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Neurology (Expert Forum)
WHAT IS THIS?
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
WHAT IS THIS?
by Pat to Kathy, Apr 06, 2000 12:00AM
Physically active,healthy, vegetarian 33 y.o. female.
Oct: pain in right calf area that comes/goes. Sometimes tender when foot is flexed but does not feel like muscle/tendon pull. IBS, cluster headaches, nasal congestion and fatigue. Calf pain checked for blood clot – goes away in 3-4 days.
Nov-Dec: bombarded by symptoms in @ following order. Mood swings, weird, tension-like headaches. Bloated feeling, constipation turns into IBS. Chilled feeling lasts for days, yet no fever. Skin feels hot, sensitive; sometimes resembles slight sunburn. Calf pain (same place) causes numb foot one night in bed – no blood clot. Eyes bloodshot (lasts weeks). Stomach pain turns into burning feeling/reflux (diagnosed w/IBS and GERD). Weird headaches turn into cluster headaches with slight visual disturbances (disturbances diminish after I stop Prolisec). Chronic congestion w/productive cough, vaginal discharge, low back pain and UTI “feeling”. Cat scan negative, all blood tests OK, UTI positive – given Cepro. Extreme fatigue, can’t get out of bed, assume I have “bug”. Intense GERD, given Prevacid, lose 20 lbs. Right pectoral muscle/underarm area sore for days (off/on) as well as chest/rib pains and right eye twitches, hear palpitations. Breast exam OK. Notice feet/hands “fall asleep” quicker than normal. Next day hands are tight/sore, arms/legs feel heavy. Following day legs/arms are achy/heavy (like after a tetenus shot) and fleeting pins/needles feeling in both legs/arms (sometimes feels like itching). Moderately sharp migratory pains (lasting for seconds) all over for 3-4 days: hands, wrists, fingers, back, neck, legs, feet, toes, bottom of feet. Went to doc regarding fears of MS/autoimmune disorders. All blood tests (ana, sed, rf, rpr, hiv, hep b/c, b-12, folic acid, potass and mag) negative. Told I have anxiety disorder and referred to therapist, started on Paxil. Low “fever” of 99 for several days. Night sweats and disturbed sleep. After days of worry, endoscopy of stomach shows “mild chronic gastritis”. Pains resume – back of one leg feels sunburned to touch. Chronic congestion again. Panicky feeling I am dying. Gradually pains diminish in frequency and to a dull ache, then disappear. Energy level resumes to normal.
March: another stressful time and same symptoms reoccur in @ same order (no GERD). This time heavy limbs/migratory pains are proceeded by several days of waking up feeling achy and stiff in back, neck and arms (like I slept wrong). Back pain/UTI feeling but test is negative (given antibiotic anyway). Fleeting pains start. Got scared when, during 1 day of walking a trade show, right quadricep felt so weak that right foot felt like it was flopping behind me. Friend said I looked like I had a drunken walk. After resting several times, entire body stiff and sore – felt like I needed a wheelchair. Exhausted, felt like I had the flu. That night right foot was numb (while in bed only).Next day entire body felt slightly stronger but ached (when I moved muscles) like I had endured intense strength training. Emotional/scared. Brain MRI “clear”, sed rate still OK. Pains and all other symptoms listed above start/continue. “Spastic” bladder feeling occasionally (pulses of pain). New symptoms: muscles sometimes feel involuntarily tensed, wake up feeling sore and stiff everywhere upon movement. Non-visible muscle “flutters”/pulses all over body. Pains/flutters seem to diminish after I start course of anti-anxiety medication, although still fatigued. See neurologist with concerns, especially MS/ALS, etc. Not even given a neuro exam, told “don’t worry” about MS or ALS and to come back in 1 month after anxiety is under control. Told fibromyalgia may be culprit (but no tender point exam). Still no explanation, and PCP is stumped.
Do these symptoms sound like MS, ALS, CFS, FMS, hemochromatosis, etc.? Could it have been too soon for MRI to show plaques after all this time? Doc said ALS symptoms are progressive and would be more noticeable by now – true?
Could virus/bacteria be cause? (undiagnosed genital herpes outbreak occurred before Oct and March “bouts”)
Could stress/anxiety be causing all this?
What should next step be? 2nd Neuro opinion? Rheumatologist? Orthopaedic (back pain)? Holistic MD for fibromyalgia?
I appreciate any advice you can offer – I’ve never been so unhealthy or scared and am too young to feel like I’m dying!
