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Neurology (Expert Forum)
Fatigue,speech,bladder probs,L'hermittes,etc= Somatization,MS???
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Fatigue,speech,bladder probs,L'hermittes,etc= Somatization,MS???
by niki__0, Nov 17, 1998 12:00AM
I have a five year history of neuro symptoms including fatigue, numbness(mainly left sided,facial,across abdomen,etc),muscle weakness(particularly in legs)slurred speech and urinary problems which I was told by a urologist was a combined dysfunction(had urodynamics test two years ago),frequency,near retention sometimes.It was suggested that I learn how to self-catherterize but have not needed to do so yet .Quite severe probs with mobility -I need two sticks and/or a wheelchair to get around outside.
I have had electric shock like sensations that come and go(from head/neck level down through to my hands) for the last 5 months.These vary in severity.Sometimes I get them everytime I move my head ,and some are strong enough to jolt my body.I had it about 3 yrs ago ( went down to my toes at that time) but it only lasted for approx a month.I also get an electrical feeling in my tongue which I associate with what my neuro suggested was L'hermittes.May be having an MRI of my neck soon.I have had three MRIs of head and all normal.EMG,minor abnormalities & Bell’s Palsy found 4years ago when being tested for Myasthenia Gravis,EVP normal,CSF normal(3 years ago)Blood screen,thyroid tests ,etc all normal.I have had other doctors(not neuro) and an osteopath tell me that my knee-jerk reflexes were fast and absent in my abdomen,but my neuro dismisses these findings because they they were tested by‘lay’ people.Although I believe that a senior general practioner should be quite capable of testing reflexes correctly, as was the case 6 mths ago.
My symptoms vary in severity and some are intermittent.I have what the doctor describes as flare-ups/attacks which leave me polaxed for a few days- a week and take months often to return to the state I was in prior to each ‘attack’.I have yet too experience a full remission.The most debilitating aspect is the fatigue and I have too rest twice a day.I currently attend physiotherapy 2-3 times a month where the intention is to follow a graded exercise programme.I have B12 injections and take 6-9mgs of Oxybutinyn daily.I have tried using antidepressents(Prozac) and Amantadine to help combat fatigue but neither have been very helpful.
I have seen two psychiatrists niether of whom have been able too find any significant pyschological cause of my symptoms( in fact the first one was so concerned about my physical state she rang my neurologist immediately wondering why I hadnt been diagnosed with MS yet)
To date I have no confirmed diagnosis but doctors seem determined to label me with CFS or Somatisation disorder and my neuro says that MS is “highly unlikely”.I am too see a reputable(in UK !) psychologist who treats M.E/CFS patients and who believes that Cognitive behaviorial therapy is the most appropriate treament.I am extremely unhappy about this as I fear I will be labelled and then every symptom,flare-up/attack ,etc from then on will be put down to CFS/somatisation. know from the research I have done online that I dont fit the criteria for CFS or Somatization and have quite simply had enough of the way my case has been handled so mush so that I am considering not seeing any doctors again, unless,an emergency arises .I dont have medical insurance so I cannot choose who I want too see.I am very motivated towards improving and hopefully recovering if that is possible and stick to my exercise programme,etc but I am gradually getting worse.
If you have any advice it would be much appreciated,also I would like like too know what the rare causes of L’hermittes are??
=====================
Dear Nikki,
thank you for the question. In reading your post I have to sympathize with you and share your frustration. MS is not our favorite diagnosis and there is a clinical criteria to diagnose it. It is a clinical diagnosis although MRI of the brain is extremely helpful in borderline or atypical cases. Your negative brain MRI along with other negative studies are reassuring that your symptoms are most likely not due to a demyelinating disease such as MS.
Unfortunately your many of your symptoms are subjective and your doctor have no way of quantifying them. The physical and neurological exam also sound normal, this again is reassuring that there is no focal process.
We are left with patients such as yourself, still with symptoms, but no diagnosis. What we do usually is tackle the symptoms and treat it individually, if you have pain treat it, if you have vertigo treat that, etc.
In your case the fatigue is being treated with AMantadine and B12 injection, both of which are standard.
