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Could this be MS?
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Could this be MS?

Hello, I am a 32 yo female, and I started experiencing numbness & tingling in my left foot approx. 6 months ago. This numbness lasted about 6 weeks, and then my other foot started with the numbness and tingling that lasted about 4 months off and on. These symptoms were associated with feet and calf twitching. I had been symptom free for about 2-3 weeks now, until 2 days ago when I started experience the foot and calf twitching again, and now my right foot is tingly again. Also, I periodically experience a 'water dripping down my shin' feeling occasionally.
Saw a neuro last month, neuro exam was normal, as was my TSH, lyme, b 12, ANA and creatinase.
My question is:  Does this sound like MS? IS the twitching a sign of MS? it is really bothersome. I am in graduate school and won't be able to get health insurance or disability insurance for about a year. Do you think I could wait this long to get a further work-up? I don't want to jeapordize my health. Any input/suggestions would be greatly appreciated.
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Avatar_n_tn
Dear Cindy:

Sorry that your having problems.  The initial phases of MS are often difficult to pinpoint and say, yes this is MS.  Your symptoms may be compatible with early MS, but also alot of other things (as your neurologist likely told you) from anxiety to cervical cord problems.  The range is broad and the work-up can be extensive depending on what is found on the initial screening.  Whether to pursue this on the basis of health insurance is problematic.  Pre-existing conditions often make insurance a problem to obtain.  Having the diagnosis of a peripheral neuropathy, MS, metabolic problem, systemic disease such as diabetes might increase the premiums or preclude you from certain insurance plans.  However, waiting (depending on the problem of course) can also have it's problems as certain problems are more easily treated earlier in the course of a disease.  I would get worked up further and get early treatment if needed, but that is my opinion and you need to make up your mind.

Sincerely,

CCF Neuro MD
15 Comments
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Avatar_n_tn
What is the criteria to be started on Avonex? Do you need to have documented neurological signs as well as documented lesions on a MRI? Just wondering because so far I have no objective signs on exam. Thanks
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Avatar_n_tn
Im also very concerned about this.  I had a complete neuro work up about 7 mos ago, my legs are twitching, calfs, upperlegs, numbness in my right leg from knee down, strange feeling on bottom of foot, facial tingle, blurry vision etc.  I was told probably not MS but I never had the question answered does MS CAUSE TWITCHING>???  I can still do things normally, its been close to a year now that this all began and it comes every month or sometimes twice a month!  I can still walk on toes, yet right calf does tend to feel weaker, I also type now backwards sometimes!!! What should I do now or go from here?

HELP
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Avatar_n_tn
Im very confused about MS.  I was told it was a disease of loss of control, starting with odd numbness, progressing.  Now i've been told that arthritis, muscle pain, joint pain Dry eyes, stomach nausea are assosiated with this.

I've been seen by a Dr who said MS not likely, and I was feeling confidend since my joints ached, I was hopefull maybe an auto-immune like lupus over MS, and also dry eyes.  but now i've been told that DRY eyes are very common in MS, because of the autonomic system being attached by MS.  Also I heard Muscle fasculations are part of MS when before I thought they were not.  I"ve also heard that visual problems for MS'rs can be other things besides neuritis and nysigmitis sorry for my spellings.  So you see its very confusing to me!!!  Are these things above true or have I been mis-informed?

Thank you if you've followed this thread.
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Avatar_n_tn
Dear Question Dr:

Fasciculations can be seen in MS but this is very late in the disease.  MS is a central or brain problem not a peripheral neuropathy type problem.  Joint pain arises only because the muscles become spastic and tight and pull unnaturally on the muscles.  The usual presenting sign of MS is optic neuritis, or muscle weakness, or parasthesias not joint pain, or loss of bladder function.  Autonomic dysfunction occurs not because of autonomic neuronal dysfunctioning, but due to central lesions that change the central over-riding mechanisms of control, such as seen in neurogenic bladder.

I hope this helps.

CCF Neuro MD
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Avatar_n_tn
Thank you for taking the time to read this.  Im sorry to the gal above for elbowing in your post.  Doctor your very kind to take your time to make someone feel better.  I cant tell you how much I appreciate this.
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Avatar_n_tn
Cindy,  I am very surprised CCF neuro did not mention the possibility of benign fascics syndrome which I feel is very high up on the list of possibilities.  Your symptoms are classic of the onset of that syndrome.  By the way, my symptoms were EXACTLY what you describe including the water dripping sensations and I was never diagnosed with MS.  I have had only normal tests over the last six years including MRI, EMGs, SPECT scan, etc.  My diagnosis is now changed to LYME DISEASE as I have improved in all areas dramatically with high dose orals over the last 6 mos.  

To the person who is wondering about the dry eyes/MS connection:  it is not uncommon for people to have MS and Secondary Sjogren's Disease.  Sjogren's causes dry eyes and dry mouth and other problems.  They can occur in conjunction.  Hope this helps.

***@****
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Avatar_n_tn
Hi I was the person who posted about dry eyes.  The beginning of your mail was encouraging to me, that I dont have MS but now im scared to death again that i do have MS are you a Doctor?

