Carpal Tunnel and MS study

For the last six months I have been given several tests for the purpose of ruling out MS. I have had various symptoms that may be consistent with MS for several years, however, never thought much about them as they woud occur and remit in cycles a couple times a year. Most recently, I went to the ENT because of severe shooting pains in my right ear that would wake me up in the middle of the night. Also, for the past year my arms and mostly hands would go numb and tingle in the middle of the night causing to me wake several times. The ENT happen to give me a paper to fill out asking about dizziness. I just so happen to have had one of my severe attacks weeks earlier so was able to describe in detail my symtoms (symptoms). He sent me for ENG and other tests. The other tests were normal but the ENG indicated my ear pain may be centrally caused. I then began the workup with neurologist. I have had MRI of Brain w/wo (Normal), MRI of lower Lumbar w/wo (Normal but tiny herniation T3-4), , VEP X2 six months apart (both indicating abmormality in left eye),Blood test for Lymes (Normal), ANA/SED rate (Normal), Lumbar puncture (Normal). Five days after Lumbar puncture I expeienced localized numbness & pain in left thigh. EMG's show carpal tunnel. EMG two years ago showed Carpal tunnel in left wrist only now both. I searched the internet for Carpal tunnel and MS and came across a study which seemed to indicate that Carpal Tunnel may mask MS. Can you tell me more about that? Also, should I be looking to have any other tests due to abnormal ENG and VEP?

[CCF-Neuro-M.D.-SH]

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.      
   Multiple sclerosis (MS) is a disease caused when your immune system attacks your nervous system.  Specifically it attacks the 'insulation' (Myelin) of 'wires' (axons) of nerve cells in the brain and spinal cord.  Without the 'insulation' around the nerve processes the signals are slowed down and can get crossed (causing weakness, numbness and pain).  These immune attacks typically occur in discrete episodes with symptoms lasting for a few days to a few weeks.  At first the attacks resolve completely, but over time they often build up to result in permanent disability.  The first attack of MS is called a 'clinically isolated syndrome' [CIS](before MS can be diagnosed).  When someone presents with a CIS then additional tests are done to look for signs of demyelination.  Some of these tests include visual evoked potentials (VEP), which looks for sign of past optic neuritis [demyelination of the optic nerves]; MRI of the brain and Cervical spine to look for demyelination plaques; lumbar puncture to look for signs of inflammation in the spinal fluid; somatosensory evoked potentials (SSEP) to look for demyelination in the spinal cord and brain stem auditory evoked potential (BAEP) to look for brain stem demyelination.  There are some conditions that can cause similar symptoms to those experienced by patients with MS.  2 of those conditions, you have mentioned, inner ear problems and carpal tunnel syndrome.  Inner ear problems can cause room spinning, loss of balance, ringing in the ears and hearing loss.  When these type symptoms are encountered then an ENG (electro-nystagnogram) can help differentiate between and ear problem or a central problem (brain problem).  Similarly carpal tunnel syndrome can cause numbness and weakness in the hands (as can MS), and a nerve conduction study can differentiate between the 2.  Your abnormal VEP on the left suggests that you have likely had a past episode of optic neuritis in the left eye (a possible clinically isolated syndrome).  The abnormal ENG is non-specific but may relate a possible brain stem demyelination lesion (although it was not seen on your MRI).  I would suggest that you get the nerve conduction study to evaluate for carpal tunnel syndrome and get a repeat MRI of the brain and cervical spine with contrast.  MS is a disease that changes over time and if your initial MRI is 'normal' it may become abnormal if you aquire new lesions.
I hope this has been helpful.

[Jon McKee]

My first visit to the Nuerologist was for what was eventually diagnosed as mild carpal tunnel in both wrists.  That was last summer.  I now have MS and my Neurologist and I still think the wrist/hand issue is carpal tunnel.  In my case my hand(s) only go numb in certain positions.  If I keep my hand straight (in line with my arm) it will not go numb, even when I sleep, which is when it used to happen most often.  My hands will go numb when I drove a long distance on the highway and sometimes if I have it draped over top of the couch while watching TV.  Now that I have MS, numbness and tingling (in my legs) is more or less constant, comes and goes, moves around, on its own and has little or nothing to do with position.  That's why I believe they're unrelated.

[Nanners123]

Thanks for the information. It helps to hear from people who are experiencing similar symtoms (symptoms). I am still interested in the correlation of Carpal Tunnel and MS and your story makes me even more curious.

[Nanners123]

On the off chance that you may look at this post again, I would like to thank you for the detailed explanation and suggestions.

[rcs2]

Nanners 123,
I'm sorry for all you pain. I can understand how frustatring it can be not having a formal dx... Adding up to all the symptoms there is always a ghost to fight with: our own minds wondering what we could have... I have been having sensory symptoms for 2 years, and can't find out what is wrong. I also have a carpal tunnel like problem, but mine is close to the elbow join, so both my hand and forearm go numb. My doctor also thinks they are not related to the other symptoms I have.

