likelihood of MS

[Shan0423]

Hi everyone,

I know there has been some talk about anxiety and I do not want waste anyone's time on here, but I am really looking for some guidance.

So, my question is: what is the likelihood of an MS Dx if you've had a normal neuro exam along with a clean brain and  cervical spine MRI?

The MS specialist I have been seeing is trying to get me to understand that my problem is psychological rather then medical. She has encouraged me to take anti anxiety medications, which I am not opposed to doing, but I'm still concerned. Also, she has said there is no reason for me to have any more testing done as all the necessary testing has been done already. According to her, MS has been ruled out.

I appreciate your time and any opinion you may have

Shannan

[kwarendorf]

Try and relax and enjoy your birthday tomorro :-)

[Shan0423]

Hi Kyle,

Dr.Google has certainly done me more harm then good and only brought about more anxiety.

I realize PPMS is very unlikely especially since I read that it most frequently occurs in your 40s-50s and I'm only 23 ( 24th birthday is tomorrow, actually).

I guess my mind went right to that because my symptoms, while they definitely come and go, I've never had an "attack"- it least I don't feel like I have, but from my reading I think that I would most definitely be aware if I've had an attack.

I've also had some blood tests drawn. My B12 was 238 which I believe is on the low side, but the specialist I saw didnt say anything about that. I'm wondering if maybe thats too low and can be causing some of this?

ugh, I believe I am driving myself crazy.

Thanks for listening,
Shannan

[kwarendorf]

Hi Shannan -

MS symptoms tend not to jump around. They are caused by damage to one or more individual locations in the central nervous system. Only those areas that receive info delivered along the damaged nerves are effected. The information that efffects your face travels a different pathway than the information that effects your feet, or hands or bladder.  The location of the nerve damage in MS if fixed.

As to PPMS, I would think it is very highly unlikely. First, it is the rarest form of MS. Less than 15% of people diagnosed with MS arfe diagnosed with PPMS. Second, as Alex said, PPMS symptoms tend not to go away, ever. Third, in the opinion of one MS specialist there are no signs of MS in either your clinical exam or your MRI.

I would encourage you to do three things. 1) Seek a second neuro opinion. 2) Seek counseling for you health anxiety before taking any anti anxiety meds. 3) Stop consulting Dr. Google :-)

Kyle

[Shan0423]

Thank you all for taking the time to read my story and responding. It is very helpful!

Shannan

[essdipity]

Symptoms jumping around are a big signal that this is NOT MS. In MS, that's simply not possible. Lesions in the central nervous system cause MS symptoms, and they do not quickly heal or reappear elsewhere within a day or two.

ess

[HVAC]

If you had PPMS your symptoms would not come and go quickly you would have the symptom forever. For example I started with double vision . Then left side weakness. Then headaches and dizziness. Now my gait is messed up and I walk slowly. None of these has gone away. I have had them for years. The symptoms were so subtle I did not notice them. My GP found my MS I did not go in and say I have this and that problem. She noticed I had a neurological problem and did a neurological exam which was abnormal. They had to convince me I had MS. I thought they were wrong. You would not notice PPMS until later stage and it would show up on a MRI and neurological exam.

Alex

[supermum_ms]

Q: is it normal for symptoms to jump around your body?
A: It's not normal or consistent as far as I'm aware for symptoms caused by MS, to jump or move around, be in one location for a day and the next it's been replaced by a different type of symptom in a totally unrelated location.

Cheers..........JJ

[Shan0423]

thank you for your response

I know everyone has different experiences when it comes to their own MS,  however is it normal for symptoms to jump around your body? For example, one day to have a tingling face and then the next day have a slightly weak arm?

Shannan

[supermum_ms]

Hi Shannan,

There is always the 'potential' that your health anxiety has unconsciously magnified a general health issue into something more serious in your minds eye and based on everything you've mentioned, it would be reasonable to follow through with the opinion that what you experience is more likely psychological and less likely a neurological condition like MS, which you have no diagnostic or clinical evidence of....

You have been provided with a specialists opinion and like any other potential medical condition, it is in your best interest to get professionally assessed for your potential alternate explanations, even when the alternative is a mental health causation. At the very least, a psychological assessment will either get the idea off your list of possible causes or it will provide you with a treatment plan that helps you in the short and long term, win win imho and well worth doing!

Cheers...........JJ  

[Shan0423]

thank you for responding!

I initially went to my primary doctor because i had tingling sensations in my legs, feet. and hands. He thought I should wait to see if it went away but I do have a history of health anxiety, so he wrote me a script for a brain MRI- that was clear. This was in March.

The tingling went away, but then my feet were burning and I also had weird burning patches around my body at different times. I was still worried so thats when I went to see an MS specialist and she order a cervical MRI and lumbar because I have a history of back pain. Those MRI's were clear along with the neuro exam.

I think my main concern that I have is with my bladder. I've experienced bladder leakage ( not retention or urgency) since September 2014. It resolved on its own and then came back in March.

I feel like my symptoms dont really match up with RRMS because I had no attacks or anything like that, so I feel like its consistent with PPMS. I'm not sure if you know anything about that or not? I know it tends to occur in people in their 40's- I'm only 23, by the way. I know if it can happen in younger people, but just not as common

Thanks again for any input
Shannan

[doublevision1]

That is very tough to say. My guess is that in the majority of cases, a normal neuro exam and normal MRIs  means no MS. There is a minority who will go on to show signs of definitive MS on exam and MRI. In these cases, it was just too early to show up when initial testing was done. This would be me. Normal neuro exam and clean cranial and spinal cord MRI. My GP said MS was "ruled out." The neuro I saw then did not use the term "ruled out" but "I see no evidence of neurologic disease at this time." I think the latter is more appropriate language.

In any event, likelihoods or % mean nothing in individual cases. Just because I ended up showing signs of MS doesn't mean you will. Just because something is possible doesn't mean it is probable.

I don't know anything re: your symptoms or what brought you to see this neuro. You could always consider a second neurology opinion before going on meds for anxiety.  I would also strongly urge anyone considering anxiety meds to have a psychological assessment first. Perhaps therapy would be more helpful. I wish docs would suggest this first instead of jumping right to meds. Nothing wrong with meds for those who need them, but not everyone who takes them needs them and in some cases they do more harm than good.