To all: I am an active 30 year old male. In 2008, I came down with what seemed like a severe flu w/ strong fatigue, muscle, and joint pain. Episodic 'brain fog' and photophobia would accompany this. Blood test showed positive ANA (1:320); rheumatologist tested me for 'everything'. Abnormalities seen were consistently low WBC and a mildly elevated CPK; negative for RA, lupus, etc..ANA remains negative to this day. Have always had Reynaud's in my hands, as well. Brain MRI was performed, clean scan.
Muscle and joint pains persisted, but seemed to wax/wane as time went on. In 2010, I came down with a bout of ‘colitis’, per CT scan and gastroenterologist's diagnosis. (CT Scan also showed what appeared to be a ‘temporary ileus’. This all resolved; but this illness marked the beginning of new symptoms that have progressed.
My right side (muscles) became weak; markedly, my right arm. Strength feels noticeably decreased, and this is affecting me both proximally (shoulders, upper arm) as well as distally (hands, specifically pinky.) Also, my right foot/ankle feels strange...hasn't been dragging at all, but just feels different with a reduction in sensation when being touched and when walking. Right hand has also weakened in terms of my grip. Photophobia again reemerged; opthamology saw nothing wrong, 20/10 vision. A brain MRI in 2010 showed the following: "Perhaps very minimal parenchymal volume loss, otherwise, normal examination." Cervical spine was not examined. Neurologic physical exam was normal.
Fast-forward to today. The issues above never completely abated, but seemed to have worsened. This past summer, had an experience with swallowing difficulties, with certain foods. (Has occurred on and off, sometimes I'm fine, other times I have to focus....no pattern.) Uncertain if this is anxiety-related, as I’ve had issues with anxiety in the past, and this seemed to ‘flare-up’ during times of stress. Had a period of five days where my left upper lip felt ‘swollen’ (it wasn’t), and felt to be ‘in the way’ during speaking, which at least to me, caused difficulty in voice inflection and expression. Brain fog, lack of focus also accompanied this. (Has since resolved.)
Swallowing issue still comes and goes, most recently as last week. Foot reduction of sensation and 'sore' ankle symptoms have not resolved, hand still has reduction in sensation, and as of January 1, all began to become more pronounced. Muscle weakness continuing on right side, in leg and arm. (Seems to be much more pronounced in areas surrounding or close to knee and elbow joints.) Still, two further neurologic exams are ‘normal’, as was a conventional EMG and nerve conduction test. (Day or two following EMG, I felt tingling and minor ‘shock’ both left and right legs, arms, and feet.) Again, hard to differentiate reality from anxiety….pulse rate was over 118 during last examination. Very, very nervous over this. MS is my main concern.
Blood test revealed a mildly elevated CK, with a borderline positive titer for Anti-AchR antibodies. (Repetitive nerve conduction test set for later this week.) B12 was normal, ANA was negative, Sjogren’s was negative. All work-ups have been at a major university hospital in a metro area. What are your thoughts on these symptoms? Another MRI of brain, and now cervical spine, slated for this week. I realize MG could also come in to play due to the above titer, but I don't have ocular symptoms.