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Full Disclosure

Hey everyone.  I’ve never done this before but I’m starting to reach out to various groups to gain some insight, support and maybe a little comradery when it comes to symptoms, doctors and MS.  My apologies for the lengthy post but I want to be thorough in case there are others out there going through or have gone through a similar situation.  Hopefully this format works.

Patient

36 yo / Male / Caucasian / 183lbs / 5’11’’

History

High blood pressure
LVH at age 30– though that has subsided with BP control
Upper/lower back spasms/locking up and SI joint issues
Localized random electric like sensations on head
Freq. random muscle spasms twitching (left eye/arms) sometimes for days on end
Blurred/cloudy vision, esp. when wearing contact lenses, in left eye
Fatigue/stress (probably due to not knowing what is going on)
Increase in headaches
Radiating left thumb pain
3 distinct episodes
-Numbness/tingling/prickly feeling in both hands lasting 2 months in 2013, worse in evening and at night
-Numbness/tingling/prickly feeling in both hands came back almost one year later and 3 weeks after the initial onset both feet began having the same sensation, off and one for a month – finally went to the doctor.  The main hand/feet sensation subsided but was always there after that.
-Two months after that the feet began having the same numbness/tingling sensation and this time the fuzz was all the way up to the knees and thighs.   Small electric like (pop rocks type) sensations in legs and definite pins and needles feeling (different than the tingling/fuzz feeling)

Tests/Results

Basic CBC, diabetes, B-12, D-3, thyroid, sedimentation rate, folate, methy. acid, trilodthyronine bloodwork all normal
Nerve conduction study, upper and lower [normal]
OCT [normal]

MRI Spine w/wo contrast [There is disc osteophyte complex making an impression on the anterior aspect of the thecal sac and cervical spinal cord at C6-7.]

MRI Brain w/wo contrast [Gray/White Matter: Several small foci of increased T2 and FLAIR signal scattered throughout the white matter of both vertebral hemispheres. These are all 4 mm or less.]

Echocardiogram w bubble test [small right-left shunt is seen with agitated saline contrast injection suggestive of a patent foramen ovale]
Lumbar Puncture
-Pressure/appearance, CSF: normal/clear
-Lymphocytes, CSF: 100
-Protein, CSF: 38
-Cell Count, CSF: 11
-RBC, CSF: 1
-WBC, CSF: 1
-Herpes Simplex Virus, PCR: Not detected
-IGG: 1340
-IGG, CSF: 3.1
-Albumin: 4450
-Alb, CSF: 24
-Alb Index: 5.4
-IGG, Index: 0.43
-IGG/Alb, CSF: 0
-CSF O-bands #: Negative
-Myelin Basic Pro: 3.04
-So far that is all that has come back

Current Medications

Amlodipine (BP)
Lisinopril (BP)
Protonix (acid reflux)

Next Steps

Waiting to see my Neuro to discuss LP test results and Cardio has scheduled a Transcranial Doppler test to look into the PFO.

So what you think?  Comments, questions? What you would be asking your doctor?  My neuro (before the LP) was putting the possibility of MS at about 50-60%.  I feel like I’m in good hands and getting the tests done that probably should be done but I'm still in the dark.  Any one experience anything similar to this before?
4 Responses
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Avatar universal
Did you ever figure out what was going on? The reason I ask is that I have the same symptoms. I have had them for about a year and a half now. It's called Paresthesia from my research. I have been to 3 doctors and have no answers. Coincidentally, I have been on the same blood pressure drugs as you from the time the symptoms started. Paresthesia and Peripheral Neuropathy are supposedly seen in only about 1% of patients on those blood pressure meds. The Doctors acted like I was full of it...pushing pills/poison is their job of course. I'm highly skeptical as I have read numerous pages of people who've experienced the same thing and some claim to have permanent nerve damage on lisinopril and amlodipine. I am going to get an MRI and see a neurologist but I have discontinued the drugs and found success in lowering my bp naturally via paleo diet. I sometimes get sharp stabbing pains in my extremeties, at various places, an electric like itching under the skin or just regular itching, individual pin prick sensations like a needle is being poked into me. I have been checked for the standard things.....2 pages of resuts for magnesium, potassium, sugar levels, thyroid, etc., all normal. The third doctor I went to checked me for heavy metals as mercury poisoning causes these symptoms. Negative via blood test.

