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Neurology (Expert Forum)
APS or MS?
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
APS or MS?
by Lynn1888, Dec 04, 2003 12:00AM
49 yo female, On warfarin for 2 yrs for APS: (showers of splinter hemorrhages, poss. PE 2 early misscarriages, 1 very diff preg- but healthy baby :), 2+- 8hr srokes R eye, 5 burst vessels in digits & 1 in lower leg after strong pinching pain and release then large bruise. Migraine daily for 3 months, Meniere's 30 days, episodic acute abd. symptoms `4x/yr). Since Warfarin get 4 splinter hem. at a time, occ numbness & tingling. Did have 1 yr. burning numbness & pain to crotch down inside of both legs & into feet/shins, L>R. Dx with Interstitial Cystitis 20 yrs ago. ACL IGG & IGM low-mod elevated 8x, all other bldwk N. CXR N.
On screening MRI -mult. wml cons. w MS, also consider Lupus, vasculitis. Saw Neuro- due to cont of neuro sx despite adequate anticoag, ?poss MS. Saw MS expert- 'not MS'. 2nd MRI unchanged. I do not have HTN or diabetes. My Aunt has Lupus & MS. Father had Sarcoidosis. No signs MS in eyes. Occ Nystagmus.
The last 6 weeks: burning pain tingling and numbness to both arms chest lower abd (also occ. tight band < 2/3 the way around lower abd) both legs Novocaine feeling to face (L>R) & severe pain to L ear/jaw/throat/L side of tongue- Dizzy++, strong at times stabbing scalp/head pain. On warfarin, neurontin, elavil, T#3, dilaudid, flexeril- sx mostly controlled. Only minor cutaneous sensory deficits. Spinal chord MRI done (no results yet) Will see Hemo ? stop Warfarin for LP.
?MS or APS? What Tx? ?When to taper of Neurontin.
I'm scared. Thanks so much for your help.
On screening MRI -mult. wml cons. w MS, also consider Lupus, vasculitis. Saw Neuro- due to cont of neuro sx despite adequate anticoag, ?poss MS. Saw MS expert- 'not MS'. 2nd MRI unchanged. I do not have HTN or diabetes. My Aunt has Lupus & MS. Father had Sarcoidosis. No signs MS in eyes. Occ Nystagmus.
The last 6 weeks: burning pain tingling and numbness to both arms chest lower abd (also occ. tight band < 2/3 the way around lower abd) both legs Novocaine feeling to face (L>R) & severe pain to L ear/jaw/throat/L side of tongue- Dizzy++, strong at times stabbing scalp/head pain. On warfarin, neurontin, elavil, T#3, dilaudid, flexeril- sx mostly controlled. Only minor cutaneous sensory deficits. Spinal chord MRI done (no results yet) Will see Hemo ? stop Warfarin for LP.
?MS or APS? What Tx? ?When to taper of Neurontin.
I'm scared. Thanks so much for your help.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Dec 08, 2003 12:00AM
I can not offer an accurate opinion regarding your diagnosis. APS could cause many of the problems you have described, and could result in similar MRI changes when compared to MS. I agree with performing a lumbar puncture. Analysis of the fluid may help to confirm or deny MS. If this testing does not solve the problem, then a second opinion at a large academic neurologic center would be recommended. Also, lupus needs to be carefully excluded. If the coumadin is failing you may need more aggressive therapy to alter your immune system, but you need to see a specialist who can review all this information first. Good luck.
