, headache, confusion , allot of pressure in jaw, sinus areas. I am tired allot. I have found allot of people on migraine forums who have the facial numbness that can last for days, so up to a point i accepted my dx of vestibular migraine although rare for a male in 30s...

The below symptoms which I also have make me wonder if more is going on.......

In addition to the above I now get random periods of sharp pins and needles and hypersensitivity throughout my body, mainly arms, torso, thighs and face, which may or may not be related to the vestibular migraine symptoms.

6 months with a good psychologist who has ruled out anxiety as a cause.
doctor
Answered by Dr. Ishu Bishnoi 1 hour later
Brief Answer:
Generalized tingling episodes

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I have read your previous questions and answers. After going though it, I can say that you are having good knowledge and clarity about your symptoms. You are having rare type of migraine i.e. vestibular migraine. It is explaining your headache, dizziness and hyperesthesia of face.

But it can not explain the episodes of pins/needles (tingling) throughout your body. Such type of symptoms are mostly caused by systemic illness like

- Multiple sclerosis - It is unlikely in your case as MRI brain is normal.

- Polyneuropathy - It can be due to diabetes, B12 deficiency, alcohol, drug abuse, Lyme disease. It is unlikely in your case as your nerve biopsy and nerve conduction studies were normal.

- Psychological illness like anxiety panic attack - As you mentioned, it has been ruled out by Psychologist.

- Posterior column - In spinal cord, posterior column disease (compressive or non compressive myelopathy) can cause such symptoms. These kind of episodes are known as "Lhermitte sign". It can be confirmed by MRI cervical spine. The compression and changes in cord are well picked up by MRI. Compressive myelopathy can be due to disc, ligament hypertrophy, listhesis, while non compressive myelopathy can be due to myelitis, B12 deficiency, ischemia.

- Autoimmune disease like Behcet's syndrome - It usually presents with recurrent oral ulceration, genital ulcers.

I think you need to re-consult a good neurologist. As your neuropathy report was close to cutoff, there may be subtle damage in your peripheral nerves. Repeat studies or follow up evaluation might pick up the cause.

I hope my answer will help you in reaching at some conclusion. If you have any doubt, do let me know.

Thanks. Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ishu Bishnoi 1 hour later
All I can say about the body pins and needles is that when I was younger in my late teens, I remember getting attacks of pins and needles when I went from cold to hot or during the 1st 10 mins of exercise... But only during those times, not any other time. back then I thought I had something called chronic urtica.
However now I get these pins and needles for no reason. They are like little pins and can go from multiple.sites to sites on my body within seconds. It's not one area, it's all.over. It does go away completely at times, which points away from something like small fiber neuropathy. When it happens my skin gets hypersensitive. I have no idea what is causing this..
Lyme s a possibility that was brought up years ago. I did test + on a igenex test but those tests are very controversial. However my symptoms match lyme very closely and I live in an area with lyme (Pennsylvania) I saw one of those "Lyme literate" docs who thinks I have had lyme... untreated for about 10 years...... He wants me to.try to take biaxin 1000mg a day for a couple months to see if there is an improvement. At this point I may have to.as I don't have much more to go
I almost feel like it's something from my brain, some type of dysfunction or diseases I just need to keep finding ideas.
doctor
Answered by Dr. Ishu Bishnoi 17 hours later
Brief Answer:
Lyme disease

Detailed Answer:
Hi XXXX, welcome back.


In young age, these symptoms occurred for short duration and vanished. I don't think those symptoms are related to current symptoms. Currently you are having recurrent episodes.

After reading your history about possibility of Lyme's disease and matching of your symptoms profile to same, I can say that we should seriously consider it. Most of the brain diseases have been ruled out normal MRI.
Biaxin (calrithromycin) can be tried in your case. Usual adult dose is 500mg twice daily. However combination therapy like clarithromycin and tinidazole is considered better than single therapy alone. The duration will depend upon your prescribing clinician.
One more thing, antibiotic therapy can initially aggravate your symptoms due to release of toxins from dying bacteria. Don't worry about that, it will settle down.

Hope it will help you. If still in doubt, do let me know.
Thanks. Take care.
Dr Ishu Bishnoi
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ishu Bishnoi 23 minutes later
It's the only dx that makes sense.

2008- working in woods as an engineer and I became very sick with flu like symptoms and swollen lymth nodes for months and extreme tiredness
2008- after illness got a little better my left side of my face became severely numb 24/7
2009-episodes of air hunger
2010- constant headaches develop
2015- vestibular migraines
2016- pins and needles all over

before 2008 i had never been sick in my life. 5 siblings 2 parents all unremarkable health.
doctor
Answered by Dr. Ishu Bishnoi 5 hours later
Brief Answer:
Most probable diagnosis - Lyme disease

Detailed Answer:
Hi XXXX, welcome back.


I agree with you. You are having a long history. The disease started as flu like symptoms with lymphadenopathy. History of generalised tingling. All these points favour diagnosis of "Lyme disease".

You have also ruled out any genetic illness as your siblings are symptom free.

Hope you will start Lyme disease therapy. Let me know about the response.
If you have any doubts, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 830 Questions

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