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Nerological Symptoms
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Nerological Symptoms

I am a 31 year old female who has been having several nerological symptoms over the past year.  Some of my symptoms include: Urological symptoms, tingling and numbness in feet and hands, dizziness, forgetfullness, muscle twitching, fatigue and vision (floaters and blind spot in vision field).  These symptoms have come and gone over the past year. Recently, I was referred to a Nero doctor for these symptoms after several blood testings came back normal.  I also had a severe cramp in my left foot that left me unable to walk for 24 hours.  My nero sent me to have an MRI of my brain and spine to rule out MS and Lymes.  My MRI report reads " There are 6 very small <5mm foci of abnomal siginal intensity involving the subcortical white matter of both cerebral hemispheres of questionable clinical significance." " Comparision to a prior study in 2002 which there was 1 lesion present." Mri in 2002 was done because of car accident.  MRI of the lumbar was unremarable. Spine and spinal cord were unremarkable. Thoracic should several disk protrusions contatacting the spinal cord.  My Nero said they were very small and should not be causing any symptoms.  Blood work from B-12 to lymes all neg. I still have no answer of to what is wrong.  Are lesions on the brain normal for my age?  I wonder if I should seek a second opion? Nero says may be Fibromyalgia, but that would not cause lesions. Eye exam normal, some farsightness. Talk of having spinal tap but have not done that at this time. I feel frustrated, Could these lesions be causing my symptoms? I need so education on this please! Thanks
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.  The symptoms you describe are non-specific, but could be experienced by someone with multiple sclerosis (MS). The presentation of MS varies, but often presents with painful visual loss (optic neuritis) or isolated areas of numbness/tingling, each that resolve in 3-4 weeks.  Fatigue is also a common symptom. The MRI findings that you describe may or maynot be significant.  Non-specific white matter spots can be seen in a number of differnt processes such as migraine headaches, high blood pressure, MS and for unknown reasons.  Lesions become more concerning for MS if they align with the corpus callosum and if they are perpendicular to the corpus callosum.  More benign spots tend to be in the subcortical areas and in the centrum semi-ovale (area of white matter).
   The concern of lyme disease is also significant.  These type symptoms can be found in Lyme, but are not specific for it.  Things that would increase your risk for having lyme would include, living in a lyme endemic area, history of a tick bite, circular rash, and joint pain.  Your initial test for lyme was neagtive, which is reassuring, but they can sometimes be negative until the disease is treated.
   With the symptoms you describe I would reccomend lumbar puncture (spinal tap) with the spinal fluid sent for Tourtelotte panel, oligoclonal bands, Kappa Free light chains and Lyme IgG and IgM (talk to your neurologist about these tests). I would also recommend visual evoked potentials, that will test for prior evidence of optic neuritis (given your history of a blind spot).
   If concern is higher for lyme due to risk factors mentioned earlier, I would recommend a trial on antibiotics and a possible SPECT scan.
4 Comments
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Avatar_n_tn
What tests are there for Lyme aside spinal tap.  Are there blood tests?  How long after a tick bite does it develop and what if its left untreated?  Scattered areas of nonspecific tiny white matter signals on T2 and FLAIR, no locations given, that be similar to lyme?  Impression is Microvascular ischemia possible related
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Avatar_n_tn
I live in the South and grew up here.  My Nero said very unlikely I have lymes.  I have never been bitten by a tick (that I know of).  I cant understand why my doctor did not test my vision more, after all that is one of my biggest complaints!  When I told him about it again he said I needed to see the ophtomologist.  The whole fibromyalgia issue keeps coming up with my Nero so now he is sending me to another doctor.  I have been to 7 DOCTORS and spent thousands of dollars.  I can not under stand why I can not get any answers.  I wonder if I should get a new Nero.
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Avatar_n_tn
I have similar syptoms (symptoms). white spots on the bain in my MRI, dizziness, reading coprehension, memory loss, loss of strength on limbs, muscle spasms that mimic turrets but i dont have that. I was hit by a car 6 years ago while i was riding my bicycle. I flew 20 feet with my bike and landed on my head and then body. I broke my back, shoulder, damaged neck back and head. Thos went untreated for 6 years due to monetary problems but going to have testing done on my memory and hopefully brain rehab.

I know how frustrated you must feel going from being able to do everything to being limited in what you could do.

If you ever want to talk about anything, email me

at ***@****


Aliyah
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