Oct: pain in right calf area that comes/goes. Sometimes tender when foot is flexed but does not feel like muscle/tendon pull. IBS, cluster headaches, nasal congestion and fatigue. Calf pain checked for blood clot – goes away in 3-4 days.
Nov-Dec: bombarded by symptoms in @ following order. Mood swings, weird, tension-like headaches. Bloated feeling, constipation turns into IBS. Chilled feeling lasts for days, yet no fever. Skin feels hot, sensitive; sometimes resembles slight sunburn. Calf pain (same place) causes numb foot one night in bed – no blood clot. Eyes bloodshot (lasts weeks). Stomach pain turns into burning feeling/reflux (diagnosed w/IBS and GERD). Weird headaches turn into cluster headaches with slight visual disturbances (disturbances diminish after I stop Prolisec). Chronic congestion w/productive cough, vaginal discharge, low back pain and UTI “feeling”. Cat scan negative, all blood tests OK, UTI positive – given Cepro. Extreme fatigue, can’t get out of bed, assume I have “bug”. Intense GERD, given Prevacid, lose 20 lbs. Right pectoral muscle/underarm area sore for days (off/on) as well as chest/rib pains and right eye twitches, hear palpitations. Breast exam OK. Notice feet/hands “fall asleep” quicker than normal. Next day hands are tight/sore, arms/legs feel heavy. Following day legs/arms are achy/heavy (like after a tetenus shot) and fleeting pins/needles feeling in both legs/arms (sometimes feels like itching). Moderately sharp migratory pains (lasting for seconds) all over for 3-4 days: hands, wrists, fingers, back, neck, legs, feet, toes, bottom of feet. Went to doc regarding fears of MS/autoimmune disorders. All blood tests (ana, sed, rf, rpr, hiv, hep b/c, b-12, folic acid, potass and mag) negative. Told I have anxiety disorder and referred to therapist, started on Paxil. Low “fever” of 99 for several days. Night sweats and disturbed sleep. After days of worry, endoscopy of stomach shows “mild chronic gastritis”. Pains resume – back of one leg feels sunburned to touch. Chronic congestion again. Panicky feeling I am dying. Gradually pains diminish in frequency and to a dull ache, then disappear. Energy level resumes to normal.
March: another stressful time and same symptoms reoccur in @ same order (no GERD). This time heavy limbs/migratory pains are proceeded by several days of waking up feeling achy and stiff in back, neck and arms (like I slept wrong). Back pain/UTI feeling but test is negative (given antibiotic anyway). Fleeting pains start. Got scared when, during 1 day of walking a trade show, right quadricep felt so weak that right foot felt like it was flopping behind me. Friend said I looked like I had a drunken walk. After resting several times, entire body stiff and sore – felt like I needed a wheelchair. Exhausted, felt like I had the flu. That night right foot was numb (while in bed only).Next day entire body felt slightly stronger but ached (when I moved muscles) like I had endured intense strength training. Emotional/scared. Brain MRI “clear”, sed rate still OK. Pains and all other symptoms listed above start/continue. “Spastic” bladder feeling occasionally (pulses of pain). New symptoms: muscles sometimes feel involuntarily tensed, wake up feeling sore and stiff everywhere upon movement. Non-visible muscle “flutters”/pulses all over body. Pains/flutters seem to diminish after I start course of anti-anxiety medication, although still fatigued. See neurologist with concerns, especially MS/ALS, etc. Not even given a neuro exam, told “don’t worry” about MS or ALS and to come back in 1 month after anxiety is under control. Told fibromyalgia may be culprit (but no tender point exam). Still no explanation, and PCP is stumped.
Do these symptoms sound like MS, ALS, CFS, FMS, hemochromatosis, etc.? Could it have been too soon for MRI to show plaques after all this time? Doc said ALS symptoms are progressive and would be more noticeable by now – true?
Could virus/bacteria be cause? (undiagnosed genital herpes outbreak occurred before Oct and March “bouts”)
Could stress/anxiety be causing all this?
What should next step be? 2nd Neuro opinion? Rheumatologist? Orthopaedic (back pain)? Holistic MD for fibromyalgia?
I appreciate any advice you can offer – I’ve never been so unhealthy or scared and am too young to feel like I’m dying!