You asked about other causes of Lhermitte's sign:
1. B12 deficiency
2. Cervical spondylosis (this is degenerative disease of the spine in the cervical/neck region that is severe enough to cause problem in the spinal cord).
3. Trauma
4. Rarely infection with spirochette (syphyllis) can cause symptoms similar to Lhermitte's sign.
Good luck and I hope this info helps.
I have had electric shock like sensations that come and go(from head/neck level down through to my hands) for the last 5 months.These vary in severity.Sometimes I get them everytime I move my head ,and some are strong enough to jolt my body.I had it about 3 yrs ago ( went down to my toes at that time) but it only lasted for approx a month.I also get an electrical feeling in my tongue which I associate with what my neuro suggested was L'hermittes.May be having an MRI of my neck soon.I have had three MRIs of head and all normal.EMG,minor abnormalities & Bell’s Palsy found 4years ago when being tested for Myasthenia Gravis,EVP normal,CSF normal(3 years ago)Blood screen,thyroid tests ,etc all normal.I have had other doctors(not neuro) and an osteopath tell me that my knee-jerk reflexes were fast and absent in my abdomen,but my neuro dismisses these findings because they they were tested by‘lay’ people.Although I believe that a senior general practioner should be quite capable of testing reflexes correctly, as was the case 6 mths ago.
My symptoms vary in severity and some are intermittent.I have what the doctor describes as flare-ups/attacks which leave me polaxed for a few days- a week and take months often to return to the state I was in prior to each ‘attack’.I have yet too experience a full remission.The most debilitating aspect is the fatigue and I have too rest twice a day.I currently attend physiotherapy 2-3 times a month where the intention is to follow a graded exercise programme.I have B12 injections and take 6-9mgs of Oxybutinyn daily.I have tried using antidepressents(Prozac) and Amantadine to help combat fatigue but neither have been very helpful.
I have seen two psychiatrists niether of whom have been able too find any significant pyschological cause of my symptoms( in fact the first one was so concerned about my physical state she rang my neurologist immediately wondering why I hadnt been diagnosed with MS yet)
To date I have no confirmed diagnosis but doctors seem determined to label me with CFS or Somatisation disorder and my neuro says that MS is “highly unlikely”.I am too see a reputable(in UK !) psychologist who treats M.E/CFS patients and who believes that Cognitive behaviorial therapy is the most appropriate treament.I am extremely unhappy about this as I fear I will be labelled and then every symptom,flare-up/attack ,etc from then on will be put down to CFS/somatisation. know from the research I have done online that I dont fit the criteria for CFS or Somatization and have quite simply had enough of the way my case has been handled so mush so that I am considering not seeing any doctors again, unless,an emergency arises .I dont have medical insurance so I cannot choose who I want too see.I am very motivated towards improving and hopefully recovering if that is possible and stick to my exercise programme,etc but I am gradually getting worse.
If you have any advice it would be much appreciated,also I would like like too know what the rare causes of L’hermittes are??
=====================
Dear Nikki,
thank you for the question. In reading your post I have to sympathize with you and share your frustration. MS is not our favorite diagnosis and there is a clinical criteria to diagnose it. It is a clinical diagnosis although MRI of the brain is extremely helpful in borderline or atypical cases. Your negative brain MRI along with other negative studies are reassuring that your symptoms are most likely not due to a demyelinating disease such as MS.
Unfortunately your many of your symptoms are subjective and your doctor have no way of quantifying them. The physical and neurological exam also sound normal, this again is reassuring that there is no focal process.
We are left with patients such as yourself, still with symptoms, but no diagnosis. What we do usually is tackle the symptoms and treat it individually, if you have pain treat it, if you have vertigo treat that, etc.
In your case the fatigue is being treated with AMantadine and B12 injection, both of which are standard.
You asked about other causes of Lhermitte's sign:
1. B12 deficiency
2. Cervical spondylosis (this is degenerative disease of the spine in the cervical/neck region that is severe enough to cause problem in the spinal cord).
3. Trauma
4. Rarely infection with spirochette (syphyllis) can cause symptoms similar to Lhermitte's sign.
Good luck and I hope this info helps.
