I am having a health problem. The symptoms cycle over a 5-10day  cycle.
some of the symptoms are: some fatigue, head itchy at times, cognitive
impairment which is the biggest problem for me, memory recall and
problem solving are difficult. Fell at times that I am lacking soem
chemical or hormone or neurotransmitteer is getting burned out. then
regererates and have a few good days again then the cyclel starts
there is also tightness in the forehead and top without too much pain,
this is generally the most dibilitation in terms of memory & problem
solving difficulty. thanks you.
again. over and over until i lose my job. stress can make it worse.
at times i can feel surges of chemicals in my body as one of the symptoms.

Hello mnelson97-ga:

My friend and colleague sublime1-ga has made an excellent suggestion:
that the cause could be a chemical imbalance. If so, there have been
amazing developments in the psychotropics class of drugs that can help
correct such problems.
 
As you probably know, your symptoms are indicative of several
conditions. So, your first step, of course, should be to call your
general practitioner and ask for an appointment ASAP. She or he may be
able to diagnose you; if not, your doctor will refer you to a
specialist -- perhaps to several different specialists -- for further
examination and possible testing.

In the meantime, here are some possible explanations for your symptoms:


*******************************************
Chronic Fatigue Syndrome (CFS)/ AKA Epstein-Barr:
*******************************************

From Dr. Andrew Lockie's site:
http://www.drlockie.com/disease/cft.htm

Symptoms include:

". . . the main symptom is extreme tiredness that affects the patient
for 50 per cent of the time and has done so for at least six months
(some doctors say three months); the onset of symptoms can be
identified;  the fatigue is very debilitating and affects the
individual both physically and mentally . . ."
 
Under the homeopathic remedy "Natrum mur," notice that "itchy scalp"
is also listed as a symptom.
 
See the article ?Chronic Fatigue Syndrome and Memory Loss,?  by Dr.
Richard L. Bruno from ?TIPS AND TECHNIQUES FOR TREATING CFS/ME,?
published in the August 30, 2002, edition of  ProHealth:

?Do Chronic Fatigue Syndrome (CFS) patients have progressive memory
loss? When I am very fatigued or stressed I am unable to remember the
word I was going to say. I'm frightened. Am I getting Alzheimer's
disease along with CFS? No, what you describe isn't Alzheimer's. You
are experiencing word-finding difficulty which has nothing to do with
memory loss or Alzheimer's disease. Like so many fatigue-related
problems in people with CFS/ME, word-finding difficulty is also
reported by polio survivors with  ?brain fatigue.? In our 1990
International Survey 79% of polio survivors reported difficulty
?thinking of words I want to say.??

Here's a roundup of articles about Chronic Fatigue at WebMD. Note that
among the suspected causes of this syndrome are possible sinus and
heart problems:
http://my.webmd.com/search/search_results/?query=chronic+fatigue&filter=mywebmd_all_filter
Also check out this paper ?CHRONIC FATIGUE IMMUNE DYSFUNCTION SYNDROME
(CFIDS) Also Referred to as: YEAST SYNDROME  or  YEAST RELATED
ILLNESS,? by Elmer M. Cranton, M.D.
http://drcranton.com/CFIDS.htm

More on ?Chronic Fatigue Syndrome?:  You can review ?Clinical Practice
Guidelines?  from the Royal Australasian College of Physicians, at:
http://www.mja.com.au/public/guides/cfs/cfs2.html

Be sure to read the link, ?2: Evaluating people with fatigue,
What is "fatigue"?
http://www.mja.com.au/public/guides/cfs/cfs2.html
You?ll see there?s a plethora of possible causes of fatigue.

Here?s another helpful site, ?Memory Loss,? from Aetna?s InteliHealth :
http://www.intelihealth.com/IH/ihtIH/WSIHW000/31393/31393.html?k=navx408x31393

The link ?Reversible Causes? link brings up:
http://www.intelihealth.com/IH/ihtIH/WSIHW000/31393/31398/347135.html?d=dmtContent
which cites sleep disorders, stress, and thyroid disorders, among
various causes of memory loss. You will also see reference here to
Dementia and Alzheimer?s. Please don?t leap to the worst possible
conclusion! There are numerous treatable disorders that could explain
your symptoms.

