Expert: Dr Ian Jackson - please note UK based - 2/25/2008

Question
QUESTION: Hello,  I had a simple outpatient surgery last May to remove ovarian cysts and tumors.  About 2 days after the surgery i started having dizzy spells and then eventually it led to being dizzy 24-7.  I was told by an ER doctor that i had vertigo, probably associated from the anesthesia and having the tube down my throat.  I was told to take seasickness pills and i would be fine.  But eventually this vertigo led to short term memory loss, dyslexia and concentration problem along with migraines.  I've seen every doctor i can think of and no one can tell me exactly what may of happened.  Is it possible to of had some sort of reaction to the anesthesia that was administered?

ANSWER: Hi Deborah
You don't mention how old you are but from the procedure described I imagine you are under 40. I am also unsure of you were well for the first 2 days before this started - it sounds like you were?
If the above is true then it is unlikely that the anaesthetic led to a delayed reaction. However I would never say never. There is evidence that the combination of anaesthesia and surgery can have a major effect on patients brain function in older patients (6% in those over 60 rising to 14% in those over 70) that is still a problem at 3 months after surgery. I suspect but cannot produce evidence that this may mean that a lower percentage of younger people MIGHT experience a similar effect.
However given 2 days of feeling OK then I am a bit suspicious that you may have experienced a viral infection following surgery that has led to your problems. Viral encephalitis can cause the problems you have experienced. I assume from your spelling that you are in the USA and so one would have to consider the various tick borne diseases as well which I have no experience of and have only read about in our medical journals. examples include Lyme disease and Rocky Mountain Fever.
So I don't have an answer for you but I can give you some ideas to follow up.
Kind regards
Dr Ian Jackson

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your quick answer.  I was 36 when i had the surgery, and i've also had 4 spinal surgeries.  I don't quite remember the first two days after the surgery, just hurting alot and very very tired.  And my ears ringing all the time, and still do.  It has affected my hearing. I know from other surgeries that sometimes after surgery i have some memory loss, but usually returned after a few weeks, with no side effects.  But not this time.  Like i said before, i have seen several doctors and have had alot of different tests, but have not come up with anything other than complicated migraine syndrome.  I'm at a loss and am tired of being this way.  Some days my brain feels like scrambled eggs because i cannot think properly.  I almost feel like a person who has at a late age developed Attention Deficient Disorder.  Any suggestions you may have to check into would be greatly appreciated.  And yes, i'm in the USA, and that's why i was happy to see that you were from another country and that you may have other idea's that my doctors are not thinking of.  Thanks again for all your help.

ANSWER: Deborah
The ringing in your ears is a bit strange. Did you have a spinal (or epidural) anaesthetic as part of your anaesthetic technique? This involves an injection in your back which is often done when you are awake but may have been attemnpted while you were asleep.
It is important to know as the symptoms you describe could be a bit like those caused by a leak from your cerebro spinal fluid. This can be a chronic condition though this is not well documented and and there are treatment options for this.
This is just another 'shot in the dark' trying to weigh up the info you are providing but it could explain how you are feeling.
Kind regards
Ian

---------- FOLLOW-UP ----------

QUESTION: I am not sure about a spinal anaesthetic during this particular surgery, to be honest we weren't told much, but the surgeon was more than willing to settle for 1/2 his bill when i had to quit my full time job due to these complications and could not pay my bill in full following the surgery.  So i have my suspicions that something may of happened and we're not being told.  I have had an epidural type anaesthetic before on one of my previous back surgeries, but that was 8 years ago.  All i know is that after loosing my weight, (I lost 130 pounds due to gastric bypass surgery) my back was fine and really had minimal back pain, but some neck pain and headaches, to which i was getting injections in my neck for pain management and some injections in my spine for the slight pain i had, but when i had to quit my full time job, i had to quit these injections, to which after this outpatient ovarian surgery, having alot of back pain with the neck pain, along with migraines, dizziness, confusion, dyslexia, and memory loss.  I've had countless MRI's, CAT scans and blood tests (we've never been told what tests they were doing) and seen several regular doctors along with neurologists, only to be diagnosed with complicated migraine syndrome, but to be honest...after this happened, it was almost like i had a stroke, i couldn't talk properly, i could think of what i wanted to say, but couldn't get my mouth and brain to correspond with each other.  And i started stuttering, with slow and slurred speech.  I started having head and arm seizures, and eventually they all got under control, but the headaches still are ongoing.  Hence the reason they diagnosed the migraines.  But none of this started until after the surgery.  We are just looking for some type of possible answer to this, or a suggestion as to where to look next, and possibly give my doctor and push in the right direction, since they seem to not either want to take the time to look, or just at a loss and don't want to tell us that, or just don't have the necessary training.  Thanks so much for all your help.  You don't know how much i appreciate it.

Answer
Hi Deborah
It is difficult to be certain about what has happened here. I have tried to give you some ideas of what might have happened - however it is not possible for me to give you a definite answer where others have failed. It is possible you had problems during your operation and the surgeon and anaesthetist involved are the only ones who will really know. The trouble is a problem during your op causing problems with blood flow to your brain would not show up anything on scans as the damage would be quite 'diffuse'.
I can only wish you all the best and I hope that you get some respite from your symptoms.
Kind regards
Ian