Do I now or will I get MS?

[teri]

I have had a history of migranes for the past 2-3 years and I am being treated by a Neurologist for the headaches. I also have a history of right leg weakness from a presumed back injury several years ago. My neurologist had a Mri of the brain ordered on me to make sure there was nothing else causing the leg weakness. He also felt that my reflexes were hyperflexia and I hand some tingling on the right side of my face that were not associated with my migranes. The Mri showed that I had multiple foci of scattered abnormality throughout the cerebral white matter, as well as one vague focus within the left upper pons.A few of the white matter had a periventricular location.The corpus collosum had no definite lesions but the undersurface of the corpus collosum was irregular to the right and left of the midline. My neurologist looked at the films because he felt that the lesions could be due to migranes, but once he saw them he felt that they were too big for to be caused by migranes. I had a spinal tap, and the spinal fluid results were negative for protein,glucose,and oligoclonal bands.The csf electrophoresis pattern was normal. The Igg was 936 and the Igg synthesis was 3.80.I now have"pins and needles"feeling in my extremities.

[diana]

I am wondering if I have MS.  I have irratable bowel problems.  I also have a burning, tingling sensation in my arms, hands, legs and feet (mostly noticed at night, can't sleep).  I feel dizzy, weak, my eyesight is blurry and my arms and legs feel heavy.  I am having trouble concentrating.  Please help!

[Karen H]

I am 28 yr old w\2 children. I have had HX of moderate recurrent Headaches daily, varies in severity, for 4+ years and slight tremor w/movement to (L) hand.  MD sent me to Neurologist in 6-98.  Performed a MRI of brain, EMG, and EEG.  EEG normal, EMG showed bilateral cervical radiculopathy.  MRI showed one area of abnormal focus of increased signal to deep white matter over the high (L) parietal region. Neurologist said this was indicative of MS but could not be since there uas only one area not multiple.  Was treated for depression and migraines x 3 months although symptoms never went away.  

In past 3 months other symptoms have been noted.  Tremors have spread to both arms and hands, also legs at times.  Affects my ability to type, write, hold a glass, etc. at times.  Headaches have increased in intensity.  Pupils are unequal often with (L) pupil larger than (R) pupil, esp. in dim light and w/activity.  Severe weakness in arms and legs as if made of lead.  Fatigue which often causes me to fall asleep easily, even at my desk at work.  Episodes of dizziness also.  Repeat MRI showed no change although spot is still there.  Neurologist says it is definitely not MS although unable to give definite DX of anything else.  Treatment w/Inderal, Prozac, Depakote, and Ocuvite vitamin x >2wks.  Neurologist DX w/anxiety, depression, cervical radiculopathy, and suboccipital cehpalgia, and transformed migraines.

Questions:  Can all this be caused by Cervical Radiculopathy?  What exactly does area of increased focus on MRI mean? Should I seek second opinion from MS specialist?  

Thanks for your time.  Am sorry to post this here but have been unable to post a question.  

Karen H.

[CCF Neuro[P] MD, RPS]

Dear Amy:

Although we never say never in medicine, the sounds of your symptoms do not sound like MS.

CCF Neuro MD

[Amy]

I have has sinusitus for 4 months now and along with this I have dizziness and lightheadedness and slight balance loss. I was taking antivert for the dizziness and it started causing blurred vision and my eyes and mouth were so dried out.  I took myself off of the antivert, my vision has greatly improved, My ENT says that he thinks this lightheadedness and dizziness is only a temporary thing. I am doing exercises to overcome the dizzyness. I am also going through menopause, and currently taking ovcon for hormone replacement. I have been having on and off for the past four months tingling in my extremities, and some stiffness.  I am currently taking levaquin for the sinuitus and flonase for the swelling in my sinusis.  I am a little worried about MS but I have no loss of strength and no trouble walking or working. The tingling is causing me a lot of worries.  I had a CT scan done and everything was normal.

[CCF Neuro[P] MD, RPS]

Dear Debra:

I am not sure I understand.  Tics usually do not cause pain as much as muscle movements.  Although if the muscle moves enough it can cause pain.  The treatment for tics is the neuroleptics.  The headaches, might be treated with a serotonin medication like the tricyclic antidepressants, triptans, calcium channel blockers or epilepsy medications like valproic acid.  I can not answer whether your symptoms are anesthesia delarosa.

