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Creeping weakness with residual fatigue
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Creeping weakness with residual fatigue


I hope someone can provide some direction on what specialty this would fall under, so that I can seek medical assistance.  Also, any idea what this is???

About 7 years ago, I developed occasional (maybe once or twice a month) "creeping weakness", which is the best way I know to describe it.  Out of nowhere, very strange bilateral muscle pain and weakness begins with my lower arms (with no hand involvement).  Over a period of the next 45-60 seconds, this pain and weekness "creeps" up my inner arms, at exactly the same pace for each.  Once it reaches my upper arms, again still the inner part of the arms, it forms a band around my chest and back approximatey 12" wide.  As soon as it reaches my chest and back, I feel very lightheaded.  I feel as though I should be white as a sheet, but those who have been around me when this happens have all said I look quite normal.  

During these episodes, it is painful to raise my arms or to use them in any way, so thankfully these episodes haven't occurred while driving!  If forced to, I could certainly move them, but I choose not to if I don't have to!!!  When these episodes first began, I recovered rather rapidly.  Lately, however, I am left with a feeling of extreme fatigue/exhaustion.  Also, now when I have an episode, I'm usually left with muscle weakness for about 24 hours. I also feel like I've lost strength in my arms and hands over time.

Does anyone know what this might be a sign of???  

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It is possible that you are describing the symptoms of partial transverse myelitis (transverse means across and myelitis is from the word "myelos," which is Greek for marrow -- they used to think the spihnal cord was the marrow of the bony spinal column: it is a good thing they did not attempt bone marrow biopsies! "itis" means inflammation).

This can be seen by itself, with MS, with something called Neuromyelitis Optica (Devic's disease) or many other diagnoses.

A neurologist would be the best type of specialist to investigate this and they will probably order an MRI of the cervical spine (and possibly the brain) and perhaps somatosensory evoked potentials. A spinal tap may be in the future based on the results of the testing and the lab results.

Good luck in your investigation and once you have a diagnosis, please let the community know what happened.
To Dr Kantor,

Can nerve conduction studies confirm transverse Myelitis or support that diagnosis?  I have had abnormal VEP tests a long time ago. Original diagnosis was thought to be MS but when MRI was normal and LP, I was told that it was neurological but not likely to be MS.

Years on I have had what I thought was a new flare with  again normal imaging on T3 MRI. Current neuro (second opinion) is under the belief it is TM even with all my normal testing.  Neuro exam is abnormal.  I am about to do NCS tests and was curious as to what they can show. This is a last ditch effort to work out what is wrong with me as I feel i have had a sml amount of progression.

Any info on NCS tests would be helpful and appreciated.

Thank you,
You mention that the symptoms described at the top of this thread sound like possibly partial transverse myelitis, and that this can be also be seen in Neuromyelitis Optica and other diseases.  

Based on that, would it be appropriate for the above individual to be tested for NMO-IgG?  

I'm only recently familiar with this test as my neurologist has ordered it for me, based on an episode of ON plus unremitting cervical myelopathy, and lesions mainly seen on c-spine with minimal brain lesions (one on brainstem) (I was dx'ed with MS in 2007 and on Copaxone since 2008).

Would ON also need to be in the picture to warrant the NMO-IgG test, or is that individual's partial transverse myelitis (if that's what it is) sufficient to warrant investigating this rare disease?

Dear Dr. Kantor,

Thank you so much for your response.  I went to my regular GP today, who ordered some bloodwork and a cardiac stress test; but said that if these all came back negative, a neurological work-up would be the next step.  She was completely baffled by the symptoms!  I will let you guys know what the outcome is, and until then, wish you all a fantastic Spring!

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