What could this be?

[zelch]

About 2 months ago, I developed what seemed to be weakness in my left leg after a period of lower back pain.  The weakness quickly spread to my other leg and both arms, I guess you could say proximal weakness.  I also developed fasciculations (visible twitching), mainly in my arms and legs, occasionally in other places.  My doctor ordered an lumbar MRI which showed some mild degeneration and a slight bulge but no herniated disk.  He sent me to a neurologist who performed an EMG on my left leg and in a few spots on my right leg, that was completely normal (nerve conduction study was also normal).  The exam was also normal,  this was the first week in January.  My symptoms seemed to improve a bit after that but not for long, they got worse again.  I should also mention that I have expierienced pain in my legs and arms, sometimes in my joints.  My hands and feet also ache occasionally.  Throughout this 8 week period, I have had a significant amount of lower back pain as well.  I am not sure what to make of all this, I am still concerned about ALS or MS or even Lyme disease.  There doesn't seem to be any serious loss of muscle strength, just extreme muscle fatigue.  Especially when going up stairs.  If you could provide some insight as to what I should do, and what this could be, I would be greatly appreciated.

[CCF-Neuro-M.D.-JT]

In the setting of a normal neuro exam and EMG, ALS would be unlikely as there should have been something seen on the exam or EMG. Doesn't sound like Lyme, and not sure about MS.  Although your symptoms aren't typical of MS, this disease can present in a number of ways and I do not know enough about your personal history or exam to make the call.  Routine laboratory tests that may be helpful include blood work to look at muscle enzymes such as CK and aldolase, inflammatory markers such as sed rate and C-reactive protein, thyroid studies, complete blood count and an electrolyte panel.  If rheumatological problems are suspected (depending on your full clinical history and exam) then an autoimmune panel may be helpful.  If symptoms get worse, return to the neurologist or consider a second opinion at a major academic hospital. Good luck.

[Numb-in-FL]

Zelch,

I felt like I was reading my own story.  I have experienced very similar circumstances.  My numbness and weakness began in my upper right arm and moved to my right hand.  Tried Chrio Adjustments and Massage therapy. Primary Care Physician (PCP) thought maybe Carpal Tunnel, but then symptoms worsened, added weakness in the right leg, and a sharp, electrical feeling in my back, arm, and (sometimes) leg when I tilt my chin to my chest.  Less weakness in legs now, but constant tingling, and real fatigue in my arm - especially my right one.  10 minutes of scrubbing, lifting etc and I am in severe pain and my arm just aches.    Pain meds help some, but do not take away the achiness.  Burning sensations in upper back and wrist.  I have always been quite active, and had a lot of stamina.   F, 35 YO, Non-Smoker, Social Drinker, Regular BP, other general stats OK.

Do you have any increased symptoms when you lean on your arms, or prop your leg up?  Mine occurs in the joint area up from the pressure.  When using the mouse its in my wrist, if i lean down on my desk with my arms, in my shoulder.

Brain MRI - radiologist report came back "unremarkable", but I have had my first visit to NeuroScience Lab here, the Nurse Practioner disagrees with the radiology report, and based on Neuro Exam, films and symptomalogy (sp?) is thinking MS.  

They drew blood (9 tubes) and I believe they will run blood tests for:

Something Viral,  Lyme,  B12 or B6 deficiency,  Lupus,   MS,  Thyroid.  

Conducting a VER (Visual Evoked Response) to determine the time it takes for my brain to register the object my eyes see.

Possible Cervical Spine MRI (to rule out pinched nerve)

I do have a lower herniated disc, but not having leg pain - or low back pain, only weakness, numb spots and some burning.

I would appreciate following along with your case, too.  To see if there are other similarities.  I will post more as I learn more.

Best of Luck and Healthy Days Ahead.

[zelch]

Yes, my symptoms are very similar to yours.  I also have some numbness and tingling, mostly stiffness and pain in my legs.  Strangly enough, I am still able to lift the same amount with my legs (I tested myself).  So I don't think there is any true weakness there, but there is certainly fatigue, in some cases it's been extreme.  Putting my legs up does seem to make it worse, especially for long periods of time.  I did have a lower lumbar MRI which was unremarkable.  My doc also said lumbar MRI's can detect MS.  My neurological exam was also normal.  I think your disk herniation could explain some of your symptoms, but certainly not all of them.  Have you had an EMG yet?  Do you also have fasciculations (muscle twitching)?  

