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atg Posted - 07/21/2006 : 12:43:53
I am feeling very torn right now. I am working part time for one of the most eminent headache neurologists in the country. I have had severe headaches for over a year, and for the majority of that time have believed unequivocally that it was a TMS manifestation. I have all of the traits. Several of his clients have tested with high CSF (cerebral spinal fluid) pressure, and the neurologist is 100% certain that that is the cause of their headaches. He treats them using a multi-disciplinary approach (the drug diamox is supposed to reduce CSF pressure) and he has about an 85% success rate.

When I saw him as a patient a year ago, he gave me a lumbar puncture and diagnosed me with having high CSF pressure as well. I discontinued taking diamox after only a minimal dose due to severe dry mouth as a side effect.

The TMS psychologist I've been seeing believes the headaches are caused by the enormous amount of pressure I put on myself, of which I certainly do. But I am being torn in the direction of the physcial seeing all of these other headache patients on a weekly basis who have the same "high CSF pressure" diagnosis that I was given, and seeing many of them be successfully treated.

I asked the neurologist what causes high CSF pressure and he said that it is unknown at this time. So I suppose that it is possible that high CSF pressure is simply the mechanism by which the TMS is working, but that seems like a bold assumption (not to mention a convenient one).

Does anyone have any helpful insight? I know there is a neurologist who frequents this board, drzzt or something like that. I'd appreciate any insight or information regarding my narrow understanding of the process.

Thanks
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drziggles Posted - 07/24/2006 : 15:53:56
In that case, you may be right. If you have no evidence of papilledema, and the pressure you mentioned, a diagnosis of pseudotumor is a bit equivocal. I think that if that is the case, and your vision is normal, it would make sense to use the TMS approach if it makes sense to you as a cause of your headaches.

Naturally, you should consult with your physician before making any medical decisions.
atg Posted - 07/24/2006 : 14:38:16
Thanks. I know that extremely high CSF pressure can be dangerous, but mine was closer to the high range. I believe that the normal range is 10-20 Hg mm or something like that. And mine is around 22-23 Hg mm. So I thought that the neurologist might be (in an attempt to find a cause) assigning this slightly high CSF pressure as the cause of the headaches when it's really just a correlation.
drziggles Posted - 07/22/2006 : 15:59:34
I would be hard pressed to call that problem (Idiopathic Intracranial Hypertension, or Pseudotumor Cerebri) a TMS equivalent. You are correct that the cause is unknown, but it can have very bad consequences (blindness) if not treated properly, so this is one instance when I would tell you to go the usual medical route. This isn't to say you should ignore your emotional health, but you should listen to your neurologist as well.

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