Another helpful article ?Symptom: Concentration difficulty,? from the
site ?Wrong Diagnosis?:
http://www.wrongdiagnosis.com/sym/concentration_difficulty.htm

************
Stress/Cortisol
************

You mentioned stress exacerbates your symptoms. There may be a problem
with your cortisol levels. See ?Stress, memory and social support,? by
Sylvain Comeau, published in the McGill Reporter (published by McGill
University, Montreal), Sept. 26, 2002:
http://www.mcgill.ca/reporter/35/02/lupien/

?Many people expect increasing memory loss as they age, but impaired
memory has more to do with stress, according to a McGill research
project.

Specifically, the project looks at the hormone cortisol, which occurs
naturally in response to stress.

" ?Cortisol is a stress hormone, and there are receptors for cortisol
in the hippocampus, the region of the brain responsible for memory,?
McGill psychiatry professor Sonia Lupien explains. ?Long-term exposure
to these hormones can cause atrophy of the hippocampus, leading to
memory impairment . . . .??

The article notes such problems can be arrested and reversed in many patients. 


*******************************
Systemic Candidiasis/ Yeast Infection
*******************************

From the Pacific Health Center in Bellevue, WA:
http://www.pacifichealthcenter.com/updates/17.asp

If you were on antibiotics just before ? or while -- your symptoms
began, it may be that you have a yeast infection running wild through
your system.  Symptoms of this disease include: ?Confusion, fatigue,
depression, poor memory. . .?

***********
Fibromyalgia
***********

Like yeast infections, Fibromyalgia is often discussed, and explored,
in conjunction with CFS. Here?s some information on both conditions,
from the ?Fibromyalgia Network?:
http://www.fmnetnews.com/pages/basics.html

Under ?SYMPTOMS AND ASSOCIATED SYNDROMES,? see: ?Fatigue - This
symptom can be mild in some patients and yet incapacitating in others.
The fatigue has been described as ?brain fatigue? in which patients
feel totally drained of energy. Many patients depict this situation by
saying that they feel as though their arms and legs are tied to
concrete blocks, and they have difficulty concentrating, e.g., brain
fog.?

**************
Diabetes Type II
**************

See this overview from  the Florida State University
http://garnet.acns.fsu.edu/~jgl8870/diabetes_type_ii.htm
" Symptoms of inappropriate blood glucose levels may include: fatigue,
increased thirst, increased urination, headache, blurry vision, dry
and itchy skin, hunger, confusion, shakiness, nervousness . . ."

Fatigue is also listed as a primary symptom of Diabetes Type II at
this site, maintained by the National Institutes of Health:
http://www.nlm.nih.gov/medlineplus/ency/article/000313.htm 

**********
Hepatitis C
**********

Symptoms of Hepatitis C include fatigue, memory loss, confusion, and itchy skin. 

See ?New Treatment Helps Some, But Cure Remains Elusive,? by John
Henkel, published in the FDA Consumer Magazine, March-April 1999:
http://www.fda.gov/fdac/features/1999/299_hepc.html

?Elaine Moreland knew she wasn't imagining the symptoms. Fatigue,
migraines, nausea, memory loss, anxiety, and dizziness all were
wreaking havoc in her life. Yet doctor after doctor could find nothing
wrong with her. . . Finally, in 1992, after suffering for several
years, she went to another doctor in tears. ?I told him that I was not
leaving his office until he found something,? she says. Through
extensive testing, he did. Moreland, then 32, had hepatitis C.?

**********
Toxic Mold 
**********

Enviro-Care, a company that removes mold, lists symptoms that include
memory loss and chronic fatigue as symptoms of toxic mold exposure:
http://www.aenvirocure.com/aec_eng.cgi?USERID=R9514852822515-66.196.90.227&DBL=BIOCONTAM

**********************
Carbon Monoxide Exposure
***********************

Perhaps you?re being exposed to elevated levels of carbon monoxide in
your home, your car, or your workplace.