So there goes the possibilities of Benign fasculation syndrom (syndrome) for me are out and its probably now MS!!

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Avatar_n_tn
1.MS is a demyelinating disease of the central nervous system that has no known cause.

2.Most forms of MS are ammenable to treatment and do not reduce life time survival rates.

3.Treatment with the ABC drugs has been shown to reduce the developement of new central nervous system lesions. These drugs do not remove old lesions. (lesions being sites of demyelination, also referred to as demyelination plaques)

4. Just because a person has a lesion or even many lesions visible by MRI ...one can not say based soly on the MRI findings what the function of the patient is. This is important. It means the body "makes-up" for the loss of myelin presumabley by increasing the number of sodium channels in the affected neurons. So what does this mean for a patient? It means that even if you lose some function, it can reverse completely, only to become manifest if your body is stressed perhaps when you get sick.

5. All these questions about symptoms relating to MS seem to require a basic understanding of the pathology of the disease.
When a nerve is denuded of its myelin, it is denuded of its insulation. Nerves carry electricity. When a nerve has its surrounding insulation removed, there is the potential for it to "short-circuit" with adjacent nerves...and hence produce a variety of symptoms, depending on which nerve it short-circuits with. some symptoms can be very strange...
it is for this reason that some patients are mistakenly referred to psychiatrists when they present to a doctor with what seems like bizzare array of symptoms.

6. This all said there is NO TEST and NO GROUP of tests available today to make a definite diagnosis of MS. The diagnosis is thus based on the clinical presentation of the patient and nature and history of symptoms, MRI findings, Spinal tap findings, and response to treatment.
Acute treatment involves the use of steroids which can result in a rapid resolution of signs and symptoms.

7. Many people with MS live long, healthy productive lives and dont ever require a wheelchair. The best advice I feel is to find a neurologist who specializes in MS. However, any good neurologist should be able to make the diagnosis.

--ps i am a medical student interested in pursuing neurology
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Avatar_n_tn
To Maureen MCL,
Yes, my neuro did mention BFS,  but I thought he just said that to alleviate my fears. Is BFS associated with numbness,tingling and the water dripping parethesias? I didn't think so, that;s why I kind of disregarded him saying that.
I'm praying everyday that I don't have MS, and take it one day at a time. Thanks for your input.
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Avatar_n_tn
Hi,

I am getting the impression that if one is experiencing Calf or fasculations in the legs, since the Dr said that its usually late in the disease, that the neuro exam would be abnormal if indeed MS?  If someone is having muscle twitching and MS obviously late in the disease and an MRI or spinal tap or something should be abnormal by then??
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Avatar_n_tn
Just a couple of comments-

(I was diagnosed with MS in 1995 after about 2 yrs of symptoms, and have read extensively on it. While it has caused many dislocations and changes in my life, I still manage to have a LIFE that is full.)

Re: dry eyes:  I have never, ever heard of or read of anyone with MS having this symptom. It is always possible that one could have an autoimmune disease other than MS that would cause this. I have dry mouth, but it is due to ditropan, a prescription to help maintain bladder control. So I live with it.

Re: twitches... well, I do have them, and had them even early. Mine are often quite visible, but I've never had a neurologist make too much of them. And actually, since I was diagnosed, I do not think I have even asked about them. If they are your main problem, and you don't have weakness and muscle wasting, I wouldn't even worry about them being a symptom of MS, unless you also have other, more common symptoms of MS.

Take care, Sally
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Avatar_n_tn
Hi Sally thanks for your reply.  Im sorry your dealing with MS but im glad you have a great outlook!

Well I have had twitching for about a year, my right leg feels heavy,numbness behind the knee top of foot my muscle feels weak at times but I can still walk on my toes, heels yet both legs ache at times.  My eyes go through wierd dry spells at night, very very dry.  Its confusing not to know whats going on and be told its in your head.  I know something is off but not sure what.  Its been one year now since this began and its been fairly continuius with no real worsening but its scarey!  Best of luck to you!!
p.s. I was told MS unlikely due to the vast symptoms... I just dont know!

How were you diagnosed if I might ask?
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Avatar_n_tn
In my very!!!! limited knowledge of the symptoms you describe, I would be looking more into the dry-eye and fasculation facets of your symptoms and if possible see about an MRI and blood work to eliminate Lyme disease and other autoimmune disorders.  I am suffering from major visual field loss (originally dx'd as Optic Neuritis), fasculations, and tingling/numbness of peripheral areas, but with MRIs and alot of blood work results the Neuro-Opthamologist and Neurologist have stated that I do not have MS (no lesions were found in any CAT scan or MRI and CSF was normal with pressure within the high end of normal range. Blood work eliminated Lyme disease, LHON, and autoimmune disorders.).  MS is a big, scary disease that has few diagnostic nails that are not applicable to many other (less scary) conditions.  Best of luck.
    Rob
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Avatar_n_tn
I have a twitching muscle under my right eye (about a month now) and some tingling in my toes and fingers.  Should I be worried about these things?
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