LIVING WITH A POSSIBLE MS DIAGNOSIS

    
      Re: LIVING WITH A POSSIBLE MS DIAGNOSIS
    


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Posted by CCF neurology MD on February 20, 1998 at 17:48:09:

In Reply to: LIVING WITH A POSSIBLE MS DIAGNOSIS  posted by SANDI NOVAK on February 12, 1998 at 20:34:55:

: HI,
  I'M SORRY IF THIS IS REDUNDANT, BUT I'VE TRIED POSTING BEFORE AND COULDN'T SUBMIT.  I AM A 49 YR. OLD RN WHO HAS HAD DIZZINESS, LEANING TO THE RIGHT, TINNITIS WITH HEARING LOSS, NUMBNESS AND TINGLING OF HANDS AND FEET FOR 6 YRS.  THE LAST FOUR YRS., I'VE HAD BLURRED VISION, FINE AND GROSS MOTOR INCOORDINATION, AND IMBALANCE WITH A CONSTANT TREMOR OR SWAYING, ROCKING OF MY ENTIRE BODY WHICH HAS AFFECTED MY WALKING TO THE POINT I MUST HANG ONTO THINGS.  I AM NOW USING A MOTORIZED W/C BECAUSE OF THIS ROCKING AND SWAYING KNOCKING ME OFF BALANCE!  
  MY NEUROLOGIST HAS DONE AN MRI OF THE BRAIN IN 94 AND 95, A SPINAL TAP AND MRI, AND EVOKED POTENTIALS WHICH ARE ALL NEG.  IN YOUR OPINION, WOULDN'T THE MRI'S WITH GADOLLIUM SHOW PLAQUES ON THE MRI WITH MS?   WHAT ABOUT THE VEP'S?  MY DOC SAYS HE SUSPECTS I HAVE MS AND HAS ORDERED AVONEX WHICH HASN'T SEEMED TO STOP THE PROGRESSION.  ON MY CHART, I HAVE NOTED MY DOC HAS WRITTEN CEREBELLAR ATAXIA.  COULD THERE BE SOME OTHER DISEASE CAUSING THESE SYMPTOMS, IE, OPCA, SPORADIC, OR SCA THAT HAVEN'T SHOWN UP YET?   I WOULD APPRECIATE YOUR OPINION.  I TRUST MY NEURO WHO HAS BASED HIS DIAGNOSIS ON MY EXAMS OVER THE LAST FOUR YRS., BUT WONDER IF SOMETHING ELSE COULD BE "COOKING.,' I WOULD APPRECIATE YOUR OPINION.  THANKS!
=Dear S. Novak, Based on the information you have supplied me, my differential diagnosis would include Demyelinating disease(i.e. MS), Cerebellar Ataxia, Vestibular Dysfunction and/or Peripheral Neuropathy. I would feel that it is prudent that you be re-evaluated to confirm the diagnosis of MS in order to provide you with re-assurance that your physician is diagnosising and treating you properly.  I would recommend a Multiple Sclerosis specialist such as those based here at the Mellen Center of the CCF(they may also be able to refer you to a specialist in MS near where you live, if you live outside of Ohio).  As far as your work-up is concerned, I would repeat your MRI of the brain plus add cervical spinal cord(w-w/o contrast), spinal tap with all tests related to demyelinating disease, visual/auditory/sensory evoked potentials and vestibular testing.  Hopefully, this work-up would be sufficient to clarify the underlying cause(s) of your present medical condition.  If not, it may be necessary to refer you to a Movement Disorder Specialist, since many of your symptons our cerebellar/brainstem in character, to further evaluate you.  "This information is provided for general medical and education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition."