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Neurology (Expert Forum)
could this be ms?
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could this be ms?
by -leah-, Jan 05, 2007 12:00AM
Hi, i'm 36 years old and have been having problems for 4 years.
The problems started with left leg stiffness and weakness, pain and visual problems in the left eye and burning shoulder pain on the left.
4 years later i have to use a walking stick to get around, both legs are stiff and weak, weakness in my left hand (drop things regularly), on and off burning sensations, muscle twitches when i lay down, chest tightness (especially on the left), right eye problems with pain and a dark area when i look up (on and off),
These problems seem a lot worse in winter when it gets colder and also pre menstrually.
I have had 2 EMGs, several brain scans and spinal scans (no contrast) all normal
My neurologist thinks its anxiety and referred me to a neuro psychiatrist who said i didn't have anxiety, i even went to CBT and was told no anxiety. My gp, friends and family don't think its anxiety either.
I last saw my neuro yesterday who still thinks its psychological but referred me to a colleague and also talked about me going to the main neuro centre in the country. "He said let me know if you find out what it is" many thanks your comments would be appreciated
The problems started with left leg stiffness and weakness, pain and visual problems in the left eye and burning shoulder pain on the left.
4 years later i have to use a walking stick to get around, both legs are stiff and weak, weakness in my left hand (drop things regularly), on and off burning sensations, muscle twitches when i lay down, chest tightness (especially on the left), right eye problems with pain and a dark area when i look up (on and off),
These problems seem a lot worse in winter when it gets colder and also pre menstrually.
I have had 2 EMGs, several brain scans and spinal scans (no contrast) all normal
My neurologist thinks its anxiety and referred me to a neuro psychiatrist who said i didn't have anxiety, i even went to CBT and was told no anxiety. My gp, friends and family don't think its anxiety either.
I last saw my neuro yesterday who still thinks its psychological but referred me to a colleague and also talked about me going to the main neuro centre in the country. "He said let me know if you find out what it is" many thanks your comments would be appreciated
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jan 26, 2007 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 that you describe are non-specific and do not point to any single disorder. The symptoms that you describe suggest spasticity (stiffness) in the legs and trunk muscles. You also describe weakness in the left hand, sensory distrubances (burning) and visual problems in both eyes. It sounds like you have had the first set of screening tests (MRI without contrast and EMG) without a diagnosis. I would recommend taking your testing to the next level in search of a diagnosis including MRI with contrast of the brain, cervical and thoracic spine, a lumbar puncture (to look for inflammation with tourtelotte panel, IgG index, oligoclonal bands), visual evoked potentials (to evaluate for past optic neruitis), genetic tests for hereditary spastic paraplegia, and mitochondrial disease. Given the level of dysfunction that you describe, one would expect some MRI findings if this was typical multiple sclerosis, and thus I would suspect an alternative diagnosis. When things do not make sense, it is a reflex to attribute symptoms to anxiety/psychiatric disease. I agree that it is often beneficial to get a second opinion at a major academic medical center. When people have psychiatric disease with the symptoms that you describe it is generally due to a conversion disorder (which is a physical expression of some emotional stress) is completely unconcious on the patients part and requires considerable skill on the psychiatrist part. I would recommend a second round of testing as described at a major academic medical center, and after all medical testing is exhausted then I would consider possible psychiatric diagnoses.
I hope this has been helpful.
The symptoms that you describe are non-specific and do not point to any single disorder. The symptoms that you describe suggest spasticity (stiffness) in the legs and trunk muscles. You also describe weakness in the left hand, sensory distrubances (burning) and visual problems in both eyes. It sounds like you have had the first set of screening tests (MRI without contrast and EMG) without a diagnosis. I would recommend taking your testing to the next level in search of a diagnosis including MRI with contrast of the brain, cervical and thoracic spine, a lumbar puncture (to look for inflammation with tourtelotte panel, IgG index, oligoclonal bands), visual evoked potentials (to evaluate for past optic neruitis), genetic tests for hereditary spastic paraplegia, and mitochondrial disease. Given the level of dysfunction that you describe, one would expect some MRI findings if this was typical multiple sclerosis, and thus I would suspect an alternative diagnosis. When things do not make sense, it is a reflex to attribute symptoms to anxiety/psychiatric disease. I agree that it is often beneficial to get a second opinion at a major academic medical center. When people have psychiatric disease with the symptoms that you describe it is generally due to a conversion disorder (which is a physical expression of some emotional stress) is completely unconcious on the patients part and requires considerable skill on the psychiatrist part. I would recommend a second round of testing as described at a major academic medical center, and after all medical testing is exhausted then I would consider possible psychiatric diagnoses.
I hope this has been helpful.
Please be advised that I am not responding to you as a medical professional with medical advice and that the information that I am sharing is conversational, educational, and factual.
With that said I would like to say that I am sorry for all of your symptoms. Your story is a sad and familiar one. More and more I find that I am seeing people present these symptoms that suggest Multiple Sclerosis, et al, and nothing comes of it clinically for clarity. And, more and more, I am seeing a raging number of people having Lyme disease. In a sense the disease has been discredited for the simple fact that it is so common yet so un-reported and when people like myself see a possible case: people think it is all we think about. Wrong.
I do not know what condition you have, but in fact, you do have a condition. You need to have a good IGENEX blood work up to test for Lyme disease and co-infections. Depending upon your region-this could make it much more certain.
I hope that I have been helpful and to simply answer your question-MS means "multiple sclerosis=many lesions" and you have none, so, no.
Good Luck!
JCmcc.
I am simply responding as a helper of persons.
Thanks,
JCmcc.
It could be MS, it could be Lyme, it could be Hughes. But if you arent satisfied with the answers from your neuro, go to a dif one. To diagnose MS you need an MRI WITH contrast and/or a spinal tap.
and just because you have not lesions, doesnt mean you dont have MS. It isnt typical NOT to have any, some out there dont. That is how I started with my MS, no lesions, but here I am with it now.
The remarks about no lesions, no MS, are in fact true. However, it is quite unlikely for most and I presumed that you had contrast.
Regards,
JCmcc.
As you stated multiple sclerosis meaning many scars or lesions.Just because lesions may not appear on a