Further Testing?

[yedwyn]

My situation is:  I suffered with viral like symptoms for several months, including dizziness, fatigue, naseau, chills, etc. Dr. thought infection but antibiotics did nothing.  White count, thyroid, iron all normal.  Muscle twitches started in the third month and I felt weak on left side.  MRI came back normal. Referred to a neuro who ran an emg and gave a diagnosis of cervical radiculitis.  Leg was perfectly normal during exam, only fascics in arm.  My questions are:

1. Does the neuro exam and result effectively rule out something like ALS?

2.  I went to the hospital er with extreme joint pain about a month ago - ana and sed rate came back normal.  My GP says this rules out Lupus and other CTDs - is this correct?

3. Went to GP a week ago for knee pain and was told that my knee joints are "lax"- they continue to be painful but are not swollen or red.  Does this point to Lupus or anothe CTD?

4.  My muscles continue to twitch and sometimes visibly shake for a moment, particularly my bicep - should the emg be redone, should bloodwork be done?  The neuro took no blood at my visit.

5.  I have a history of pins and needles numbness in my hands and feet, periods of flu-like illness and diagnosed Raynaud's syndrome as well as psoriasis. My ANA was "slightly positive" during my pregnancy two years ago but other bloodwork showed nothing.  I am frightened that my Dr. is being unduly resistant to the idea of Lupus.  What further tests would rule out/confirm this disease?

Thank you for your time.  I am a 31 year old mom in need of some help.

-M.C.

[CCF-Neuro-M.D.-CS]

Without examining you and taking your history I cannot make an accurate diagnosis. I am not sure how the cervical radiculitis diagnosis was established. However, if the only abnormality is in your left arm, then a diagnosis of ALS cannot be made. I am not a rheumatologist, who specializes in Lupus, but it would be unusual to have a negative sed rate and active lupus. There are other auto-anitbodies which can be checked. They include anti-nuclear, anti-double stranded DNA, and anti-smith to name a few. Perhaps a consultation with a rheumatologist would be good. You should also discuss with the neurologist the change in your muscle symptoms. Good luck.

[mineandours]

Check out Lyme disease. It's often mistaken for Lupus, MS, ALS, Parkinson's and other diseases.  Here's some info to get you started.  (BTW, At the height of my Lyme disease, my ANA was 320 but it's down to 40 now.)  It's a very puzzling disease.  Here's some info to get you started:  (Email me ***@**** if you have questions.)

Head, Face, Neck
Unexplained hair loss
Headaches, mild or severe
Twitching of facial or other muscles
Facial paralysis (Bell's Palsy)
Tingling of nose, cheek or face
Stiff or painful neck or creaking
Jaw pain or stiffness
TMJ – sudden onset
Sore throat
Loss of sense of taste
Difficulty Swallowing

Eyes/Vision
Double, blurry or dim vision
Increased floating spots
Pain in eyes, or swelling around eyes
Over sensitivity to light
Flashing lights
Optic neuritis

Ears/Hearing
Decreased hearing in one or both ears
Buzzing or clicking noises in ears
Pain in ears or sound sensitivity
Ringing in one or both ears
Pressure or feeling of fullness in ears

Digestive and Excretory Systems
Diarrhea
Constipation
Irritable bladder (trouble starting, stopping)
Frequent urination that is not normal
Upset stomach (nausea or pain)

Musculoskeletal System
Joint pain or swelling or tenderness
Stiffness of joints, back, neck
Muscle pain or cramps
Bone pain

Respiratory and Circulatory Systems
Shortness of breath, cough
Chest pain or rib soreness
Night sweats or unexplained chills
Heart palpitations or extra beats
Heart blockage

Neurological System
Tremors or unexplained shaking (especially at night)
Burning or stabbing sensations in the body
Weakness or partial paralysis/stroke-like symptoms
Pressure in the head
Numbness in body, tingling, pinpricks
Poor balance, dizziness, difficulty walking
Increased motion sickness
Lightheadedness, wooziness
Sudden jerking of fingers or entire limbs

Psychological well-being
Mood swings, irritability, rage
Unusual depression
Disorientation (getting or feeling lost)
Feeling as if you are losing your mind
Overemotional reactions, crying easily
Too much sleep, or insomnia
Difficulty falling or staying asleep

Mental Capability
Memory loss (short or long term)
Confusion, difficulty in thinking
Difficulty with concentration or reading
Going to the wrong place
Speech difficulty (slurred or slow)
Stammering speech
Forgetting how to perform simple tasks

Females only:
Unexplained menstrual pain, irregularity
Unexplained breast pain, discharge

Males only:
Testicular or pelvic pain

General Well-being
Unexplained weight gain, loss
Extreme fatigue
Swollen glands
Unexplained fevers (high or low grade)
Continual infections (sinus, kidney, eye, etc.)
Symptoms seem to change, come and go
Pain migrates (moves) to different body parts
Early on, experienced a "flu-like" illness, after which you have not since felt well.  (You may not even recall this.)

LYME FACTS
1. You do not have to recall a bite or have gotten the target rash to have Lyme disease. Less than 50% of people with Lyme do.
2. The tick that carries Lyme is as small as the period at the end of this sentence and their nymphs are nearly microscopic.  
3. You do not have to experience ALL of these symptoms to have Lyme disease.  It is also typical for many of these symptoms to come and go.
4. It is possible to have Lyme disease and have a negative test result.  After it enters your system, it tricks your immune system into no longer producing antibodies to fight it, hence, a negative test result.
5. Lyme bacteria hide in the spinal fluid, bone, tendons, muscle and nerve fibers and tissues and in many cases are not “floating” around in the bloodstream where they can be picked up on a test.
6. It takes a LYME SPECIALIST to diagnose and treat Lyme disease and any of its associated co-infections. To find one go to www.LymeNet.org.
or www.ilads.org.  They do not require a referral.