To Quix can u help decipher this xxxxplease

[janbubears]

Hi there i will copy paste my original symptoms thank if you can help

Hi Folks well here goes. I started with a numbness in my left arm over 5 months ago, i was initially sent home from work with this problem. I went straight to my GP who conducted an ECG which was ok, but he refered me to a neurologist.

In the meantime my sister works at a private hospital and got me in to see a spinal surgeon. When i was examined by him he thought i had a herniated disc ( think thats right ) in my neck, at this point i did not have any neck pain. spinal surgeon said no disc displacement shown on MRI so;

To cut a long story short - i have now been refered back to a neurologist because a swelling was found on my spine ( not told where about just said neck area) after my first MRI. I had a second MRI with contrast, and a brain scan. I have now after 5 month got horrendous pain in my left arm, although its numb - i have a feeling of something burning and crawling around in my arm. My neck is absolutely killing me, i cant even bend my neck to eat my meals. I have aching and painful feet also. spasms in chest and legs.

I am now on anti depressants because i was experiencing horrible detached feelings like i was losing my mind. very scary.. this only started at same time as pain got worse. I am still in agony can hardly use my left arm hand fingers are numb pins needles also in my feet .

I have now been told my mri showed a number of areas in my brain within increased  signal - but seem quite a long way from ventricles.

NEURO WROTE.   Demyelination does remain a possibility and increased signal in brain could be down to her smoking... There is also a history of auto immune within her family. I have arranged for a Lumber puncture appointment, a 3rd MRI and a 3 day course of intravenous methyl prednisolone.

I have a history of lower back pain for years, which seems to flare up now and again. I have also had a few dizzy spells ..Please help i do not want to self dx but if these symptoms seem familiar in first stages of MS with anyone please tell me .

[janbubears]

Hi There

quix asked about period of my MRI,S answer above.

I also found out today that my life insurance is now invalid because im having investigations for ms.  ***** x

they have put it on hold until my dx is found x

jan xx

[janbubears]

Thank you quix  had 1st MRI when sx of numbness pins needles lft arm back in january 2010

2nd MRI with contrast and brain scan april 2010

3rd Cervical MRI only  had on 21st june

14th july LP

21st 22nd 23rd intravenous steroids
thanx jan xx

[Quixotic1]

Well, it seems like the neuro is keeping MS in mind, or at least some kind of immune-inflammatory disorder.  That is why he is giving the IV Steroids.  

He is close to falling into the common trap of being willing to attribute all of yor brain lesions to smoking.   It is true that smoking is a risk factor for small T2 Hyperintensities on the brain MRI.  However, the large studies that I have read list smoking as a "minor risk factor" compared to age, hypertension, diabetes and migraines.   This is where that reasoning breaks down:  In the studies that associate smoking with brain lesions they studied people without neurological symptoms.  The lesions are there, but apparently cause NO SYMPTOMS.  That is an important thing to keep in mind.  Now, when a patient comes to you WITH neurological symptoms and you do an MRI looking for the possible cause, it is irrational to see small hyperintensities and dismiss them as simply due to age or smoking.

The good doctor - who's brain has not completely made a break for it - will look at EVERY test result keeping in mind that something is causing neurological symptoms.  The diagnostic process requires that you find the diagnosis that explains the symptoms, the phsycial signs, AND the test results!  Smoking might account for some of the lesions, but it doesn't account for the symptoms or every longterm smoker would have weakness, spasticity, paresthesias, vertigo, optic neuritis, ad nauseum.

Furthermore, we know that smoking is a risk factor for MS.  So, in the great, big, cosmic picture, a smoker with lesions should arrouse more suspicion of MS than it should cause the neurologist to dismiss the lesions from consideration.  Garbled, but true.

At any given time, no one can say that a non-specific lesion is or is NOT due to MS.  Again, it is the whole picture that is important.  Your lesions sound like they are in the deep white matter.  MS lesions do NOT have to be periventricular.  They certainly can be sub-cortical, deep white matter, juxtacortical, etc.  The litmus test is not "Are the lesions "classical" for MS, but it is "Can lesions like this be seen in MS."

My only, measely single brain lesion at the time of diagnosis was in the deep, frontal, white matter.  My 7th neuro dismissed it outright as a UBO (Unidentified Bright Object), but certainly not MS because it wasn't in the "right place" and "I was too old".  He failed to note that it was ovoid, and oriented with it's long axis perpendicular to the ventricles - a classic shape and orientation of an MS lesion.

Okay, enough about me.  Your neuro is keeping MS in mind.  This is good.

This will be your third MRI.  Over what period of time?

quix

[jensequitur]

Sounds like a third MRI and LP are a good idea - I think you're on the right track with this neuro.

[janbubears]

hi there i too thought it was a disc problem until the spinal surgeon said there was no disc protrusion on MRI he called it a swelling he had seen on spinal column and  refered me to a neurologist

so this makes me wonder xx

jan x

[jensequitur]

I still think that herniated disc could be causing many of your symptoms.  The only thing that doesn't sound like it's connected to your neck is your feelings of being disconnected, which I can relate to.  I had several moments like that before my diagnosis - I thought I was losing my mind, too!

[slightlybroken]

Hi,

I'm just bumping today..just had surgery and saw your question going to the second page.I'm out of it today so I'll bump it and maybe others will shime in.

Take Care