From the Illinois Department of Health?s Web site:
http://www.idph.state.il.us/public/hb/hbcarbon.htm
?At low levels, CO exposure causes no obvious symptoms, although
people exposed to low CO levels may experience decreased exercise
tolerance and shortness of breath during exertion. Tightness across
the forehead, flushed skin and slightly impaired motor skills also may
occur. The first and most obvious symptom is usually a headache with
throbbing temples.? Symptoms can progress to include ?fatigue? and
?diminished judgment.?


*********
Parkinson?s
*********

While most of us think of this as disease that causes shaking and
impairs motor skills, symptoms include memory loss.

From Rutgers University?s ?Memory Loss Project?: ?In addition to the
motor symptoms in Parkinson's disease, there are also cognitive
symptoms which may be evident even in the early stages of the disease.
These may include deficits in executive function (especially planning
and attention), set-shifting (ability to alternate between two or more
tasks), and memory . . .?

Note the mention of dopamine neurotransmitter. You can read more about
dopamine at this page from the ?Memory Loss Project?:
http://www.memorylossonline.com/glossary/dopamine.html

****
PMS
****

You didn?t mention your gender, but if you?re female, this could be a
severe case of PMS, which would explain the sense of hormone/chemical
surges, and the fact that these symptoms typically occur in 5-10 day
cycles.

See: ?Female - Premenstrual Syndrome,? by Chanchal Cabrera MNIMH, AHG.
Published in Medical Herbalism (date unknown).

?The imbalance of estrogen and progesterone may be due to a disruption
of the normal feedback systems that control the
hypothalamus-pituitary-ovary axis or to a dysfunction of any one of
these glands (most commonly the ovaries).? Symptoms include dramatic
changes in energy level.

Another possible hormonal explanation: Many women experience memory
loss, along with fluctuating energy levels, during menopause.

************
Lyme Disease
************

See the American College of Physicians? ?Patients? Guide to Lyme Disease?:
http://www.acponline.org/lyme/patient/diagnosis.htm

If your symptoms began quite recently, it?s possible you?re in early stage Lyme.   

**************
Form of Amnesia 
**************

It sounds farfetched, but this is a possibility. Please see ?Memory
Problems and their Assessment. Synonym: amnesia,? from Patient UK
http://www.patient.co.uk/showdoc/40024840/

?Amnesia may occur as a temporary state as is seen with transient
global amnesia, in which there is a sudden onset of severe amnesia
that lasts several hours before resolution. Recurrent attacks of
self-limiting amnesia may occur as a consequence of epilepsy. Patients
with dementia are often unaware of, or deny, their memory loss. The
problem is more often presented by a concerned friend or relative.
Patients who present themselves are more likely to be suffering from
anxiety or depression. Memory loss is also a feature of any cause of
acute confusion.?

You may be tempted to experiment with some of the herbal remedies,
diets, or exercise regimens recommended in some of the resources I
cited, but I suggest you refrain from doing so. I urge you to see your
doctor at once, as your first step. When you go, take along a list of
all the symptoms you've been experiencing. Also, try to remember when
these symptoms began; where were you, what happened, etc. All of these
clues will help your doctor diagnose your condition.
 
It?s essential that qualified medical personnel evaluate you. Should
you need a reuptake inhibitor, or be found to have high blood sugar,
etc., you will need to be under sustained medical supervision.

Chronic Fatigue, a very possible culprit in your case, remains under
debate; some doctors consider it a "phony disease." (In the '80s, when
the disease first surfaced, it was derisively referred to as "The
Yuppie Flu.")
 
If testing rules out any other condition, and you find yourself
convinced that it is Chronic Fatigue, and if your doctor is among
those physicians who believe this disease is psychosomatic, find a
doctor who does believe your problems are real and who is committed to
helping you.
  
Search Strings:

itchy head +memory +fatigue 
fatigue AND itchy AND confusion
memory loss AND fatigue
sudden onset cognitive problems +memory loss
sudden onset cognitive problems +memory loss +itchy scalp
memory loss AND tightness in forehead
 
I hope my research is of help to you, and that you are diagnosed (correctly) soon.
 
