Her Face Droops Without Explanation. Can You Tell Us Why?

Alvin

Alvin

Senior Member (Voting Rights)
For the past year, Ann felt as if she had been dealing with an overwhelming set of medical problems. Nearly 30 years earlier she developed diabetes but managed the disease by using an insulin pump. She had been a little too heavy when she was younger but lost most of her excess weight by eating better and exercising more often. But over all, she was healthy and happy until the year before when she developed a terrible burning pain and pressure in her throat and stomach any time she ate.
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https://www.nytimes.com/interactive/2018/11/16/magazine/netflix-diagnosis-series-ann.html
 
I submitted some thoughts, has she been checked for seizures during the episodes and so forth.
Any other ideas?
 
NelliePledge said:
Myasthenia Gravis maybe
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Apparently that was ruled out
She had many tests. A CT scan of her head was unrevealing as was an M.R.I., so it wasn’t a stroke or a tumor. A lumbar puncture (also known as a spinal tap) was performed and was normal, showing the cause of her symptoms wasn’t an infection or some kind of malignancy. It wasn’t Lyme, it wasn’t myasthenia gravis; it wasn’t multiple sclerosis; it wasn’t Sjogren’s. She wasn’t pregnant. It wasn’t H.I.V. or syphilis. Her inflammatory markers were in the normal range. So was her thyroid hormone level. (Many of the specific lab results can be found here.)
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[My bold]
Because the patient had symptoms but normal studies, the gastroenterologist suspected that Ann’s stomach and throat pain came from what is called a functional disorder. These are disorders that affect the way a body system works. Testing is normal; there is no structural or biochemical abnormality. But something about the way some system in the body works — in this case, the GI tract — causes the patient to have pain or discomfort.

This is not a psychiatric diagnosis; it’s not caused by stress, though, like many disorders, stress can make it worse.
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It is my understanding that many doctors in the UK would disagree with the idea that a functional disorder is not psychiatric. Many of them blame the patient's mental health and tell them they are probably stressed and they should lose some weight, do some exercise, and get plenty of sleep... Then they would prescribe anti-depressants and send the patient away hoping that they won't have to see them again.
 
It says she has a history of Lyme. That means a tick bite. I'd check for all TBDs that may be possible where she lives or traveled to that can progress to neurological symptoms. That list would include bacteria and viruses and parasites.

I am unclear what tests they even ran to determine she no longer had Lyme. I can see the antibody ratio in one of her CSF results but not certain that relates to Bb.

Regardless, if they have good evidence she once had Lyme, they by extension know she was bitten by at least one tick and hence all TBDs that can impact cranial nerves should be on the table.

Edited To Add: I see the WB reference, but find the "Imaging: No results found" claim a little disconcerting, ie, you'd think some immunological artifact would appear, say band 41. Again, I suppose it depends on how confident the earlier Lyme diagnosis was.
 
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Seems to be an issue with the nerves regardless - possibly further away from spine and a local issue? Even the response to Nortrip, a particular effective medication in conditions affecting the nerves suggests this.
 
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