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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes headache, twitching in the facial muscles and stiffness in the neck?

Answered by
Dr.
Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3650 Questions

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Posted on Sat, 10 Sep 2016 in Brain and Spine
Question: In the past 37 days I have experienced the following symptoms:

Mild Headaches
Twitching of facial or other muscles
Bell’s Palsy
Stiff or painful neck
swelling around eyes
Oversensitivity to light
Flashing lights, peripheral waves in eyes
Decreased hearing in one ear
oversensitivity tosounds
Ringing in one ear
Bone pain, joint pain
Stiffness of joints, back, neck
Muscle pain or cramps
Night sweats
Tremors in legs
Burning sensations in legs
difficulty walking, including shaking legs when going down stairs
irritability
Over-emotional reactions
Difficulty falling or staying asleep
Panic attacks, anxiety
difficulty thinking
Difficulty finding commonly used words
Symptoms seem to change, come and go
Pain migrates (moves) to different body parts
Early on, experienced a “flu-like” illness

Treatments have been:
Flu test - negative (32 days ago)
Lyme Titer - negative (35 days ago)
XRay of Lungs - Clear
MRI of Brain/Sinus area - Clear
CT Scan of Brain - Clear
2 Eye Exams - No structural issues
3 Ear Exams - No structural issues
CBC - Normal for an infection when taken
BP - Was initially elevated but is now within normal range

Only prescriptions were from PCP, which was 5 day Zpak and ENT and it was a 21 day course of Prednisone starting at 70mg and Valtrex for 7 days (4g per day). The prednisone has given me acne and the course ended 3 days ago.

The symptoms above started as a flu-like illness which no one in my family ever contracted (5 in family in 1000SF home). And has progressed up and down from the symptoms above.

I think it must be Lymes with 35% of total possible symptoms, and other specialist have suggested, but PCP isn't sold.

I have been to ENT's, Eye Doctors, ERs, PCPs and consulted with a NeuroOncologist friend and no one can find anything wrong with me after my "mysterious illness 37 days ago"

No one thinks it is cancer

What is going on?

Should I push for a new lyme titer or do I have enough symptoms to warrant the antibiotic treatment. I do not want this stuff getting worse and not sure too many other tests are left to run? I live in a heavily infested Tick Area. No bulls-eye was ever present.
doctor
Answered by Dr. Olsi Taka 1 hour later
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I understand your concern.

I do not think there is enough evidence from what you describe to initiate treatment for Lyme. None of your symptoms are specific for Lyme, they can be found in many other conditions. I know that blood test does not exclude Lyme, but you do not mention even an indication of infection (high leukocyte count, sedimentation rate, c reactive protein). You do not mention fever either. Again none of these exclude Lyme, but there is nothing to support it.

The testing you have had is pretty extensive, any threatening issues have been excluded. If the symptoms persist what I would add would be testing for connective tissue conditions such as lupus, rheumatoid arthritis etc. Would also repeat Lyme antibody testing after 8 weeks (from onset of symptoms).

For the moment I think you should just wait and try to relax. I am mentioning relaxation because I think that while an infection (not necessarily Lyme, any viral infection may cause those symptoms) I think that anxiety is contributing at least partially in perpetuating them. Apart from the Bell palsy and initial flu anxiety can cause all the symptoms you mention. You do not have to fear it getting worse, not with all tests normal.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 7 minutes later
I am sorry I did have fever during flu like illness for 5 days. And blood test did show some sign of infection the ER doc said, but felt it was normal overall... Nothing serious. There were some elevated counts.

Does that change anything?
doctor
Answered by Dr. Olsi Taka 12 minutes later
Brief Answer:
Not much.

Detailed Answer:
Thank you for the update.

If you have no more fever now it doesn't change that much really. Fever and some transitory increase in the leukocyte count is common in the setting of flu symptoms, remains something not specific which can be due to any viral infection. If not present anymore there is still (fortunately) no reason to think about an active evolving infection.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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