Best Regards,
nancylynn-ga
Google Answers Researcher

---

Request for Answer Clarification by mnelson97-ga on 27 Jul 2005 03:04 PDT

Thanks. I had meant to add to the question today but you have
answered already. I meant to add that I have taken ativan on
and off for about 2 years. I am a seeing my family dr and finally got
him to test for cortisol, testosterone, DHEA. no results yet, any others he should
test for. i also have an apt. with a neurologist. any thoughts on a
vascular problem, I did have an mri which was relatively normal.
finally, the feeling is though my brain is not getting enough oxygen.
dont think this is the case but thought i would mention it. thanks.

---

Clarification of Answer by nancylynn-ga on 27 Jul 2005 11:59 PDT

Hello again mnelson97-ga:

I?m sorry to learn your problems have been ongoing for so long.

In response to your request, I found this information:

***********************
Vascular Dementia (VaD)
***********************

From the Memory and Aging Center at the University of California at
San Francisco Medical Center:
http://memory.ucsf.edu/Education/Disease/vad.html 

?The term Vascular Dementia (VaD) is usually reserved for an
insidiously (subtly) progressive worsening of memory and other
cognitive functions. In this way and others, VaD patients present with
similar symptoms to Alzheimer?s disease (AD) patients. However, the
related changes in the brain are not due to AD pathology but due to
chronic, reduced blood flow in the brain, eventually resulting in
dementia.?

From Memory Loss & The Brain newsletter, Summer 2000 issue, published
by Rutgers-Newark: This article, ?Causes of Vascular Dementia,? cites
oxygen cutoff as a cause of this form of dementia:
http://www.memorylossonline.com/pastissues/summer2000/vasculardementia.html

?The underlying cause of vascular dementia is an interruption of blood
flow to the brain. Starved of oxygen for even a short time, brain
cells perish.  . . .?

? . . . vascular dementia . . . is probably the second leading cause
of dementia, but has been somewhat overshadowed by the more well-known
Alzheimer's disease. Caused by blockages and breaches in the brain's
blood supply that damage the brain, vascular dementia can be prevented
and, in some cases, even reversed.?
 
*******************
Hemiplegic Migraine
*******************

Here are some references (but not necessarily full articles,
unfortunately), to migraine-induced confusion:

You mentioned off-and-on tightness in the forehead and itchy scalp,
but didn?t describe it as a headache or migraine, but this information
still may be of interest:

See the National Library of Medicine?s citation to the research paper
?Episodes of acute confusion or psychosis in familial hemiplegic
migraine,? published in the April 1982 issue of Acta Neurol
Scandinavia:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7102264&dopt=Citation

Also, from the same site, see ?Hemiplegic migraine,? a reference to a
1995 paper in Presse Medicale. (That study has been published only in
French.) Symptoms include confusion and cognitive impairment:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7899422&dopt=Citation

Hemiplegic migraine is usually defined as having sudden weakness in
one side of the body, but confusion can be a symptom, too.

See the ?Headache/Migraine? site, maintained by Teri Robert, at About.com:
http://headaches.about.com/od/migrainediseas1/a/hemiplegic_mig.htm
 
?Hemiplegic Migraine is a rare form of Migraine disease, made more
confusing by there being two variations: Familial Hemiplegic Migraine
(FHM) and Sporadic Hemiplegic Migraine (SHM).? (The latter, Sporadic,
sounds closer to your symptoms.)

Symptoms include: ?Impaired consciousness ranging from confusion to
profound coma.?

*******************
Ativan Side-Effects
*******************

Did your memory problems start after going on Ativan?

From WebMD?s ?RxList?:
http://www.rxlist.com/cgi/generic/loraz_ad.htm
?Memory impairment? has been reported by patients using this class of drugs.

Other Possibilities:

**************
Pick?s Disease
**************

From the National Neurological Institute of Neurological Disorders &
Stroke (NINDS):
http://www.ninds.nih.gov/disorders/picks/picks.htm

?Pick's disease is a form of dementia characterized by a slowly
progressive deterioration of social skills and changes in personality,
along with impairment of intellect, memory, and language . . .?

