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Neurology (Expert Forum)
Symptoms for MS?
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Doctor's Answer
by CCF-Neuro-M.D.-SH, Sep 09, 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 first symptom of possible multiple scerlosis (MS) is the hardest. As the name implies multiple sclerosis requires multiple events seperated in time, or diagnosed retrospectively by neuroimaging (MRI). The first attack is often called a clinically isolated syndrome, which may be labeled as MS after further symptoms develop. MS is not a hard diagnosis to make, it just needs a comprehensive workup.
Typical first symptoms include:
-numbness in an isolated distribution, usually in an arm or leg
-optic neuritis (loss of vision in one eye, usually painful)
-Dizziness or sense of imbalance
-weakness in an isolated distribution, usually in an arm or leg
-L'hermites sign, when you flex your neck, an electrical shock radiates down to the arms and legs.
-episode of double vision
-Fatigue is also a common complaint, but not specific
These symptoms typically last for 2-6 weeks and then get better, often back to baseline, or at least close. There are more rare presentations, but the testing remains the same and remains adequate.
After a detailed neurologic exam, which if not currently having an exacerbation/attack may be normal except for some hyper-reflexia the following tests should be performed:
-MRI of brain and C-spine with contrast and saggital flair
-Lumbar puncture for inflammation (tourtelotte panel/IgG index, oligoclonal bands)
-Evoked potentials (visual evoked potential and somatosensory evoked potential).
The most common mistakes in the diagnosis of MS are:
-not completeing the workup (some will stop after one negative test)
-Stopping after all tests come back normal after the first attack, which may become positive as more episodes occur.
-Patients who continue to pursue the diagnosis of MS, despite multiple tests that are all normal. These patients often do have a diagnosis that needs to be made, but end up spending a long time ruling out MS.
I would also recommend seeing a neurologist in an established MS center, since they are well versed in the testing, and have connections to set up disease modifying therapy if the diagnosis is made.
I hope this has been helpful.
The first symptom of possible multiple scerlosis (MS) is the hardest. As the name implies multiple sclerosis requires multiple events seperated in time, or diagnosed retrospectively by neuroimaging (MRI). The first attack is often called a clinically isolated syndrome, which may be labeled as MS after further symptoms develop. MS is not a hard diagnosis to make, it just needs a comprehensive workup.
Typical first symptoms include:
-numbness in an isolated distribution, usually in an arm or leg
-optic neuritis (loss of vision in one eye, usually painful)
-Dizziness or sense of imbalance
-weakness in an isolated distribution, usually in an arm or leg
-L'hermites sign, when you flex your neck, an electrical shock radiates down to the arms and legs.
-episode of double vision
-Fatigue is also a common complaint, but not specific
These symptoms typically last for 2-6 weeks and then get better, often back to baseline, or at least close. There are more rare presentations, but the testing remains the same and remains adequate.
After a detailed neurologic exam, which if not currently having an exacerbation/attack may be normal except for some hyper-reflexia the following tests should be performed:
-MRI of brain and C-spine with contrast and saggital flair
-Lumbar puncture for inflammation (tourtelotte panel/IgG index, oligoclonal bands)
-Evoked potentials (visual evoked potential and somatosensory evoked potential).
The most common mistakes in the diagnosis of MS are:
-not completeing the workup (some will stop after one negative test)
-Stopping after all tests come back normal after the first attack, which may become positive as more episodes occur.
-Patients who continue to pursue the diagnosis of MS, despite multiple tests that are all normal. These patients often do have a diagnosis that needs to be made, but end up spending a long time ruling out MS.
I would also recommend seeing a neurologist in an established MS center, since they are well versed in the testing, and have connections to set up disease modifying therapy if the diagnosis is made.
I hope this has been helpful.
My symptoms are:
tingling and numbness throughout my body - mainly in the legs but sometimes in my stomach and back. It's mainly on the left side as well but my right leg is included. I've also been dizzy now for about 4 months - very lightheaded as if I have had too much to drink. and for a few days my left knee felt odd, like it was swollen but it wasn't. I had a normal neuro exam with slight clonus. And finally, I do have stronger tingling in my legs when I put my head down to my chest (l'hermittes?)
I'm terribly scared and am dreading the results tomorrow.
What do you all think? Are these symptoms similar to yours?
Thanks.
Sorry for hear about your problems...
I've been pretty much in the same situation for about 1 year and 3 months, and it's really hard...
I've been to 3 neuros, 1 internal medicine specialist, a cardiologist, and nobody has a clue about what I have.
I am also terrified about MS, I can't stop thinking about it...
What are your symptoms???
Hope we can get an answer soon!! :)
Good luck
I have had symptoms for atleast 10yrs, I also have Fibromyalgia.
Symptoms are. Off balance, twitching, memory problems, feel weak, flu like, numbness feeling (but not numb just less feeling)tingling. Muscles ache, water in the shower looks like balls of fire. Just really odd things.
I don't fear MS, Many many people have this disease and live full functioning lives and they dont die from it. I look at it as a chronic illnes (like fibro).
I would just like to know so I can have the appropriate treatment for whatever it is that I have.
Hope
I think you are right... Not knowing what you have can drive you crazy.
I have some of your symptoms (I will find my old posting in this forum and send it to you).
Have you ever been tested for Lyme? I myself think I might have it... Everybody says the tests are not accurated... I was tested but it was negative (ELISA).
Good luck!! :)
I doubt mine is lyme, I don't live near woods and I don't go in the woods or wooded areas.
Do you live in that type of area? If you do then I would test again.
Hope
i have been reading the questions and comments here over the last couple of days. I also am having strange symptoms..mostly tingling..happens every day. I went to have a MRI last week and this week was told that the results were "nonspecific" and inconclusive" but that there was an area of concern..possibly inflammation or demyelination. because of my age (33) it is not normal so I am going to see a neurologist on monday. i am very scared...
I hope everything is Ok for you, I never heard of demyelination
not sure what it means.
Im sending you good thoughts :)
Hope
Good luck with your results! I can identify with the dizziness, when it hits me I'm off balance ALL day...I won't even drive.
My doctor asked me what I did when this hits, I told him I stay put in my house and I dont leave until its gone. Strange thing for him to ask...lol
HOpe
MS usually presents itself with visual disturbances first,blurred vision or optical neuritis,loss of vision in one eye.One sided weakness,not having the ability to use the leg or arm.
MS has many symptoms and can effect everyone differently.A diagnosis to MS can be a very long process,a diagnosis of exclussions.
Usually during a neuro exam the reflex's will be hyper,babsinski sign present.
Your symptoms are wide spread,but consistant with MS.
Demyelination is where the nerves have lost there myelin covering and signals are being stopped.(example:an electrical cord loses its plastic covering and you can see the silver and copper wiring,the electrical current is being blocked).
Hang in there.No one likes to hear they have MS,the medical community has come a long way with this disease and there are meds available to help.
I mostly have tingling on my hands and feet (most common while I'm in bed), also have patches of "numbish" sensation that travels around my body and lasts only a few minutes. Fatigue, difficult in thinking, and a weird feeling all the times (for 1 year now) on the left side of my face and scalp.
I think the most weird symptom is the morning pain in the sole of my foot...
These are the ones I remember... similar with many of your symptoms. I don't have weakness, lack of balance, etc.
Please, keep me posted about your findings, and hang there. I think that having a disease like MS can be hard, but also not knowing what is going on with your body is even worse...
Hope we all can find answers!! :)
Hope
Was this to a particular person or all of us???
Thanks