Neurological Symptoms

[miked18]

I am a 26 year old male. I have been having symptoms for the last 4 years. All began with a fainting spell. For nearly 2 months after I had dizziness and vision issues. Gradually it went away to the point where I could exercise and work again. Then in Nov of 2012, muscle twitching started. I actually noticed my left arm kind of felt odd before the twitching began. But anyway, I have been having them ever since. They pop up all over my body but definitely more so in my left arm. The more general twitches vary from small repetitive ones to the occasionally large one that will cause my entire limb to jerk. But the ones in my left arm feel different, almost like they're closer to the bone and not near the surface of the skin. I also notice an increased frequency if I bend my arm a certain way or hold it up over my head. I have noticed other changes with my body. When I roll my shoulders I can hear many bones cracking/popping and its uncomfortable, almost painful. When somebody brushes up against my foot I jump like crazy (which I never had before) and occasionally I will get a random electric shock like jolt through the bottom of my foot. The symptoms are leading me to believe my issues stem from the nervous system.

In January of 2013 I had a normal MRI followed by a normal EMG. Also had blood testing for many many things including Lymes and Guillian Barre. Over the last two years, I have noticed only mild changes. I did stop working out because I found it to be more painful and it felt as if I was damaging my body. I have had to remove two links in one of my watches over the last two years. I play guitar and notice my timing has worsened and my control over my pinky is not as good as it once was. I play tennis often and switched from a two handed backhand to a one handed, because I was not having any control over the two hander.

Anyway, over the two years I visited other doctors. I was sent to Mayo in J'ville who after a basic strength test sent me on my way. I then went to USF Tampa which performed an EMG, also with normal results. Two weeks ago I once again had the EMG and MRI redone. Again normal.

This past week the vision problems and lightheadedness has returned although not nearly as severe as the first time. It always seems to be this time of year when I get these symptoms.

Most recently my neurologist suggested a muscle biopsy. Another neurologist suggested a spinal tap. Given my symptoms, do these tests sound necessary? Where should I look next considering Ive had so many EMGs, two MRIs, and countless blood tests?

Thank you kindly.

[miked18]

I had an MRI of the spine and brain. One initially after the symptoms 2 years ago, one back in September of this year. Yes, all the EMGs had nerve conduction studies with them. And Im not sure about thyroid tests, but I would venture a guess that they were done. What tests look for thyroid function?

Does a muscle biopsy or lumbar puncture seem reasonable or a waste of my time and money? Thanks for your time.

[CP3kids]

Given that your radiological studies have all been negative, as well as the EMG's and blood tests, I don't think that further diagnostic testing is unreasonable.  Were the EMG's done with NCS (nerve conduction study), typically they are but since you didn't mention it, I had to ask.  Also, you don't state what the MRI's were of (head, neck, etc) and that's important to know.  You say you had several blood tests, but didn't specify, so again I have to ask, were thyroid function tests done?  Are these your only medical problems, or are there others that have been present (whether treated or not)?  It's difficult at best to know where to lead you, given the lacking information.