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Neurology (Expert Forum)
possible MS
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possible MS
by shadais, Aug 25, 2006 12:00AM
I have been experiencing several different symptoms especially sudden lose of balance which causes me to fall. I was diagnosed in 1995 at the age of 35 with fibromalagia and chronic fatigue syndrome at this time I thougth it might be MS. I was diagnosed by a primary care physician not a Neurologist. I have had 3 MRI, one in 2002 that showed increased periventricular
T2 bright signal white matter bilaterally along the frontal horns more prominent on the left than right. The MRI’s in 2004 also showed there was increased white matter. I have been doing some research and I do seem to have symptom that are consistent with MS, but not with FMS. I have experienced everything from tremors to blurry vision to burning sensations.I am due to see a neurologist with in the next few weeks my suspicion is that I
may have MS and it not been diagnosed correctly, it seems that my health has continued to spiral downward.With just some of this information is it posible I may have a valet suspicion about MS.
shadais, Trenton, NJ
T2 bright signal white matter bilaterally along the frontal horns more prominent on the left than right. The MRI’s in 2004 also showed there was increased white matter. I have been doing some research and I do seem to have symptom that are consistent with MS, but not with FMS. I have experienced everything from tremors to blurry vision to burning sensations.I am due to see a neurologist with in the next few weeks my suspicion is that I
may have MS and it not been diagnosed correctly, it seems that my health has continued to spiral downward.With just some of this information is it posible I may have a valet suspicion about MS.
shadais, Trenton, NJ
Doctor's Answer
by CCF-Neuro-M.D.-SH, Aug 27, 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.
Yes, you have a vaild concern about MS(multiple sclerosis). The symptoms and story you describe can be found in MS, but you will need some more testing. Multiple sclerosis is caused by an auto-immune reaction (your bodies immune system attacks your nervous system) and leads to focal loss of the Myelin ( a substance that surrounds nerves and allows them to function optimally). This appears clinically as a focal dysfunction (for example: optic nerve involvement->blurry/loss of vision, posterior fossa-> dizziness/vertigo, primary sensory cortex (parietal lobe of brain)->burning/tingling in arm or leg on one side). Along with the focal dysfunction is also fatigue, which can be severe. The reason people develop this auto-immune reaction is unknown.
There are many things that can mimic MS, and thus we test for signs of focal demyelination and inflammation in the spinal fluid. In fibromyalgia (there is no test for this) people complain of multiple sites of myofacial pain (pain under the skin) and this is thought to be related to sleep disorder (this would not explain your dizziness and vision problems). The MRI findings of increased periventricular white matter changes in T2, is consistent with areas of focal demyelination in MS, but can also be from hypertensive disease(high blood pressure) and/or migraine headaches (your neurologist should be able to tell).
I would recommend that you get a lumbar puncture (spinal tap) to evaluate your spinal fluid for signs of inflammation (cell count, tourtelotte panel (IgG index) and oligoclonal bands). You should also have visual evoked potential (VEP) (tests for past optic neuritis) and a full ophthamological exam. You should also have an MRI of your cervical spine with contrast as well (MS often affects the c-spine). If your previous MRIs were not done with contrast, then you should have a repeat brain MRI with contrast and saggital FLAIR (a sequence on the MRI that help differentiate if periventricular lesions are due to MS)
I cannot say if you have MS, but your story is consistent with possible MS, and I encourage you to get the testing done, so that disease modifying therapy can be started if the diagnosis is confirmed.
I hope this has been helpful.
Yes, you have a vaild concern about MS(multiple sclerosis). The symptoms and story you describe can be found in MS, but you will need some more testing. Multiple sclerosis is caused by an auto-immune reaction (your bodies immune system attacks your nervous system) and leads to focal loss of the Myelin ( a substance that surrounds nerves and allows them to function optimally). This appears clinically as a focal dysfunction (for example: optic nerve involvement->blurry/loss of vision, posterior fossa-> dizziness/vertigo, primary sensory cortex (parietal lobe of brain)->burning/tingling in arm or leg on one side). Along with the focal dysfunction is also fatigue, which can be severe. The reason people develop this auto-immune reaction is unknown.
There are many things that can mimic MS, and thus we test for signs of focal demyelination and inflammation in the spinal fluid. In fibromyalgia (there is no test for this) people complain of multiple sites of myofacial pain (pain under the skin) and this is thought to be related to sleep disorder (this would not explain your dizziness and vision problems). The MRI findings of increased periventricular white matter changes in T2, is consistent with areas of focal demyelination in MS, but can also be from hypertensive disease(high blood pressure) and/or migraine headaches (your neurologist should be able to tell).
I would recommend that you get a lumbar puncture (spinal tap) to evaluate your spinal fluid for signs of inflammation (cell count, tourtelotte panel (IgG index) and oligoclonal bands). You should also have visual evoked potential (VEP) (tests for past optic neuritis) and a full ophthamological exam. You should also have an MRI of your cervical spine with contrast as well (MS often affects the c-spine). If your previous MRIs were not done with contrast, then you should have a repeat brain MRI with contrast and saggital FLAIR (a sequence on the MRI that help differentiate if periventricular lesions are due to MS)
I cannot say if you have MS, but your story is consistent with possible MS, and I encourage you to get the testing done, so that disease modifying therapy can be started if the diagnosis is confirmed.
I hope this has been helpful.
situation. Did your husband have an MRI and if so what was his result. I will certainly keep you posted. I wish you Both the best. Thank you for comment
had increased weakness in my hand's more on the left than right.
this was measured during a nueropsychological exam,also bilateral sensory/motor impairment more right than left, also cognitive and concentration skills were found to be very impaired it was suggested that a neurological reason my be the cause for these symptoms. So much information please help it make sense to me!!!!!!!
Thank YOu