Question Title: Combination of problems - neurological and /or orthopaedic?

Forum: Neurology Forum
Topic: Lupus

Posted by CCF Neurology MD(B) on February 25, 1998 at 18:20:52:

In Reply to: Combination of problems - neurological and /or orthopaedic? posted by Linda on February 13, 1998 at 23:08:47:

: Hi,
I am a 35 year old female writing to ask a question about some problems I have been having since last summer. It all started with a stiff neck which progressed to tingling on face, tongue numbness ,optic neuritis, leg weakness and various tingling and strange sensations all over. Eyes still sensative to bright lights ocassionally and busy patterns and fast movement still cause me dizziness which has basically left after about 6 months. (finally)

I suffer from a head too heavy for my neck as I call it - which seems to get worse towards the end of the day. My upper arms burn towards the end of each day. I have what I call bladder problems - my bladder seems to forget to notify me when it is time to go to the bathroom - when my back begins to ache - that is when I know it is time to go. I have had no urinary or bladder infections as far as I know. My genital area occassionally goes numb.

I have been having problems with my right leg going numb on the front of my thigh to down below my knee and the area of decreased sensation has never fully recovered all it's normal feeling - this often extends down to my ankle area and at times seems to creep up on the left side up to my calf area as well. When walking long distances - this same area burns tremendously.

Not long ago I woke up and could not walk - severe pain in the tailbone area - emerg doc said it was a muscle spasm .A few months or so ago I started waking up in the middle of the night trembliing,vibrating from head to foot and then drifting back to sleep - this happened several times over a period of about 3 months.

I have had all the tests for MS,Lyme and Lupus. All bloodwork negative, MRI normal and spinal tap normal. CBC shows slightly elevated cholesterol and everything else falls into normal range.

My question is this - could this be a horrible virus which is finally wearing out? Could this be caused by spinal problems? My neuro says he is confused but wants to continue to monitor me for a few more months. I feel so much better than I did a few months ago, but am still not back to my normal self.

Is this consistent with MS - should I just continue on with my daily routine and forget about it as I have tried to do these past months, hoping none of these symptoms return, or should I investigate the spinal route?
=Dear Linda,Because of your age, gender ad the following symptons:optic neuritis, sensory changes, extremity weakness, spasms and bladder dysfunction that was initially improving and now (per your second message) is again, at least partially worsening, would indicate that a demyelinating disorder (i.e. MS0 should be ruled out. This would mean that you be re-evaluated by a neurologist, preferably one who specializes in MS/Demyelinating disorders, and it may be also necessary to repeat the MRI (with the addition of cervical and thoracic spine), the spinal tap and to add VEP(Visual Evoked Potential). It may also be beneficial to repeat the blood work for Infection(viral), Lupus, Metabolic and Lyme(if you were in area where the tick is found). After this clinical evaluation, hopefully a diagnosis will be forthcoming. "This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition."
Any suggestions would be greatly appreciated- my funds are greatly dwindling after all of these expensive tests, but I do not want to neglect a spinal problem if that could cause irreversible damage.

Thanks so much for your time -

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