mid thirties male, oilfield worker/drive truck-night  shift 5'11" 260lbs

I'm starting to wonder if it is MS and if not then what? I wonder about exposure to chemicals in the oilfields which are a mixture of so many things it's like a needle in a haystack. I'm wondering also after having discontinued these meds if these effects will go away naturally. Next stop neurologist...
Helpful - 0
5112396 tn?1378017983
I think Kyle missed your o-bands results (I nearly did too). As MS is the only medical area I have any real level of knowledge in, when looking at those LP results to be honest I skimmed until I saw the oligoclonal band results. That's not to say the other information isn't useful, it's just not the most relevant to MS testing.

Your negative result in this area, as Kyle said, moves the needle away from MS. That's not to say it's impossible. Unfortunately, there's no home run test for MS. Of the battery of tests usually done for an MS workup, o-band information can be the most wishy-washy. A positive result doesn't mean someone has MS. A negative results doesn't mean they don't. Really, all it does is help refine the direction the neurologist is pursuing. Some skip it altogether these days.

Have you had a full neurological exam yet? MS, at the end of the day, is still a clinical diagnosis. For example, with all high tech lab work and testing machines in the world, a trained neurologist will know something is unequivocally wrong in my CNS by simply running a car key (or toothpick, sharpened pencil, or any other low tech thing on the desk) up the bottom of either of my feet.

Others may fail various tests of proprioception. We often look like we've been pulled over for erratic driving in that exam room. "Touch you finger to your nose". "Walk in a straight line". "How many fingers am I holding up". A comprehensive exam can provide extremely valuable information and direction in all of this.

Nothing of what you wrote shouts MS, but as I said unfortunately it's often not as simple as that. Other things that might move the needle away are the bilateral presentation of your symptoms. MS symptoms typically, though not always, will manifest on one side of the body or the other. They also don't typically spread. Numbness in a limb is more likely to subside and return or a new symptom altogether begins (an eye issue for example) than it is to travel up said limb. But again (frustrating, I know) I'm sure there are exceptions.

You brain MRI results could be the result of a few things, but given your age, they should be looking into likely causes. Some can be completely benign, and your blood pressure issues could certainly be a reason (ischemic issues show up in the brain, oftentimes). Everyone gets spots that show up in the brain as we age, but 36 is a bit young for that alone to be an explanation for you.

Stating that you feel in good hands with your doctor is fantastic! Many of us here can attest that's half the battle. It can take time to tease out what's causing your issues. Sadly, health mysteries in the real world aren't neatly resolved in 1 hour (counting commercial breaks). But you'll find many people here who can at the very least commiserate on the journey.
Helpful - 0
Avatar universal
Hi Kyle,
Thanks for the reply.  It looks like the oligoclonal bands in CSF are zero so that's good.  We'll wait to see what the other results are.  Thanks for your input.  
Jack
Helpful - 0
1831849 tn?1383228392
Hi YJ - Welcome to the group.

The symptoms you describe can be related to MS, but can more likely be related to other issues. The MRI findings can also be attributed to MS or many other things. It seems to me that you are on the right road to get answers. One of the things that can cause similar symptoms and MRI findings is high blood pressure, which seems to be part of your medical history.

The one component our LP that's missing ( I'm assuming that's the part your waiting for) is the O-band information. If there are oligoclonal bands in your spinal fluid but not in your blood drawn at the same time, it is an indication that there is inflammation in your central nervous system. If this is the case the needle starts to point back towards MS. If there are no unique o-bands the needle starts to move away from MS.

When do get your LP results?

Kyle
Helpful - 0
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