My joints also ache from time to time, especially in my right arm and knee (front and back of the knee).  The only symptom I can't relate to is the electrical sensations, but I do get occasional burning in my arms.  One possibility I have considered is Fibromyalgia.

[Numb-in-FL]

Muscle fasciculations - I believe that is a YES answer.  I can be sitting and my arm or shoulders just toss themselves.  Last night was the first time it happened in my legs.

I definitely have decreased strength and capability in my arms.  My legs don't tire from walking, they seem ok, but go weak for moments... as if they were "weak knees" and give out - but again, only momentarily.

By the way, my symptoms have been going on about 2 months, too.  Before these symptoms began, the only other thing I have noticed is that I have taken several severe falls this year, and about 2 weeks before I noticed the numb spots, I was having severe itching spells, as if I had been bug bitten, first on an arm, then a leg, then it would go away for a few hours.  But no bug bite, no change in soaps, no change in detergent.

I feel like I am losing my capacity to function in many ways.

They have not ruled out carpal tunnel, but put it to the side in light of the other symptoms.

The neurologist seems to think that the herniated disc, because I can lift my legs with out any pain in my leg or back, is not playing a part in this.

THANKS and lets keep the ideas flowing.  I do appreciate it.  I have been trying to post an original question for about 3 weeks, and hadn't had any luck.   When I saw your post, it was so very close to my symptoms, I just had to reply.  

THANK YOU!

Mich

[carrots]

I underwent surgery on the 12th of november 2002.The procedure performed was a L5/S1 posterior   lumbar interbody fusion with accompanying alar transverse fusion. The instrumentation utilised were BRANTIGAN CARBON
CAGES for the interbody fusion and posterior instrumentation was performed utilising bone screws and rods in the MOSS MIAMI SYSTEM.A bone graft was harvested from my left hip. I seem to have had a great recovery with almost no pain within 4 weeks of surgery. On week 10 while walking on a treadmill I felt a pulling/ripping feeling towards the top of the mid line incision and between the hip graft site. This set back has brought back the pain I had in my left leg which was absent for 2 years following an l5s1 discectomy in 2001.
I would be very thankful if someone can give me some insight in to what to expect while going through the recovery process.

[zelch]

My symptoms really seemed to come out of nowhere, after a period of mild to moderate back pain.  For me, it was almost disconcerting that there was no disk herniation shown on my MRI.  At least that is something relatively benign compared to some of the other horrible things out there!  I shouldn't say that because I know back problems can really be miserable but that's the way I felt at the time.  It should be noted that I was also under a lot of stress at the time and still am.  I was also spending a lot of time at my computer, probably with horrible posture. Walking does not really seem to be a problem for me unless I am walking up flights of stairs or up a steep hill.

[The Crusader]

PLEASE, WHATEVER YOU MAY THINK, AND WHATEVER YOU'RE TOLD, DO NOT, I REPEAT, DO NOT ALLOW THEM TO INJECT YOU WITH EPIDURAL STEROIDS SUCH AS DEPO-MEDROL.  MOST DOCTORS ARE NOT EVEN AWARE OF THE TRUTH!  GO TO:  http://groups.msn.com/DepoMedrolDidItHarmYou/depomedroldiditharmyou.msnw

[PT-works]

Carrots-I am a Physical Therapist who underwent a spinal fusion of L5/S1 (Rays Cage)in June 1998.  My fusion was necessary due to an unstable 13mm spondylolithesis and neurological dysfunction involving bowel and bladder. I'm confused about why you underwent the fusion if all your pain was relieved with the discectomy in 2001? Why was it necessary to use a cage and the Moss Miami alar transverse fusion together?   Your pain  on the treadmill----if the pain is severe must rule/out movement of the internal fixation devices thru DR. visit post-op and/or X-ray. If everything is stable, a source of discomfort may involve your Sacroiliac Jt. With the loss of motion at L5/S1 more stress will occur at the level above the fusion and in the pelvis(especially females with menstral hormones which relax ligamentous structures!). You would benefit from a post-op physical therapy program to GENTLY assess pelvic alignment and teach a Lumbar Stabilization Ex Program. ect. I also felt a sharp ripping type pain once I started to increase my activity level and my S/I joint was the problem. Avoid X-legged sitting .  Recovery takes 6 to 12 months minimum. Good luck.

