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Neurology (Expert Forum)
MS, Lyme, any ideas?
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MS, Lyme, any ideas?
by Shanghai SD, Aug 13, 2006 12:00AM
Hi, from an Aussie living in Shanghai China!
4 months ago, returned from Bahrain awoke with weird feeling in my legs and fast heart rate. This cont. for 2 weeks. Then developed stomach cramps and I was dx with Helicobacter Pylori and started triple therapy for 7 days.
1st day of treatment and twitching started in my left calf and 2 days later to my arms. I then went to Australia for R & R and some more tests. Full Bloodwork was fine. On last days of the treatment and for a couple of weeks following I had whole body muscle twitches, very high blood pressure, myclonic jerks, drenching night sweats, tingling throughout whole body.
MRI Brain - Normal
Adrenal Tests - Normal
EMG+Nerve conduction - Normal
Gastroscopy - Dueodenal Ulcer
Treated for anxiety, 20 days later had 1 day of no symptoms, so had a beer (Aussie tradition), only anxiety!
Next day symptoms started building again and until now have had-
Whole body/facial muscle twitches - irregular and inconsistent
strange cracking creaking noises in neck throat
Whole digestive system feels wrong
Strange eczema looking rash develop on my stomach
Some eye pain + increased floaters
parathesias in eyes, cheeks, nose, makes eyelids dry
occassional tinnitus
strange new headaches which radiate from my neck
transient muscle and joint pain
1 time intense testicular pain
1 time shock like jaw pain
1 time heart palpatations, 120 heart rate(watching TV)
Now in China, Lyme testing not possible. Started Doxycycline?
MRI Cervical spine - Normal
1 doc said maybe MS, but not able to diagnose!
Any ideas
4 months ago, returned from Bahrain awoke with weird feeling in my legs and fast heart rate. This cont. for 2 weeks. Then developed stomach cramps and I was dx with Helicobacter Pylori and started triple therapy for 7 days.
1st day of treatment and twitching started in my left calf and 2 days later to my arms. I then went to Australia for R & R and some more tests. Full Bloodwork was fine. On last days of the treatment and for a couple of weeks following I had whole body muscle twitches, very high blood pressure, myclonic jerks, drenching night sweats, tingling throughout whole body.
MRI Brain - Normal
Adrenal Tests - Normal
EMG+Nerve conduction - Normal
Gastroscopy - Dueodenal Ulcer
Treated for anxiety, 20 days later had 1 day of no symptoms, so had a beer (Aussie tradition), only anxiety!
Next day symptoms started building again and until now have had-
Whole body/facial muscle twitches - irregular and inconsistent
strange cracking creaking noises in neck throat
Whole digestive system feels wrong
Strange eczema looking rash develop on my stomach
Some eye pain + increased floaters
parathesias in eyes, cheeks, nose, makes eyelids dry
occassional tinnitus
strange new headaches which radiate from my neck
transient muscle and joint pain
1 time intense testicular pain
1 time shock like jaw pain
1 time heart palpatations, 120 heart rate(watching TV)
Now in China, Lyme testing not possible. Started Doxycycline?
MRI Cervical spine - Normal
1 doc said maybe MS, but not able to diagnose!
Any ideas
Doctor's Answer
by CCF-Neuro-M.D.-SH, Aug 14, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. The symptoms you describe are most consistent with Lyme disease, or another encephalitis (likely viral). If testing is limited the right thing to do is to start antibiotics, but I would recommend a 3 weeks of IV rocephin from the symptoms you decribe. Ceftriaxone (Rocephin) has good central nervous system (CNS) penetration and thus would be my drug of choice.
Even with state of the art laboratories, diagnosing Lyme is not easy. The agent that causes Lyme, Borrelia burgdorferi, is immunosuppressive and results can come back falsely negative until treatment is started. The Borrelia can also hide intracelluarly and does not turn over rapidly, making genetic tests such as PCR, also have a low yeild. The best test is Western blot for Borrelia burgdorferi protiens.
Given your normal MRI of the brain and cervical spine, makes Multiple sclerosis less likely. A SPECT scan of your brain would be helpful to evaluate for CNS vasocontrictive disease that causes many of the strange symptoms of Lyme that do not show up on MRI.
I would also suggest a lumbar puncture (spinal tap) to look for other infections (viral encephalitis panel). Your neurologist will be able to choose a panel appropriate for your region, but I would include herpes simplex virus, west nile, St. Louis/Lacross/Equine,etc.
I hope this has been helpful.
Even with state of the art laboratories, diagnosing Lyme is not easy. The agent that causes Lyme, Borrelia burgdorferi, is immunosuppressive and results can come back falsely negative until treatment is started. The Borrelia can also hide intracelluarly and does not turn over rapidly, making genetic tests such as PCR, also have a low yeild. The best test is Western blot for Borrelia burgdorferi protiens.
Given your normal MRI of the brain and cervical spine, makes Multiple sclerosis less likely. A SPECT scan of your brain would be helpful to evaluate for CNS vasocontrictive disease that causes many of the strange symptoms of Lyme that do not show up on MRI.
I would also suggest a lumbar puncture (spinal tap) to look for other infections (viral encephalitis panel). Your neurologist will be able to choose a panel appropriate for your region, but I would include herpes simplex virus, west nile, St. Louis/Lacross/Equine,etc.
I hope this has been helpful.
Over the past 9 months I have had a myriad of symptoms and diagnosis, and tests.
Severe Stomach problems, gerd, pain, bloating, felt like gall stones - treated with prilosec, no response. Disappeared after a short dose of antibiotics for another bug. No more prilosec, no more problems (march-may of this year)
pains in my upper chest, lats and back to the point of going to the ER for heart problems - cleared of everything, pains have moved on (Dec 05-Feb 06)
Severe anxiety (first major symptoms I had) sept 05 - May 06, treated with Xanax, no help at all other than a pain getting off xanax.
Various shooting pains in my arms, chest, and legs - more or less gone now.
The latest - This crippling jaw pain that comes and goes throughout my face, sometimes numbness on the left side of my face and problems in my trap muscles and shoulders. More left than right, but both.
That combined with PVC's - both came on around June, got real bad, now are just a constant pain. I wake up feeling OK, and it gets worse every stinking day.
I've had stress tests, echos, 64 slice CT's on my heart, brain MRI for MS.
Everything comes back clean.
Anxiety is blamed, but those drugs do not help.
I've pulled ticks off me in the past as I do lots in the woods.
FRUSTRATING as hell.
It's either severe neuromuscular in my neck, and jaw with hormones causing PVC's, or something else.
I can exercise for hours without chest pain.
Passed a basic Lyme titer back in February of this year.