In the menu at left at this page, you can link to research and studies.

At DoctorUpdate, see this list of causes of memory loss:
http://www.doctorupdate.net/du_toolkit/s_sorters/s51.html
You?ll see several problems linked to occasional memory loss,
including thiamine deficiency.
 
**********************************************
Wernicke's Encephalopathy: Thiamine Deficiency
**********************************************

From the Whitaker Biomedical Engineering Institute at Johns Hopkins:
http://www.bme.jhu.edu/labs/chb/disorders/wernicke.html

?The mental changes, usually a quiet apathy initially, only later may
convert to the confabulation that some patients have with Korsakoff's
psychosis. The major cognitive deficit is one of memory, predominantly
incorporating new memories. It is also important to note that patients
may have as their only sign of Wernicke's disease, a change in mental
function.?

Search Strings:
sudden onset cognitive problems +memory loss +vascular
vascular dementia
ativan +side effects
Hemiplegic migraine
recurring memory loss +oxygen
recurring memory loss AND 5-10 days AND oxygen
thiamine deficiency +memory loss

I hope this additional information is of help to you.

Best Wishes,
nancylynn-ga

---

Request for Answer Clarification by mnelson97-ga on 29 Jul 2005 13:10 PDT

thank you for all the info. helpfull. Once more clarification
if you might. like i had said i have been taking ativan on 
and off, mostly on, for a couple of years. I have noticed a couple
of webiites that say long term usage can cause cognitive problems.
aside from just stopping taking it, do you have any recommendations
for what i might take or do instead to get through a withdrawal,
if this is the cuase, it said on one website it might take 6-18 mo
for the brain to recover fully. i know about ssri and many other
meds for reference. i would like to try to stay as natural as possible
for awithdrawal. any comments wold be appreciated. thank you. ps i
have pain in the back of my sinuses at teh sime time i hva the cog 
problems, and sometimes tightness and pain behind the eyes. have an
apt with a neuro soon but what do you recommend in the mean time during
the withdrawal trial. thanks. i had done withdrawal once before and the
cog disfunc. still reappeared at one point. bu maybe i need to stay off
for a long tme to see full results. thanks.

---

Clarification of Answer by nancylynn-ga on 29 Jul 2005 21:43 PDT

When you go to the neurologist, make sure you bring a list of all your
symptoms. Describe these episodes with as much detail as you can, to
assist the neurologist in making a diagnosis. Even write down a
detailed description of an episode, in case you're having a bad day
the day of your appointment.

The pain you're describing behind your eyes, in your sinuses, etc.,
may suggest that your problem is rooted in migraines or Chronic
Fatigue. I included some information on those conditions in my answer,
and that's something you should discuss with the neurologist.

To learn about migraines without headaches, go to the previously cited
Headache site at About.com:
http://headaches.about.com/od/asktheclinicia1/f/062804_4f.htm

Then click on "Anatomy of a Migraine" to bring up:
http://headaches.about.com/cs/headpain101/a/anatomy_mig.htm
Symptoms from the aura stage include: 
"difficult finding words and/or speaking . . . confusion . . ." 
 
Also see the Northern Virginia CFS/FMS Support Group's site about
"Chronic fatigue and immune dysfunction syndrome (CFIDS)," aka Chronic
Fatigue Syndrome:
http://www.geocities.com/cfsnova/whatscfs.html

"CFIDS is characterized by incapacitating fatigue (experienced as
profound exhaustion and extremely poor stamina) and problems with
concentration and short-term memory. It is also accompanied by
flu-like symptoms such as pain in the joints and muscles . . . " and
dry eyes" . . . and "sinus pain." [Symptoms vary widely from one
patient to another.]

"Additional symptoms are frequently reported . . . such as
word-finding difficulties, inability to comprehend/retain what is
read, inability to calculate numbers and impairment of speech and/or
reasoning. . . ."