[Numb-in-FL]

Well... what a day.   Called the Neuro, as I was tired of waiting for them to call.  I have not had my VER yet, however, all the results of my blood test are back in.  Per the Nurse Practioner, all the blood results are normal, thus ruling out Thyroid, B12, B6, Sediment??, Lupus, and a few others.  I couldn't keep up as I was dazed by what she was saying.

Per the Neurologist, my MRI shows only one brain lesion, therefore it cannot clinically be ruled as MS based on the MRI and the ruling out of the other tests.  But will probably conduct a Spinal Tap after I see the Neurologist.  I am going to also ask for a nerve conduction study to rule out Carpal Tunnel once and for all.

Another interesting note is that my vision in my left eye - which has always been weaker than the right, deteriorated over the past year at a much faster rate than normal.  My Optometrist said that she didn't see any pallor(?) on the optic nerve, however the field of vision test is indicative of something happening on my left eye in a single area.

I am at my wits end - they are still saying it's like MS, but cannot be defined clinically with only the one lesion.  Any other thoughts, ideas other than MS that could cause this?  I still have not had a cervical MRI.

My symptoms have increased, too.  While not as intense, I have tingling in my entire right hand now.  I have had numb spots and tightness in areas of my right leg and today I had twinges - I think they are called fasculations in my right arm and the right side of my back and a twitching in my right eye.

The twinges in my back felt as though I had a TENS unit attached and it was randomly shocking different sections of my back.

Any thoughts or help would be appreciated.  I am the primary bread winner in my home, and this is affecting my ability to work regularly as I once did.

I am probably in the midst of my own personal pity party at the moment, I do realize that many people in this forum are having much more severe symptoms than I am having, but I am just scared, I guess.

THANK YOU all.  I enjoy reading the posts and seeing more about the different folks who are brave enough to share and ask questions.

THANK YOU.

Numb-In-FL

[danaji]

Zelch and Numb,

I just came across your posts, and they sound so much like what I've been going through for months now with no real answers. Have either of you found some answers? I'm in Florida and looking for a doc who doesn't write me off as a psyche patient. Although I would bet that chronic pain and the frustration of having to change one's lifestyle radically with no "real" reason for it all could make anyone nuts.

I've had a vast array of symptoms that appear to be like MS or ALS or possibly Lupus, but the most persistent, I think, is the aching of arms and legs when I use them. Walking doesn''t usually bother me, but stair-climbing is excruciating. I feel like it has something to do with blood supply. Lumbar & cervical MRI revealed scoliosis, bulging discs and foraminal stenosis, but apparently no significant pinching of nerves or arteries.

I wish I knew where to turn next. Hope maybe you guys have found some relief and some answers to pass on.

happy healing,

danaji

[azurerain]

danaji,

This sure sounds like a cervical problem (which you have documented). I have similar symptoms, and cannot even walk up one flight of stairs. My first MRI of neck was REPORTED as normal, so I've now had about 5 doctors who were convinced I was having panic attacks or faking it.

MRI from March of this year shows C5-6 disease. One doctor told me this was probably the cause of probems but then just two weeks ago, I  had another doctor tell me that it was impossible and asked me if I was seeing a psychiatrist!

I'm going to another doctor. The documentation (MRI) is there.

[Freddd]

I had all these symtoms and more for 50 years.  And believe me, it get's a lot worse.  My life changed on May 21, 2003 when I placed a 1000mg sublingual methylcobalamin under my tongue.  Within 1 hour that strange severe fatigue drained from my muscles and a lifelong depression lifted; the lights came on and have stayed on since then.  The neuropathies all over my body are regressing.  My muscles are normal now and building with exercise instead of deteriorating wqith much pain no matter what I do.  My pain meds are down 1/3 in the last month.

It's all changing and getting better.  80% of the people I know locally who try this methylcobalamin, and it needs some other supplementation too so something else doesn't immediately become the weak link, have a substantial response within 48 hours, and some within 15 minutes, myself included.  I'm currently taking 10-15mg/day of methylB12 (methylcobalamin).  It costs about $8.00 for a small bottle of sublingual methylcobalamin at a healthfood store to see if this is a problem.  It can't hurt and it could help.  Good luck.