CCF Neuro MD

[debra]

I have a had an extremely difficult hx with trigeminal neuralgia. I've had MVD,Facial disection {above the right eyebrow},Partial rhizotomy,Radiofrequent rhizotomy,and a complete Rhizotomy. The last occurring Oct 1999. I have had nasty headaches since my surgery. They are frontal inbetween but above the eyebrows. Like a pressure HA. Nuerosurgeon is confused about them. MRI is normal. Also have a pressure-ache-bruised-heavy sensation in the inner canthus and nasel area where the tic was the worse. Could this be Anesthsia Delarosa? Could the tic pain ever return?
Thankyou so much for you help.         Debra

[Judy]

Boy am I confused (as is my neurologist!). 4 years ago developed restless leg syndrome and tinnitus, with balance problems.  Had periods where the back would "hitch" and walking impossible.  Still have RLS and tinnitus, and sometimes balance problems. Oct of 98 developed numbness on inside of left leg and painful burning, tingling sensations throughout my body, including face.  Nuerontin helps.  MRI showed multiple foci in the cerebral white matter and a lesion in the periventricular region. Spinal tap and bloodwork are normal.  There are times when I feel worse, but have not been without symptoms. I also have occasional mental confusion (not blonde related) and problems with words.  My dr. states the lesions are not a typical MS pattern, so hesitates to make the DX.  I also have occasional (10 times a day) numbness in my arms, from shoulder to finger tips, as if arm falls asleep.  Have woken from shooting knife like pain going down arms. During any exertion arms will turn bright red, burn hot, but hands are cold.  She is now looking at vascular problems.  I am 45.  Any ideas what questions I should ask?

[CCF Neuro[P] MD, RPS]

Dear Mary:

Your symptoms really do not sound like MS.  Headache can be associated with MS but usually there are other symptoms.  The gamma knife was for ?  Anyway, it really doesn't sound like MS as the symptoms in MS are episodic, they come and go. The symptoms are usually sensory or muscular and not strictly pain.

Sincerely,

CCF Neuro MD

[Judy]

Boy am I confused (as is my neurologist!). 4 years ago developed restless leg syndrome and tinnitus, with balance problems.  Had periods where the back would "hitch" and walking impossible.  Still have RLS and tinnitus, and sometimes balance problems. Oct of 98 developed numbness on inside of left leg and painful burning, tingling sensations throughout my body, including face.  Nuerontin helps.  MRI showed multiple foci in the cerebral white matter and a lesion in the periventricular region. Spinal tap and bloodwork are normal.  There are times when I feel worse, but have not been without symptoms. I also have occasional mental confusion (not blonde related) and problems with words.  My dr. states the lesions are not a typical MS pattern, so hesitates to make the DX.  I also have occasional (10 times a day) numbness in my arms, from shoulder to finger tips, as if arm falls asleep.  Have woken from shooting knife like pain going down arms. During any exertion arms will turn bright red, burn hot, but hands are cold.  She is now looking at vascular problems.  I am 45.  Any ideas what questions I should ask?

[Mary Castleberry]

Hi!  I just read all your interesting articles and have a few questions myself.  I have had a chronic headache which increases/decreases with severity from day to day.  I have been to several neurologists, had a gamma knife procedure done and am more than likely going to try a nerve block in the next month or so.  My question though is...my mother has MS and has had for over 20 years.  I have had an MRI and a Spinal Tap (both negative)but was wondering if there is still a chance this could be MS related.  I also have tingling on the right side of my face (which my neurologist thinks may have been caused from the gamma knife procedure)and my headache is located only on the right side of my face with the pain coming from my right temple and behind my right eyeball.  I also have a slumpy eye on that side.  I know it's hard to do anything through E-mail but was just wondering what the chances were that I have gone all this time being misdiagnosed...

Thank you for any imput you might give me.

Good luck to all of you who are suffering!

Mary

[CCF Neuro[P] MD, RPS]

Dear Betsy:

A high normal IgG index is likely normal.  There are many things that can induce the CNS to produce antibodies.  Unless the clinical examination is abnormal, and the MRI is also abnormal, I would not consider a high normal to be indicative of MS.

CCF Neuro MD

[Betsy]

I have a question regarding the CSF index and the IgG.  If someone were having these symptoms and the high reference for the index were.7 and the results were a .5 and the IgG were 1274,and they were within the normal range but toward the high level, how often would one monitor the patient before they can actual rule out MS?  I appreciate your input and your knowledge. You have been very help here on this forum.