Doctor's Answer
by CCF Neuro[P] MD, RPS, Apr 06, 2000 12:00AM
Dear Patti:
The symptoms you describe really do not have the classical MS flavor. Although the initial phases of MS might be sensory in nature, usually there is a muscle component where muscle strength is diminshed by examination. You don't tell me of any muscle weakness. The clear MRI also suggest against MS. ALS also does not usually present with sensory symtpoms. Actually, ALS is virtually sensory spared without any involvement of bowel and bladder function. Cramping is a symptom but not with any sensory findings. Herpes can and often does give symptoms as you describe. However, over the internet one can not say for certain. A "viral syndrome" might also give you symtpoms as you describe. Vitamin B12 might also give symptoms as you describe especially in the face of gastritis and veggie diet. Even with a normal B12 level, but I am sure your neurologist discussed this with you and ruled it out. Cipro has been described in the literature to give a neuropathy picture in some patients.
My overall feel is that your suffering from a viral syndrome picture, whether it is a HERPES or another virus is impossible to tell over the internet. One cannot rule out fibromyalgia but until you meet the criteria it is not a diagnosis yet.
Stay in tough with your family physician as he/she is lkely controlling all the specialist. A rheumatologist is a good consultation to get.
Sincerely,
CCF Neuro MD
The symptoms you describe really do not have the classical MS flavor. Although the initial phases of MS might be sensory in nature, usually there is a muscle component where muscle strength is diminshed by examination. You don't tell me of any muscle weakness. The clear MRI also suggest against MS. ALS also does not usually present with sensory symtpoms. Actually, ALS is virtually sensory spared without any involvement of bowel and bladder function. Cramping is a symptom but not with any sensory findings. Herpes can and often does give symptoms as you describe. However, over the internet one can not say for certain. A "viral syndrome" might also give you symtpoms as you describe. Vitamin B12 might also give symptoms as you describe especially in the face of gastritis and veggie diet. Even with a normal B12 level, but I am sure your neurologist discussed this with you and ruled it out. Cipro has been described in the literature to give a neuropathy picture in some patients.
My overall feel is that your suffering from a viral syndrome picture, whether it is a HERPES or another virus is impossible to tell over the internet. One cannot rule out fibromyalgia but until you meet the criteria it is not a diagnosis yet.
Stay in tough with your family physician as he/she is lkely controlling all the specialist. A rheumatologist is a good consultation to get.
Sincerely,
CCF Neuro MD
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Paresthesias, Body Twitches - MS? (27 replies):I am a 25 year old female. No major health problems. H...[more]
Re: muscle weakness.In Oct. my legs/arms felt very heavy and "tired", but no problems with daily functions. In March I had that incident at the trade show (1 day) where right leg felt weak (like jello) after walking 1/2 hour (also had slight muscular pain in that leg while walking). Got worse throughout day - really had to exert effort to walk. Next day was stronger but both legs felt like I'd gone through a major weight workout. Lately arms get mildly achy (feels like mild muscle burn/heavines such as in lifting weights)and tire easily (for instance, holding both arms over head while drying hair).
What exactly is definition of muscle weakness, specifically for MS or ALS? Is it normally extremely pronounced in that objective weakness would not allow me to perform daily movements/routines?Could I be experiencing subjective weakness?
Again, thanks for your valued input.
The effects of cipro are in the PDR. The picture of neuropathy (not a true neuropathy such as demyelination or axonal block) is one of myalgia, tremor, ataxia, weakness, parasthesia, dysphasia, and nystagmus.
CCF Neuro MD
CCF Neuro MD
I too have experienced many strange symptoms. The fist started 6 years ago with a horrible dizziness that lasted about 5 days. My dr. treated me for vertigo, although the medication didn't help. About 1 year later the same dizziness occurred. I went straight to a neurologist who did a battery of tests (blood work, sleep-deprived EEG and an MRI), all negative. He told me it was probably stress & sent me on my way. I have had 2 more attacks of dizziness in the last 3 years. Both times I visited my neuro, who examined me and said it was still stress and not to worry about MS (always been a fear of mine). This Monday I woke up with a numb left foot. After about a day I started feeling numbness in my left arm and face (note, it felt numb but when I touched these areas I did have feeling) The numbness has finally subsided and left my left leg with quite a bit of muscle soreness. I went back to my neuro and he still feels it's stress but ordered an MRI to rule out MS. He said he would be shocked if I really did have MS. This has been scary and very nerve racking. I have spent hours on end searching the internet, which has really only intensified my fears. I do hope that you are doing well and have been able to identify the cause of your symptoms. I have my MRI next Thursday. If the Neurologist on this site has any insite for my I would really appreciate it!!