Hoping for answers to hemiparesis

While on a deployment to the gulf in 07 I had what is best described as a stroke like episode. I was fine and then the next thing I knew I had lost most of the major muscle control over the whole left side of my body to include my face (drooped like bells palsey), arm/hand, and leg/foot. With the loss of muscle control there was also a loss of sensitivity on that side(not total, but if pinched or poked it didn't really hurt) All on the left side. I gained a tremor and muscle twitches/spasms on the left side as well. My hand and foot will lose color if I don't keep them moving to circulate blood. I also developed a severe pain in my chest.

I spent a significant amount of time in overseas hospitals during port visits and was eventually flown back to the states for a weeks hopsital stay and numerous tests. Spinal tap, electric shock, needles in muscles, MRI's , Contrast Mri's all came back with nothing.

I was given a diagnosis of Raynaud's because of the color change to my hand. I asked how raynauds could possibly be causing all the other symptoms and was told "sometimes these things just happen".

At this point I am used to the sensory loss of that side so I don't trip over my foot as often and don't accidentally bite my lip anymore. I do have days that are worse then others however. I am left with a body that on it's best day is at 75% and on worse days I can't get up for fear of falling and won't speak much for embarrassment of the slurred lisp and no diagnosis.

Thank you for any input.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

The symptoms you describe of sudden onset one-sided body weakness and sensory loss would of course be most concerning for a stroke. Other causes of one-sided body symptoms that occur suddenly and remain over time include brain tumors, multiple sclerosis, and vascular malformations. It sounds like you have had extensive testing including MRIs, EMG, and other tests that did not show any abnormalities. These would exclude stroke, MS, tumors, and other lesions in the brain and spine.

I can not comment on your diagnosis of Raynaud's, but in general Raynaud's does not lead to neurologic symptoms. Spasm of the arteries in the brain could (what is termed cerebral vasoconstriction syndrome), but this would not have been ongoing since 2007 without showing MRI abnormalities.

If a neurologic cause to your symptoms has been excluded based on testing (i.e. an identifiable problem in your central and peripheral nervous system can not be found), one possibility is a condition called conversion disorder. This is a psychiatric disorder, but does NOT imply that you are "crazy" or "it's all lin your head" or that you are faking it. This is basically an underlying stressor manifesting (presenting) with neurologic symptoms. If you have an ulcer in your stomach, your stomach hurts. If you have a tumor in your brain, you may get a headache. If you have a stressor, instead of being stressed, or depressed, or anxious (the more common expression of stress), you may have one-sided weakness. The stressor may not be initially apparent, you may feel you are fine and that you don't have any stressors, though surely being in the Gulf during the war is a stressor. With psychological counseling and sometimes medications (if associated feelings of depression or anxiety present), recovery can occur. Evaluation by a psychiatrist and psychologist is recommended, as is followup with your neurologist and other physicians.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.