Is this MS or anxiety?

[shenten]

I'm a 21 year old female. Over the past few years since I was 18 I have had episodes of loss of balance, vertigo which would last for a few weeks then just disappear.Sometimes my hand would suddenly get weak and drop like a dead weight and I wouldn't be able to use it for a day. My legs (knee below) would feel heavy and numb, sometimes they would painful cramps. I would get a sort of painful muscle spasm in my left thigh which would last for 2 days. Like I said all of these would come and go.
But 4 months ago I've had non stop painless muscle twitching up till now which is driving me insane. Buzzing, tingling, electric shock like feelings on my skin. Sometimes I feel like there's water on my skin or there are ants biting me.
I also have a sort of tremor in my left leg when I'm standing..it happens every now and then. My left side is weaker and I can't use the stairs without a railing for fear of falling.
I feel like I have a brain fog and I've become ridiculously clumsy. Sometimes when people are talking to me, I zone out. I'm listening to them but I really can't understand what they are saying and they need to repeat themselves constantly which has become quite embarrassing.
I had gone to my GP and I did my blood test. Everything turned out to be normal except for my Vit D levels which were very low..around 8ng/ml. Which I started taking supplements for. But still, nothing has improved. It's worse if anything. So he told me it's probably anxiety. I've been on the internet and MS seems to match a majority of my symptoms. What should I do?

[Adult Neurology, M.D.]

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 a doctor.

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

A lot of the symptoms you reported like sudden onset hand/arm weakness and clumsiness/trouble walking would make a physician suspect a multiple sclerosis attack.

Multiple sclerosis is a disease that primarily affects the central nervous system (brain, spinal cord, nerves from the eye, the optic nerves). Symptoms may be mild to severe, ranging from tingling and numbness to paralysis. There is not one test alone or one symptom that can diagnose MS, but there are well-established criteria that help neurologists make the diagnosis. These include taking a thorough history, doing a thorough physical exam, conducting an MRI of the brain and sometimes the spine, and sometimes ancillary testing such as lumbar puncture and visual evoked potentials ((a test of how the nerve from the eye, the optic nerve, is functioning). If an MRI of the brain and spine is normal, the diagnosis of MS becomes highly unlikely. Alternatively, if someone has several lesions on the brain MRI, but they have not had distinct episodes of neurologic symptoms, or they have specific findings on neurologic examination, then a diagnosis of MS cannot be made.

Patients who have MS usually have symptoms like: sudden loss of vision in an eye from optic neuritis, sudden weakness, numbness or stiffness in one or more limbs, loss of balance and incoordination.

Vit D deficiency can give you generalized muscle weakness but not all the symptoms you describe.

It is difficult for me to determine if you have MS without being able to get a detailed history or without being able to examine you. You should go to your PCP and have routine tests like complete blood counts, electrolytes, renal and liver function tests, thyroid tests, B12 performed. Also I would advise you to be evaluated by a neurologist.

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

[rj1961]

Hi...I was reading your post and you have a lot of the same symptoms as me.  I have been dealing with this for almost a year and half.  I'm 25 female.  I too have had normal blood tests etc.  I'm curious to know what your nuerologist finds out because I have seen 2 so far and they don't know what's wrong.  The second one told me I have peripheral neuropathy in my right hand due to ulnar nerve compression which stumped me because my right hand is absolutely fine as far as I can tell.  It's actually my left that bothers me.  Anyway I have another appt for follow up on 1/15. Please keep me posted on your results.  Have you had any vision problems?  I get blurry vision which comes and goes and usually lasts for about a week when it hits.  My constant symptoms are tingling, numbness (can still feel), weakness, lack of coordination, vertigo/dizziness, muscle twitches, vibration feeling, chills etc.

[shenten]

Thank you for the reply.
I had done a complete CBC, even the B12, it was around 400 PG/ml. Everything was normal except for the Vit D levels. I had forgotten to mention involuntary jerking of my knees, shoulders and lips randomly. I guess it warrants a visit to the neurologist.
Again, thank you for your opinion.

[patsy155718]

I'd get a b12 level done.  When you have it, if it is the standard serum b12 blood test, it is unlikely your doctor will know that this test measures total b12 in your blood. This comprises both haptocorrin and holotranscobalamin. Haptocorrin is the inactive form of b12 and your body cannot utilise it. It makes up a minimum of 20% of your total b12 level - and can be up to 80%. I'd also get MMA checked and homocysteine and, depending on where you are in the world, holotranscobalamin or the Active B12 test. Don't eat any meat prior to the test or shell fish because these will artificially raise your serum b12 levels.