Re: MS vs. Chronic Fatigue/Fibromyalgia

[CCF neurology MD MM]

Posted By CCF Neuro MD MM on November 05, 1998 at 07:02:39:

In Reply to: MS vs. Chronic Fatigue/Fibromyalgia posted by MS'er on November 04, 1998 at 23:59:32:






: Hi. I am seeking input based on my latest round of testing (totalling over $3,000 and having been seen by two neurologists, a rheumatologist, and a urologist, along with family practitioner).
After over a year of tests, tests, and more tests, the doctors have diagnosed me with chronic fatigue along with fibromyalgia. I bought a book on chronic fatigue, and it says it can only be diagnosed after ruling out all other possible causes (and it went on to name a few). I am most interested in knowing how long it takes before MS can be ruled out. I have had 2 mris, a lumbar puncture, and the evoked potentials studies, all normal. Have also had EMG looking for neuropathy, also negative. The only thing abnormal (and I've been checked from head to toe) is a hyperreflexic bladder due to some underlying neurological problem of unsure cause (urologist diagnosed).
1.  Can I really believe this is chronic fatigue vs. MS? Doctors agree bladder problem doesn't "fit" with chronic fatigue, but says that there are absolutely no indications of MS.  
2.  Is it worthwhile to have the MS tests repeated at a future date, or is having them done one year after symptoms adequate to have something show if it is going to show?
3.  Are the symptoms I am having seen frequently with MS or more frequently with Chronic fatigue?
My symptoms include (in addition to the fatigue), pain in my feet, hands, and jawline, urinary urgency and incontinence, painful knees and a right leg that has pain from the hip down to the foot (with a lot of pain usually in the quadricep), and overall icky, flu-like feeling.  
I feel confident other things are ruled out, as I don't have the symptoms that go along with so many of the other things. I just need some answers so I can get on with my life.  
Thank you for all of the help you provide to myself and others here.
Charlotte




I am not confident that I can second guess you doctors and tell you what
is causing your bladder problem but this is the only thing that you have
which is consistent with MS.
Pain is a very rare presenting feature of MS, particularly in this
widespread distribution without and demonstrable sensory loss, weakness,
ataxia or eye problems.
Given these atypical symptoms and the various negative tests I would not
consider the diagnosis of MS any further at this point and would not consider retesting
unless an new typical symptom develops which is correlated with changes
on clinical examination.
I would re-evaluate on the basis of objective abnormalities on the clinical
examination rather than on symptoms alone.
The pain problems sound very similar to those described in fibromyalgia, and
very atypical for MS.



_______


: I have MS and FM and have been on the Harvard MS Forum since April or May and on thing many of the others say is that they DO have pain with their MS.  Do you specialize in MS?



=
I was very careful to point out in my reply that pain is  " a rare
presenting feature " in MS, and that this was particularly rare in
the absemce of   "demonstrable  sensoryloss, weakness, ataia or eye
problems".
I specifically did not say that pain is not a feature of MS as it is a
frequent complaint in relation to features oif the established disease.