Another possibility: ME/ICD-CFS (Myalgic Encephalomyelitis,
Classification of Diseases, Chronic Fatigue Syndrome). From a December
2001 report published by the UK's 25% M.E. Group:
http://www.25megroup.org/Information/Medical/what%20is%20me.htm

Symptoms include:
"Vascular headaches are common and recurring . . . Problems with
short-term memory are common: cognitive impairment is significant and
includes difficulty with memory sequencing, processing speed, word
searching; dyslogia, spatial organisation, calculation (dyscalculia),
and particularly with decision-making. In relation to the degree of
cognitive impairment, American researchers found that 'the performance
of the CFIDS patients was sevenfold worse than either the control or
the depressed group' . . . ."

I understand your concerns about Ativan and your desire to try going
off of it. I don't know which Web sites you've reviewed re: long-term
effects of Ativan, but WebMd is a very authoritative site. Here's
WebMD's page on Ativan:
http://my.webmd.com/drugs/drug-6685-Ativan+Oral.aspx?drugid=6685&drugname=Ativan+Oral
 
I suggest you read that information very carefully, then raise any
concerns about the drug with the neurologist.

It would be the height of irresponsibility for me to recommend that
you go off the Ativan now and replace it with any alternative,
including an herbal one. I'm also leery of you adding herbs at this
time, as it could cause a serious interaction.

From MedicineNet.com:
http://www.medicinenet.com/lorazepam/article.htm
"Like all benzodiazepines, lorazepam can cause physical dependence.
Suddenly stopping therapy after a few months of daily therapy may be
associated with a feeling of loss of self-worth, agitation, and
insomnia. If lorazepam is taken continuously longer than a few months,
*stopping therapy suddenly may produce seizures, tremors, muscle
cramping, vomiting, and/or sweating*."

I also saw references to patients going into seizures after stopping
Ativan cold turkey. So, as you can see, stopping use of this drug
could lead to even more misery -- just what you don't need!

If you believe the Ativan is making your problems worse, I suggest you
call your gp on Monday to ask if you can try going off the drug. If
your doctor agrees (which is doubtful!), s/he will tell you how to
wean yourself slowly and safely off Ativan. However, in that event,
the doctor is also likely to insist that you then go on another drug.
(It may be that going off and on the Ativan, as you have, may have
exacerbated problems.)

If your gp isn't amenable to the idea of you going off Ativan at all
at this time, you'll have to wait until you see the specialist. The
neurologist may come up with a new diagnosis and switch you to another
drug, or may be able to explain to your satisfaction why it's best for
you to remain on this drug, despite the risks. (My personal suggestion
is that you not change your regimen until you see the neurologist.)

Here are some resources about Ativan and herbs, but it's isn't promising news: 

Several articles about "Ativan Side Effects," from About.com's Panic/Anxiety site:
http://panicdisorder.about.com/od/ativansideeffects/

Regarding natural alternatives to Ativan: I can't find any concrete
information that there is generally agreed upon herbal replacements
for, or complements to, Ativan. Here's some examples of what I found:
 
"Hops, Kava-kava, Valerian, St. John's Wort" are suggested at 
http://www.energywave.com/alternative-complementary-therapies/herbal-RX.htm
Energy Wave's medical adviser is Richard Podell, MD:
http://www.drpodell.org/

But on the other hand:

"Case reports show that St. John's Wort *can decrease* the therapeutic
effects of lorazepam medicine. Talk to your health care professional
before taking any nonprescription or herbal products." From Dr. John
Grohol's "Psych Central:
http://psychcentral.com/meds/ativan.html

In fact, while searching for herbs, I mostly found warnings -- from
reputable medical sites -- about possible harmful interactions from
combining herbs and Ativan. I certainly didn't find anything to
suggest that an herb can be as effective as benzodiazepine in a case
like yours that involves such serious symptoms.

So please check with your doctor before weaning yourself off Ativan
and/or using any herbs. When you meet with the neurologist, make clear
that you are interested in any possible natural remedies. This
specialist may be able to suggest some or, just as likely, warn you
which herbs you should avoid. There may be some herbs that will help
you, but I don't think you should expect to be told that you can
replace a prescription medicine with an herb -- that's unlikely.