Thank you

[CCF Neuro[P] MD, RPS]

Dear wax and wane:

The symptoms of MS come and go.  They may last for a variable length of time but will remit.  The remission may also be variable from never occurring again to occurring within months.  This is why the name is "multiple" sclerosis.  There are usually multiple events that occur periodically.  During the attack or exacerbation, the loss of function will be present and may or may not return to normal.  Usually, there is a slight loss of function with each event, but not always.  There is no single diagnostic test that tells you the you have MS.  Several tests, such as MRI and CSF analysis can help in the diagnosis but they in and of themselves do not give the diagnosis.  The diagnosis is done by clinical exam by the physician.

CCF Neuro MD

[wax and wane? trying to understand]

Hi,

Im   trying to understand all this,  im sorry, im far from medically inclined.  Ok wax and wane,  you mean durring an episode (attack) like you feel better and worse throughout the attack, or do you mean throughout the course of the disease?  Like with an attack I was under the assumption that you feel real crappy and slowly get better. Not a few good  days and a few bad in between. (I picture a raw nerve within the body and see it causing problems untill it scars over) In your profession do you commonly see individuals who's flare ups last for several months?

The clinical diagnosis is also one that puzzles me.  It sounds as if you present all the symptoms, an MD can diagnose you withouth testing, yet  it also sounds like if you have passed all the testing normally you do not have it.  So why would a Dr diagnose clinically if he/she can just run a battery of tests.  I understand this  disease is a very complex one, and I admire your ability and knowlege to understand it.  I sure dont!  Thanks so much, awaiting your input.

[CCF Neuro[P] MD, RPS]

Dear Angie:

The MRI of the brain and/or spinal cord would be abnormal and would remain abnormal.  The clinical symptoms would wax and wane with periods of recovery between episodes.  The duration of episodes would be individual and vary from episode to episode and person to person.  Usually, during an excerbation the CSF would be abnormal and produce oligoclonal banding and increases in Myelin basic protein levels.  Usually the oligoclonal banding will remain between episodes.  If all the tests, neurological exam are normal, then you do not have MS.  If only the clinical evaluation is abnormal and suggests MS, you likely have MS.  The diagnosis of MS is clinical and can be made in the face of normal MRI and CSF studies, but only an experienced MS physician would likely make that diagnosis.

CCF Neuro MD

[Migraine and MS, connection?]

I read somewhere that People with migraines can go on to develop MS and tha Migraine ws a possible auto immune disorder.  Do you have any data for the amount of MS patients (in your office) and a connection to a history of Migraine?  Any other scientific data on this topic?  Thank you

[Angie - MS question Dr]

Dear Dr,

Say one has had ms type symptoms on and off for a few years, would am MRI by now show abnormalities? Typically how long does an attack last and does it reach a peak then dwindle off, I've been feeling things for the past 3 months, not getting better.  Im guessing Ms would start to clear up now with remission.  Also with muscle twitches, is this part of ms and is it typical all around or isolated with one section of the body.  I hate to bombard you with so many questions.  What tests could give me a better knowledge of the disease and if all neg does that dramatically reduce chance of ms?  Again I appologize for the amount of questions and understand if you wish to skip this, I cannot post when I hit post, only under this message.  Thanks so much for your time

[Katherine]

Can you respond to my posting/comment of March 14/15 2000.  I still have some unanswered questions.

Thanks,

I really do appreciate it.

[teri]

The MRI scan was T2 and axial Flair, but it does not mention the ages of the lesions or the sizes of the lesions. The only symptom that I had that was one of the reasons for doing the Mri that I no longer have was some tingling on the right side of my face.  The IgG synthesis was high in the labs reference standards. I am 43 years old.

[CCF Neuro[P] MD, RPS]

Dear Terri:

I am sorry to hear about your problems.  When they did the MRI scan, on the FLAIR or T2 images, where there areas of different ages?  I don't hear the symptoms waxing and waning.  But high on the list of possible etiologies would be MS.  I can tell you for sure without doing the exam myself and seeing the films, but MS is a very likely diagnosis. Was the IgG synthesis in the CSF high on the labs reference standards?  I would think that you likely have MS but the diagnosis should come from your neurologist.

Sincerely,

CCF Neuro MD