Dr. Hitesh Kumar
Neurology
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Patient's Query
Hello doctor,
I recovered from a COVID infection four months ago. After that, I have brain fog, concentration issues, headaches, memory issues, balance issues, lack of mental precision, depression, anxiety, and PTSD issues. My headaches are constant and can last for days or even weeks. I also have a tingling sensation in both my hands and feet. And my nerve conduction studies revealed carpal tunnel syndrome of both hands.
I have attached my laboratory reports.
Kindly review my reports and give your opinion.
Hello,
Welcome to icliniq.com.
I would like to know some further details about your headache.
1) Since when you are having headaches?
2) Which part of the head aches?
3) What kind of headaches have you felt?
4) What is the duration of one episode of headache?
5) Do you have any nausea or vomiting during headache episodes?
6) Was your headache associated with any redness in the eyes, watering from eyes, or nasal blockage?
7) Have you noticed any specific triggering factors?
8) How frequent were those headaches?
9) What is the intensity of headaches?
10) Did you take any medicine for your previous headaches?
11) What was told by your doctor about the radiological impression of your lesion in the cervical spine?
12) How is your sleep pattern?
13) How is your usual mood in day-to-day activities?
14) How is your appetite?
Kindly revert with the answers.
Patient's Query
Hello doctor,
Thanks for the reply.
The answers are as follows;
1) I have had headaches in the past, but now, my headaches are debilitating.
2) Headaches are not consistent, it has been on the sides and back of my head.
3) Mostly throbbing type of pain.
4) They last for days or longer with or without painkillers.
5) No nausea or vomiting.
6) No redness or other issues in the eyes.
7) No triggering factors.
8) Frequency of headaches are almost every day.
9) Intensity is moderate to severe.
10) I took a tablet Tylenol for pain two months ago.
11) My doctor advised me to get an opinion from a neurologist as it looked like multiple sclerosis.
12) I usually wake up once while sleeping. But recently I could not get enough sleep. My sleep lasts for about 30 minutes only.
13) I am fine during the day, and my mood is good and energized.
14) Appetite is also acceptable.
Also, my brother and father both have MS. Do I need any further investigations to rule out the cause?
Thanks.
Hello,
Welcome back to icliniq.com.
Your MRI (magnetic resonance imaging) of cervical spine lesion is still undiagnosed (attachments removed to protect the patient’s identity), as it is not showing any contrast enhancement. And it does not seem to be multiple sclerosis as there is no lesion in the brain and spinal cord. There may be a possibility of a non-enhancing tumor of the spinal cord.
You have not shared other reports of CSF (cerebrospinal fluid) report. I would like to know detailed reports of CSF fluid. Till now, whatever you have shared, shows high protein content in CSF. High protein alone cannot give any impression, as it can happen in numerous conditions of the brain, spine, and radicles.
As you are having headaches for years, they all seem unlikely to be of infectious origin. There are many possibilities for it to be a migraine headache with tension headaches or a chronic migraine headache with daily headaches.
Take care.
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