Another suggestion: You might want to check out, and even post a
question at, the Cleveland Clinic's Neurology Forum. See their
discussion board on "benzodiazepines [including Ativan], brain
atrophy, and much more":
http://www.medhelp.org/forums/neuro/messages/32911.html

To post a question there, go to:
http://www.medhelp.org/forums/neuro/wwwboard.html

I hope the neurologist can diagnose your problems and get you on the
road to full recovery soon!

---

Request for Answer Clarification by mnelson97-ga on 30 Jul 2005 15:40 PDT

thank you for all the info. it has been very helpfull.
i have a little trouble reading allof it right now as
i am having the problem. have to read slowly and dont
absorb it nearly as well as normal. its almost like a
cramping of the brain, or the brain is strained. sorry
for all the clarification request but as i said my memory
is not that great when this is happening. lasts 2-8 days.then a
few good days. 
i do not seem to have any permanent damage as when i am
ok i seem quite normal. i am familiar with the withdrawal
problems of ativan etc. i have been going to work like this
on some days and not funcioning well and it causes me incredible
stress. i feel i am damaging myself with stress going to work like this
but i just started the job 3 mo ago, and am very concerned about
losing the job, it is a great company, the best i  have ever
worked for. thinking about going on short term dis. if they
allow it. the only problem is they would want to know what the
problem was when i go back, so i would have to find a dr. that
would word it the right way. stress,anx would not be good to write.
i honestly hope it is the ativan, that way i know what it is and
what to do. i feel like the only person in teh world like this. 
i did go to that neurol. posted a question on the anx. section.
will also post one on the neuro part when they allow more questions.
went to the uk site also, a little scary, but i would almost rather
know what it is than constantly be in doublt. adding numbers in my
head is difficult, normally extremely easy. I did try going off the
ativan some time ago. had a few good days, but about five days or so
later, cant quite remember, the problem recurred, maybe i need to be
off it for much longer for the effect to completely go away, it was
very disappointing when i had the recurrence when i was off the ativan
for several days. ativan seems to have no effect on this when it is
happening, and i am not visibly or mentally anxious WHEN IT IS HAPPENING
and can even smile, but am a little anx and depres. due to having a major
health problem of course. again sorry for the clarification requests.
one last question, would a vascular problem show up on an mri. thanks.

---

Clarification of Answer by nancylynn-ga on 31 Jul 2005 13:12 PDT

Hello:

I was worried that I was giving you too much information at once. This
is a complicated subject, but of course, the last thing you need is to
feel even more overwhelmed!

It may well be the Ativan that's adding to your woes, and the
neurologist may be open to weaning you off of that and switching you
to something else. Again, please don't attempt withdrawal on your own.
Nor should you introduce herbal remedies to your system without the
doctor's permission.

As for vascular dementia showing up on MRIs: yes, it seems evidence of
dementia can be spotted on MRIs.

See  "Vascular Dementia," written by Richard L. Strub, MD, published
in the Ochsner Journal, Volume 5 (date unknown):
http://www.ochsnerjournal.org/ochsonline/?request=get-document&issn=1524-5012&volume=005&issue=01&page=0040
   
" . . .  many cases of dementia are caused by cerebrovascular
disease?vascular dementia caused by cerebrovascular lesions. Factors
supporting the diagnosis of vascular cognitive impairment and dementia
are:
History of hypertension

Previous cerebrovascular accidents (CVAs) or transient ischemic attacks (TIAs)

A progressive deterioration in mental status

The presence of abnormal neurological signs

Scattered cognitive defects, e.g. aphasia

Extensive ischemic changes on MRI scan . . . "

So, yes, there would be evidence of dementia on an MRI.

You told me the MRI your doctor had ordered turned out "relatively
normal."  If it's been a while since that MRI was done, the
neurologist is apt to order another MRI.

This article may help you prepare emotionally for your appointment:

" Evaluation and Tests - What is a Neurological Exam?"  from the
University of Chicago's Jack Miller Center for Peripheral Neuropathy:

http://millercenter.uchicago.edu/learnaboutpn/evaluation/neuroexam/index.shtml

I realize how you worried you are and I empathize completely. Try your
best to stay positive. There are numerous conditions that could be
causing your problems and many of these conditions can be controlled.

