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Neurology (Expert Forum)
ms-like neurological symptoms
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ms-like neurological symptoms
by mattsnow71, Jan 06, 2007 12:00AM
45 yr old male
2000 - must touch nose to swallow for 21 days
2000-prsnt - vertigo several times
2004, oct - 1 toe of L foot numb for a couple of days
2005, mar - same toe numb for 2 days, then 7 days entire left calf feeling, not numb - more like skin crawling, vibrating, tickling - ever since then, left calf constantly has mild knotty feeling in small spot center rear of calf, sometimes disappears for day or two, sometimes feels like it is in different place
2005, april, mild stinging entire middle 3 fingers L hand for 1 day, middle 3 fingers R hand next day
2005 april to present, various odd sensations, mostly fluttering or vibrating feelings in small patches, most often on legs or in arch of foot, ribs, hips, upper arm, sometimes feels as though cool breeze blowing on small patch of skin, sometimes, slightly warm spot, lasting minutes, recurring for days, then fading
2005, days at a time, tips of toes feel slight sensation of downward pressure, even though nothing is there - feelings of vibrating strings inside of groin and hip areas, apprx 2 sec on, 4 sec off
2005, rhythmic clicking noises in ears, 2-3 hertz for minutes at a time, recurs since then
2005 summer - tendency to get cramps in feet and legs
2005 fall - small shingly-like rash on chest, then on back
2006 tingly spots on scalp above left ear, visible eyelid twitch
almost everything described recurs + others
had shingles as 23-year old, had migraines weekly as child
MRI of brain shows headache-like pattern of spots, C-spine clear
brother has RRMS, ON presenting, taking copaxone
is this mild MS?
2000 - must touch nose to swallow for 21 days
2000-prsnt - vertigo several times
2004, oct - 1 toe of L foot numb for a couple of days
2005, mar - same toe numb for 2 days, then 7 days entire left calf feeling, not numb - more like skin crawling, vibrating, tickling - ever since then, left calf constantly has mild knotty feeling in small spot center rear of calf, sometimes disappears for day or two, sometimes feels like it is in different place
2005, april, mild stinging entire middle 3 fingers L hand for 1 day, middle 3 fingers R hand next day
2005 april to present, various odd sensations, mostly fluttering or vibrating feelings in small patches, most often on legs or in arch of foot, ribs, hips, upper arm, sometimes feels as though cool breeze blowing on small patch of skin, sometimes, slightly warm spot, lasting minutes, recurring for days, then fading
2005, days at a time, tips of toes feel slight sensation of downward pressure, even though nothing is there - feelings of vibrating strings inside of groin and hip areas, apprx 2 sec on, 4 sec off
2005, rhythmic clicking noises in ears, 2-3 hertz for minutes at a time, recurs since then
2005 summer - tendency to get cramps in feet and legs
2005 fall - small shingly-like rash on chest, then on back
2006 tingly spots on scalp above left ear, visible eyelid twitch
almost everything described recurs + others
had shingles as 23-year old, had migraines weekly as child
MRI of brain shows headache-like pattern of spots, C-spine clear
brother has RRMS, ON presenting, taking copaxone
is this mild MS?
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 could represent mild Multiple Sclerosis (MS), but you need more information for a diagnosis. Multiple sclerosis does not have a known cause, but people with a first degree relative with MS are more likely to be diagnosed with MS. However, there are multiple things that can cause the symptoms that you describe including migraine headaches. There is a subtle difference between MRI findings in 'mild MS' and a 'headache like pattern'. Multiple sclerosis tends to have periventricular lesions (next to the brain ventricles) and are oviod with orientation perpendicular to the ventricles (the hollow inside of the brain filled with CSF). While 'headache related' spots tend to appear deeper in the subcortical white matter and are round without specific orientation. However it is certainly possible to easily confuse these two. I would recommend getting the second line of testing including a lumbar puncture (Tourtelotte panel, IgG index, oligoclonal bands), visual evoked potentials and Somatosensory evoked potentials (SSEPs). I would also suggest a repeat MRI of the brain and C spine with GAD contrast 6months to 1 year after your previous scan or if new symptoms present. If the above tests are negative then I would suggest exploring alternative diagnsoses such as your migraines as a cause of your symptoms.
I hope this has been helpful.
The symptoms that you describe could represent mild Multiple Sclerosis (MS), but you need more information for a diagnosis. Multiple sclerosis does not have a known cause, but people with a first degree relative with MS are more likely to be diagnosed with MS. However, there are multiple things that can cause the symptoms that you describe including migraine headaches. There is a subtle difference between MRI findings in 'mild MS' and a 'headache like pattern'. Multiple sclerosis tends to have periventricular lesions (next to the brain ventricles) and are oviod with orientation perpendicular to the ventricles (the hollow inside of the brain filled with CSF). While 'headache related' spots tend to appear deeper in the subcortical white matter and are round without specific orientation. However it is certainly possible to easily confuse these two. I would recommend getting the second line of testing including a lumbar puncture (Tourtelotte panel, IgG index, oligoclonal bands), visual evoked potentials and Somatosensory evoked potentials (SSEPs). I would also suggest a repeat MRI of the brain and C spine with GAD contrast 6months to 1 year after your previous scan or if new symptoms present. If the above tests are negative then I would suggest exploring alternative diagnsoses such as your migraines as a cause of your symptoms.
I hope this has been helpful.
And, your spots are not related to MS. MS abnormalities are going to show either/or/ Dawson's Fingers, or round to oval signals.
There should be a look at your cervical spine. Have you looked at Vasculitis?
JC, did you get my email? I emailed you, I guess, last week. Maybe it went to spam?
sorroy to read you trouobles. It is not eassy.
I have freinds with MS.and there is a widie vary, many of them have a rather mild corse tto date. That is why they have disignated the types. Are you able to be seen by an MS specialist? They would be able to explain what they know from practicing in that specific fieldd.
Also, a trained professional reading your scans fisrt hand is the onequalified to interprate what your spots indicate to rule in/out a condition.
Hang in there MAtt, and i hope you feel beter real soon.
Amo
Stick in there and don't let the doctors get you down, or tell you that you're crazy.
Back in 95 I was 31 and was told I had a stroke.
since then I have been re-diagnosed several times.
I have a 1.6cm x 2.6cm cyst in the upper frontal lobe,
and definite MS symptoms that have recently worsened.
They have operated on my cervical spine for stenosis, with
no change in my symptoms. 12 yrs later they are telling me I dont have MS and wish to take me off injections for a second time and send me to yet another specialist, because I do not "fit the mold", or there is "a missing piece to your puzzle". I am 42 now and getting really tired. Stick it out, be persistant, and don't let anyone tell you you're crazy.