Hi there. De quervain’s disease is a painful inflammation of the tendons in the thumb that extend to the wrist. The common symptoms are pain along the back of the thumb with decreased thumb motion due to the rubbing of swollen tendons and their coverings against the narrow canal through which they pass. There may be pain on direct pressure. You might be having twitching in the thumb. There are certain causes responsible for muscle twitching like diet deficiency, drug overdose, and side effects of diuretics, corticosteroids, estrogens, exercise, benign twitches, and nervous system conditions like amyotrophic lateral sclerosis or ALS, muscle dystrophy, spinal muscular atrophy and myopathy. Your neurologist needs to look into these conditions one by one. The other possible cause could be multiple sclerosis and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Causes of strokes can be investigated like high blood pressure and high cholesterol along with brain hemorrhage. Take care.
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