Dec 16, 2012
Let me start by saying that my cd4's are ridiculously good... 1742 at last check 5 mo ago and that is not a typo. As a set up to the following, I have had neck problems for 15 yrs including bulging discs and bone spurs at C5,6 &7. I have had a flue shot x 3 weeks ago and an upper respiratory infection x 6 weeks ago.
I have been struggling for over a week with odd symptoms. 12/6 putting up fake Christmas tree, became lightheaded and disoriented. Severe chills/teeth chatters, took my temp and it was over 101. Head ached but not terribly. Felt extremely off balance, light headed ness continued. Managed to drive myself to the ER going really slow. Testing ensued. BP was a bit low. CBC elevated white blood cells. Cultures negative. Chest xray nothing. CAT scan of head negative. Suspect viral infection of some kind, kept over night for observation, fever went away by next afternoon, sent home to let it run its course. Saturday-Weds 12/12 about the same. Light headed, off balance, walking slowly so as not to fall over, ridiculous fatigue. Overall felt hungover/drunk, mild disorientation but could focus. 12/12 ER again with doc's encouragement- repeat CAT scan of head, negative. Chest xray negative again. Repeat blood labs, all normal no more white blood cell elevation. Spinal tap- slightly elevated Alkaline Phosphatase and Bilirubin, told these are likely nothing/possibly errors. By Friday 12/14 I was still not feeling better, partner noticed walking more precarious, stumbling. Headache (due to lumbar procedure? Classic symptom of pain while upright relieved when lying down.) This ON TOP of the light-headed, drunken sensation. Continued fatigue. Doc again encouraged ER, this time with an eye on a neuro consult. Got one. Neurologist tested basic sensations, reflexes, said all was normal. Watched me walk a few steps. Diagnosed presyncope- almost fainting. Sent me home and told me to increase salt. Which, hi, I have had a TON of in the past week, as eating conveniently has won out over eating right through all this.
SO After three trips to the ER I have been told it could be: viral infection (apparently undetectable in any labs)-- wait till it passes malaise/depression (I am a psychotherapist, and a happy one) and "pre-fainting" presyncope (eat more salt)
I found ADEM and thought it seems a bit similar... but wouldn't the spinal have alerted them to it? What do u think?
Response from Dr. Holodniy
Your symptoms and physical examination are not consistent with ADEM. Given the negative studies and normal exam, it is likely a viral syndrome of some kind.
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