If not MS, then what?

Several years ago I began having pain and weakness in quadriceps. It happens periodically & often in hot climates. Had difficulty swallowing, but tests showed nothing & it was attributed to GERD. Also have IBS & Raynauds. Other symptoms that come and go are: numbness & tingling in right calf & foot; discomfort around ribcage; fatigue; itching across back with occasional tingling; muscle cramping in calves at night; muscle twitching all over in legs, which Dilantin controls; waking every couple hours at night. Four years ago I had an MRI of the cervical and thoracic spine not showing any lesions. I was diagnosed with Restless Leg Syndrome. Clonazepam & Levedopa made me very drowsy, & started taking Dilantin. A year ago I started taking Carbamazapine while decreasing Dilantin. I was feeling nauseous & blood tests showed low sodium level, so taken of Carbamazapine. Then I had blurred vision, headache, was confused & disoriented. CAT scan was normal. Opthalmologist said my vision changed drastically since three months earlier but eyes looked healthy. Vision clarity comes & goes, but is worse in morning & I see spots like smudges.

This Christmas, I was very fatigued & my legs became very painful & weak. They would buckle, & I fell down some steps. Brain MRI, evoked potentials, EMG are all normal. Blood tests are normal except for C-Reactive Protein of 2.7. Unable to do any exercise or even walking or pain gets worse. Scheduled for spinal tap tomorrow.

If MS is not diagnosed, I'm not sure where to go next. Also, had rheumatic fever as a child, as did my mother. Any ideas?

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

The symptoms sound more like a problem of the neuromuscular system with the cramping and tingling rather than a brain problem. The EMG is a good start, but blood tests such as muscle enzymes, electrolytes, aldolase, and urine studies may be helpful in sorting out the problem. Consider seeing a neuromuscular specialist at a major clinical or academic center for a repeat EMG and formal exam. Muscle biopsy may also be necessary. Good luck.

[HelenR]

I forgot to mention that the first EEG showed a mild abnormality in the mid-temporal region but a sleep deprived EEG was normal.