Re: MS, Lymes, Lupus, Guillian-Barre etc. ? Im confused!

Posted By CCf neuro MD MM on November 26, 1998 at 11:35:17:

In Reply to: MS, Lymes, Lupus, Guillian-Barre etc. ? Im confused! posted by Lone on November 25, 1998 at 05:47:46:






Dear MD!
Please help me get these diseases separated from each other.
Each of them has been mentioned in connection with my symptoms:
sensory symptoms (facial numbness + tingling - all over)
1) MS
2) Lymes
3) Lupus
4) Guillian-Barre
5) Sjoegrens disease
A) Most commen symptoms?
B) How to diagnose ?
C) How to exclude?
Thank you - thank you - thank you!
Lone
NB: I have had MRI, LP*, EVP - all normal, except VEP (110 ms on both eyes). (* No oligoclonal bonding, protein level 0.48).




I will try to answer briefly, you have asked three detailed questions
on each of five diseases, fifteen questions in all.
This sort of detail is way beyond the scope of the time we can devote on a
voluntary basis to one person's posting,I will point out the most distinctive
salient features of each one and suggest that you fill in the blanks
by asking you own physician or consulting a reference book.
Guillain Barre ; an ascending paralysis which works it way up from the feet
usually very rapidly over a couple of days, diagnosed by finding high protein
in the spinal fluid and by EMG.
MS, Lupus, Lyme disease : All can present with essentially any neurological symptom
as they can affect any part of the nervous system and therefore can produce
any possible symptom, typically optic neuritis is found in MS, lupus is associated
with arthritis and skin rashes and Lyme disease with a typical skin lesion erythema chronicum migrans.
Diagnosis :
MS - MRI, spinal fluid analysis for oligoclonal bands and evoked potentials.
Lupus - MRI, antibody testing in blood,
Lyme disease - antibody testing to the bacterium Borrellia burgdorferi (in blood )
Sjogrens is an autoimmune disease related to lupus which is associated
with similar synmpyom but also has an association with dry eyes , dry
mouth due to antibodies attacking the tear glands and salivary glands.
It is much easier to make a diagnosis than exclude one, frequently a
diagnosis can never be excluded, but the usual way in the case of the
diseases above is to perform the tests mentioned for each one and if they
are all negative to conclude that this is probably not the diagnosis.
You are obviously being worked up for possible MS, the results you quote
give no evidence to support the diagnosis, they may not absolutlet exclude
it but they provide no evidence for it.