Hello Micheal,
Thank you for your query at DoctorSpring.com
I have gone through your query and you have a quite a lot of symptoms which are unrelated.
I also reviewed your reports, and even though the EEG findings are not specific a neurologist will be able to give you a better opinion about it. Since this is a board review case, he will be replying to you too.
Among the reports that you have mentioned, you have mild liver derangements, and some EEG findings, but they are not suggestive of the symptoms you're having.
Apart from your thyroid, did you get your cortisol, and adrenaline levels checked? If you have kindly mention the values.
Most of your symptoms such as reduced concentration, fogging of brain. tremors , sudden increase in heartbeat, feeling of insecurity, persistent fatigue could all indicate possible depression symptoms.
Regarding your urine dribbling, i see that your prostate size is normal. But since the dribbling has persisted in absence of UTI, chronic prostatitis/ cystitis needs to be ruled out. I will advise you get your prostatic secretion cultured. Because urethral swab is clean and urine routine is also normal, the only other cause of urinary dribbling is prostatitis.
You mentioned twice you were given antibiotics and you felt worse after taking them. Do you remember the name of the antibiotic?
You also seem to have nystagmus, with rolling eye movements. It needs to be checked out by an ophthalmologist. If nystagmus is persistent it may cause further fatigue and later problems with balance.
Feel free to discuss further,
Regards.
Patient replied :
Hi,
thanks for your answer. I have not had cortisol nor adrenaline checked. I'll make sure to ask my doctor.
I am getting a second opinion from a urologist and I will suggest the possibility of prostatitis/cystitis.
1) I don't have nystagmus - the neurologists examining my eyes have ruled that out. My eyes are perfectly fine, I have been to an ophtalmologist recently as well. However, I do have that strange problem with reading and I would like to find an explanation for it. It's very annoying and it makes reading very difficult. From what I've read on the internet I think that it's best described by a problem with saccading movements of eyes... I'm no doctor to diagnose that though. Is there any test that could help to objectivise this problem?
2) From your perspective, am I right to say that we can rule out all immunological deficiencies/problems?
3) the first antibiotic was pennicillin I think... The second one's name I can't remember, it was a strong 3-day course ATB against bronchitis.
Hello,
Thank you for your follow up reply.
To reply to your specific queries,
Saccading movements of eyes could also occur in patients with no ophthal complaints. There are no such tests. With a normal ophthalmology examination, and nystagmus being ruled out, there is no need to worry.
Yes, your symptoms as i said are mostly suggestive of depression. Apart from that there is another possibility, which is rare but i have come across a few cases like that. It is known as Chronic Fatigue Syndrome, which is triggered by a viral ( upper respiratory tract infection ) and the recovery takes a long time. The affected patient usually has persistent fatigue following recovery, depression, chronic myalgia, and other anxiety manifestations. The cause is still not very clear, and the recovery is gradual but spontaneous.
But yes immonological causes have been ruled out.
Now one thing completely different from CFS/ Depression is your urine dribbling, and i think it is better you get your prostatic secretions cultured and rule out prostatitis, because there is really nothing else that can cause such dribbling. If confirmed, antibiotics for 6-12 weeks will cure it and symptoms will subside.
Hope this was helpful,
Regards.