Jon McKee,
Would you mind sharing with me what symptoms you had/have?? I also have a numbish feeling that travels on my legs, tingling, needle sensation. My major symptoms is on my face, where I have a fullfillness sensation under my skin all the times, sometimes worse, sometimes not that bad. I wonder about the sensations I have on my legs, sometimes arms, because they can come and go in minutes, what seems not to be a MS pattern... Anyways, I hope you are doing fine, it's really scary having neurological problems that you don't know how far they will go. I have ups and downs, now I have been able to start putting my life back together (I'm 31), but I'm always scaried of my health in the future.

All the best for all of you.

rcs2

[Nanners123]

Thank you for your concern. Yes it has been somewhat difficult to be experiencing so many symptoms and not having  actual answers to why they are occuring. Today I went to the eye doctor at the request of my neurolgist and found out that I have what is called "open angle glaucoma with borderline findings. Now I need to have a visual field testing that will hopefully give us more information on if it is glaucoma or some other problem.

For the first time, after this appointment, I feared that I was closer to a diagnosis of MS. Hopefully in about two weeks I will more answers!!

Good luck to all of you who are going throught he same maze that I am.

[Jon McKee]

I'm definitely MS, have positive brain MRI and positive Spinal Fluid (Oncogical Bands, elevated proteins, etc.).  I have had symptoms in different areas of my body.  Last November I had an attack that left my middle right abdomen profoundly numb, my right leg so weak that I was limping and I had a difficult time driving because I could not hold my foot off the accelerator.  Within a week or so my right leg grew suddenly stronger and my left leg became very patchy numb and within a few days was totally numb and within another few days was up my left buttock and into the parianal area.  This lasted for a couple of weeks and then subsided to the point of almost completely going away.  By January the attack was over and now I'm still profoundly numb on my right abdomen. My right leg and recently my right arm are up and down weak and my left leg has patches of up and down numbeness itching and also I now have a burning sensation in my left foot of various levels almost all the time and occaisonally in my right foot too.  I also feel from time to time vibrations down my legs particularly around the knees, so I'm on Avonex now and hopeful that I can go along long time before this gets worse.  Will see...

[DRC]

I am also experiencing the same frustrations you are! I got in the car about 3 years ago and was fine. The trip was about 2 hours long and when we reached our destination and I went to get out of the car my right leg was so weak I could not walk properly and I have been "dragging" it ever since. I tried chiro and massage as well as Migun beds and nothing really helped.

I had an MRI in February which showed "white spots" on my brain and brain stem. I had the spinal tap which showed only 2 bands of white cells and was told 5 was the threshold for a definitive MS diagnosis. All my other labs have been normal and they have tested for everything! I had SEPs last week and was told they are "fine"!

In addition to my leg spasticity which causes me to fall a lot, I experience the urinary urgency symptoms, some mild numbness in my right hand from time to time, and headaches.

I don't know if I have MS and I don't have a clue what else could be causing my symptoms and this lack of knowledge is unnerving at times!

[rcs2]

Tks all for sharing your symptoms... we are pretty much in the same boat.

So sorry for hearing that so many people are having such neurological problems... Wonder what's going on? I don't think that in the past there were so many "misterious" neurological diseases...

To me the worse part (besides the symptoms by themselfs) is not knowing what is going on with me... where all this will/could end... I don't have a real "thing" to fight against...

Hope we all can figure what we have, and that the researchers can find best treatments for neurological disorders, like MS, Parkinson, etc...

All the best for you all!

[1 of 7 in 1 fam]

I have had problems with my hands going numb and server crushing pain in my arms when I sleep, it doe's not matter what position I fall asleep, ie: recliner, couch, or bed. This problem first begin around ten years ago, was diagnosed then with Carpal Tunnel. But the problem went away after a few weeks, then I developed optic neuritis, was then diagnosed with MS, have done fairly well for years until recently the arm problem has returned and my neurologist says that it is related to the MS, he gave me Lyrica to take @ bedtime witch seems to help sometime.

[1 of 7 in 1 fam]

I have had problems with my hands going numb and server crushing pain in my arms when I sleep, it doe's not matter what position I fall asleep, ie: recliner, couch, or bed. This problem first begin around ten years ago, was diagnosed then with Carpal Tunnel. But the problem went away after a few weeks, then I developed optic neuritis, was then diagnosed with MS, have done fairly well for years until recently the arm problem has returned and my neurologist says that it is related to the MS, he gave me Lyrica to take @ bedtime witch seems to help sometime.

[Nanners123]

Thank you for this information. I was actually prescribed Lyrica for the numb spot and pain in my left thigh. But after reading your post, I realized that not only has it been helping the pain somewhat, but looking back, I have not had the trouble with my arms and hands going numb and tingling since taking the Lyrica. Thanks for the insight!!!

Can you tell me what trouble you were having with your eyes before getting the diagnosis of optical neur.?

Thanks