I am a 30-year-old female with a height of 5 feet and 5 inches and a weight of 280 pounds. I am currently taking tablets 100 mg of Sertraline, 60 mg of Adderall XR, and 10 mg of Adderall IR. Throughout my life, I have experienced several unusual symptoms such as an electroshock sensation, concentration issues, migraines, eye twitches, and sleep apnea. Since my last C-section, when I developed a CSF leak, my symptoms have worsened. I recently had an MRI and would like to get a second opinion on the possibility of having Chiari Syndrome and the extent of the herniation.
The most troublesome symptoms I experience include:
Intense headaches and pressure that start from the base of my skull and radiate down my back, which makes me feel as if my head is going to explode.
Difficulty remembering words, tasks, and names of people I have known for years. This struggle occurs on a daily basis.
Trouble with speech, often forgetting words mid-sentence and resorting to backtracking or substituting words. I also experience slurred speech and occasional stuttering.
Difficulty concentrating and persistent fatigue, despite being on a high dosage of Adderall for an ADD diagnosis made four years ago.
Electroshock-like sensations travel through my body, particularly to my fingertips and the tip of my tongue. Although I have had this sensation for a while, it has recently intensified and become more widespread.
Daily numbness in my hands and feet, which has now extended to my legs, arms, and face. I am unable to feel anything if I prick my skin with a needle.
I would appreciate any insights or opinions on these symptoms.
I have thoroughly examined the submitted MRI (magnetic resonance imaging) slices (attachments removed to protect the patient’s identity), and unfortunately, it is extremely difficult to provide a definitive diagnosis based on only eight slices. In slice eight, there appears to be a downward migration of the cerebellar tonsils, but the length cannot be accurately measured, making it challenging to confirm a diagnosis of Chiari Syndrome. Additionally, there is no evident dilatation of the cervical central canal, which is commonly associated with Chiari Syndrome, although it is not clearly visible in the slices examined.
Regarding the other slices, no pathological modifications can be observed, but it is important to note that these slices do not cover the entire brain. It is worth mentioning that slight tonsillar herniation can occur after a prolonged cerebrospinal fluid (CSF) leak, but it can also be spontaneous. Considering the symptoms you have described, such as numbness and clumsiness of the hands and feet, these can be associated with Chiari Syndrome, but they are also nonspecific and can be attributed to various other pathological disorders. The remaining symptoms you mentioned are not typically related to Chiari Syndrome.
In conclusion, I do not believe that the symptoms you are experiencing are directly related to the findings on the imaging. Further, MRI surveillance is necessary to gather more comprehensive information.
I hope I have addressed your concerns. Feel free to reach out if you have any further questions.
Investigations to be done:
Further MRI surveillance is needed
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