Once you're diagnosed, consider joining a support group. Not only will
you have other shoulders to lean on, you'll undoubtedly learn some
coping skills from others who have dealt with the same condition.

I wish you the best,
nancylynn-ga

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Request for Answer Clarification by mnelson97-ga on 01 Aug 2005 06:58 PDT

I think this will be the last clarification.
Something I remembered to mention to the doctor
yesterday. When i move my head to the left and
right and other ways including physically moving
parts of my head with my face you can hear a 
crackling noise, it wasnt my  neck. the dr agreed.
he wasnt sure where it was coming form. Kind of
frightening but may be the source of the problem. 
one thing the dr mentioned was arthritis. arthitus
in the head? thanks.

---

Clarification of Answer by nancylynn-ga on 01 Aug 2005 20:17 PDT

I'm afraid I can't find much information on this symptom, although
arthritis certainly seems a plausible explanation. (Skull or cranial
bones do move, so if you have some arthritis in those bones, that
would explain the cracking sounds, I would think.)

See this discussion board on arthritis of the neck and skull at HealthBoards:
http://www.healthboards.com/boards/archive/index.php/t-15135.html

The participants there have been diagnosed with other, associated
conditions, too. If any of those sound like your symptoms, just Google
the name of the condition.

It could be TMJ:

"Clicking, popping, or grating sounds in the jaw joint when opening or
closing the mouth (which may or may not be accompanied by pain) . . ."
From WebMD:
http://my.webmd.com/content/article/66/79637.htm

TMJ is also associated with Fibromyalgia. See the Mayo Clinic's page
on that condition:
http://www.mayoclinic.com/invoke.cfm?objectid=96E57CAC-F3E9-468B-8824304CCE012FD1&dsection=2

You may also want to review a Google Answers question "Q: popping sound in head":
http://answers.google.com/answers/main?cmd=threadview&id=249563
which was answered by my colleague pafalafa-ga, who proposed two
theories as the possible cause: "(1) Noises related to
exposure to electromagnetic radiation, and (2) noises as a result of
perilymphatic fistula -- a leaking of fluid in the ear." Pafalafa-ga
provided extensive information on those conditions, and reading that
information may be worthwhile for you.

I really don't have any other leads on this symptom, but the cracking
sounds are certainly something you want to mention to the neurologist.

Since you are having difficulty remembering symptoms, you may want to
print out this page and give the doctor our Q & A dialogue to review.
I'm sure my comments will be of little interest to a highly trained
specialist (!), but your original Question and Requests For
Clarification will give the neurologist a good, comprehensive overview
of your symptoms.

Giving your doctor a printout of this page will be especially helpful
if on the day of your appointment you're having a bad day.

---

Request for Answer Clarification by mnelson97-ga on 02 Aug 2005 12:35 PDT

Hi. thanks for the info. I went to another dr today and he didnt give
an honest listend for the crackling even though i prodded him.
probebly never heard of it before so didnt want to listen. first said
he didnt hear anythign then said it was  my neck. by the way it is not
tmj. thanks for the info

---

Clarification of Answer by nancylynn-ga on 02 Aug 2005 15:15 PDT

It is likely arthritis. If the doctors aren't concerned about that
symptom, I wouldn't worry either.

I'm afraid I've pretty much exhausted every lead on your symptoms. The
neurologist should be able to put all your symptoms together for a
diagnosis --I certainly hope so.

Again, I hope you're diagnosed correctly very soon and I wish you the best.

mnelson...

I worked in the mental health field for 20+ years.
It sounds to me like you may, indeed, have an imbalance
in brain or endocrine chemistry. Many people don't realize
that such imbalances are often related with what are called
mental illnesses.

I would strongly recommend that you seek a psychiatric
evalutation in which a thorough discussion of your symptoms
can help determine whether this is something which needs to
be treated as a psychiatric condition or a physical one.

sublime1-ga