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WHAT IS THIS?

by Pat to Kathy, Apr 06, 2000 12:00AM
Physically active,healthy, vegetarian 33 y.o. female.



Oct: pain in right calf area that comes/goes. Sometimes tender when foot is flexed but does not feel like muscle/tendon pull. IBS, cluster headaches, nasal congestion and fatigue. Calf pain checked for blood clot – goes away in 3-4 days.



Nov-Dec: bombarded by symptoms in @ following order. Mood swings, weird, tension-like headaches. Bloated feeling, constipation turns into IBS. Chilled feeling lasts for days, yet no fever.  Skin feels hot, sensitive; sometimes resembles slight sunburn.  Calf pain (same place) causes numb foot one night in bed – no blood clot. Eyes bloodshot (lasts weeks). Stomach pain turns into burning feeling/reflux (diagnosed w/IBS and GERD). Weird headaches turn into cluster headaches with slight visual disturbances (disturbances diminish after I stop Prolisec). Chronic congestion w/productive cough, vaginal discharge, low back pain and UTI “feeling”. Cat scan negative, all blood tests OK, UTI positive – given Cepro.  Extreme fatigue, can’t get out of bed, assume I have “bug”. Intense GERD, given Prevacid, lose 20 lbs. Right pectoral muscle/underarm area sore for days (off/on) as well as chest/rib pains and right eye twitches, hear palpitations. Breast exam OK. Notice feet/hands “fall asleep” quicker than normal.  Next day hands are tight/sore, arms/legs feel heavy. Following day legs/arms are achy/heavy (like after a tetenus shot) and fleeting pins/needles feeling in both legs/arms (sometimes feels like itching).  Moderately sharp migratory pains (lasting for seconds) all over for 3-4 days: hands, wrists, fingers, back, neck, legs, feet, toes, bottom of feet. Went to doc regarding fears of MS/autoimmune disorders.  All blood tests (ana, sed, rf, rpr, hiv, hep b/c, b-12, folic acid, potass and mag) negative. Told I have anxiety disorder and referred to therapist, started on Paxil. Low “fever” of 99 for several days. Night sweats and disturbed sleep. After days of worry, endoscopy of stomach shows “mild chronic gastritis”. Pains resume – back of one leg feels sunburned to touch. Chronic congestion again. Panicky feeling I am dying. Gradually pains diminish in frequency and to a dull ache, then disappear. Energy level resumes to normal.



March: another stressful time and same symptoms reoccur in @ same order (no GERD).  This time heavy limbs/migratory pains are proceeded by several days of waking up feeling achy and stiff in back, neck and arms (like I slept wrong). Back pain/UTI feeling but test is negative (given antibiotic anyway). Fleeting pains start.  Got scared when, during 1 day of walking a trade show, right quadricep felt so weak that right foot felt like it was flopping behind me.  Friend said I looked like I had a drunken walk. After resting several times, entire body stiff and sore – felt like I needed a wheelchair. Exhausted, felt like I had the flu.  That night right foot was numb (while in bed only).Next day entire body felt slightly stronger but ached (when I moved muscles) like I had endured intense strength training. Emotional/scared. Brain MRI “clear”, sed rate still OK. Pains and all other symptoms listed above start/continue. “Spastic” bladder feeling occasionally (pulses of pain). New symptoms: muscles sometimes feel involuntarily tensed, wake up feeling sore and stiff everywhere upon movement. Non-visible muscle “flutters”/pulses all over body.  Pains/flutters seem to diminish after I start course of anti-anxiety medication, although still fatigued.  See neurologist with concerns, especially MS/ALS, etc.  Not even given a neuro exam, told “don’t worry” about MS or ALS and to come back in 1 month after anxiety is under control.  Told fibromyalgia may be culprit (but no tender point exam). Still no explanation, and PCP is stumped.



Do these symptoms sound like MS, ALS, CFS, FMS, hemochromatosis, etc.?  Could it have been too soon for MRI to show plaques after all this time? Doc said ALS symptoms are progressive and would be more noticeable by now – true?  

Could virus/bacteria be cause? (undiagnosed genital herpes outbreak occurred before Oct and March “bouts”)

Could stress/anxiety be causing all this?

What should next step be? 2nd Neuro opinion? Rheumatologist? Orthopaedic (back pain)? Holistic MD for fibromyalgia?



I appreciate any advice you can offer – I’ve never been so unhealthy or scared and am too young to feel like I’m dying!

Doctor's Answer

by CCF Neuro[P] MD, RPS, Apr 06, 2000 12:00AM
Dear Patti:



The symptoms you describe really do not have the classical MS flavor.  Although the initial phases of MS might be sensory in nature, usually there is a muscle component where muscle strength is diminshed by examination.  You don't tell me of any muscle weakness.  The clear MRI also suggest against MS.  ALS also does not usually present with sensory symtpoms.  Actually, ALS