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Sensory problems
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Sensory problems

Female, 20, 5'8, 138 pounds. A few years ago I noticed that I can't bend (or "curl") three of the toes on my right foot anymore. I now don't feel heat or cold quite as well in my right hand or foot. I have been noticing that my right leg tends to get overheated when I am wearing a blanket, but my left leg does not. I've had intermittent tingling and numbness in my hands for a few years, but lately it feels like my feet are constantly tingling. I have been having a lot of muscle twitches in places I don't think I've ever had twitches or spasms before. I have been having severe back pain (lower, upper, thoracic, neck, everything), pain when turning my head to one side, swollen knees, etc for a couple of months now. I ran out of Adderall (adderrall) a week or two ago (prescribed for POTS), and on the second night my mouth and the area right around it went numb like I was at the dentist, my hands wouldn't stop shaking, and I didn't understand anything people were talking about. I have been waking up with my eyes shaking up and down uncontrollably. Sometimes my eyes will just "focus out" for no reason in particular and everything will go blurry for around a minute. If I just relax the muscle, it usually goes away. Can anyone tell me what exactly this might be indicative of? Also, please answer if you know what this is: when I was a kid, I'd get this weird feeling in my hands like I couldn't make a fist or use the muscles very well. It was almost painful, but not quite.

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Hi there. Your symptoms are suggestive of multiple sclerosis, a demyelinating disorder affecting the white matter of the brain. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder  symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. You have many of these symptoms. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination MRI shows MS as paler areas of demyelination , two different episodes of demyelination separated by one month in at least two different brain location. Spinal tap is done and CSF electrophoresis  reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons transmit nerve signals slower than non demyelinated ones and can be detected with EP tests. These are visual evoked  potentials, brain stem auditory evoked response, and somatosensory evoked potential. slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI and a spinal tap. Take care.


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Axial GRE results:

http://img23.imageshack.us/i/gre8.jpg/
http://img204.imageshack.us/i/gre7.jpg/
http://img34.imageshack.us/i/gre6.jpg/
http://img197.imageshack.us/i/gre5.jpg/
http://img200.imageshack.us/i/gre4.jpg/
http://img15.imageshack.us/i/gre3u.jpg/
http://img215.imageshack.us/i/gre2e.jpg/
http://img824.imageshack.us/i/gre1.jpg/
http://img546.imageshack.us/i/gre9.jpg/

Normal VEP, EEG showed "lowered seizure threshold".
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