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What other conditions may mimic MS?
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What other conditions may mimic MS?

Greetings!

I am a 37 year old white female, non smoker, happily married and active in church with various symptoms.

Medical history includes : Hoshimoto Thyroiditis diagnosed approximately 4 years ago.  Medications
include Synthroid, Estrostep Oral Contraceptives & a Daily multivitamin and 81 mg of ASA .

Current symptoms  include (in order of progression) : Blurred vision, (Onset beginning around
10 years ago) often with dizziness at times. Usually lasting 15 seconds up to a couple of  minutes.
Frequency from several times a week to once every few weeks .

Furthermore, with in the last year, everyday my right index finger started  going "cold"
(change in temperature) not numbness & does not turn white. ( this is occurring too many times
during the course of the day to count)

Weakness and inability to control my right arm has occurred twice after using our weed eater
on a hot day .  (Lasting a couple of hours before function totally returned).

I have occasions of numbness in my jaw, tongue and extremities. Numbness first started on my right
side of my body. Then a week later the left side became involved. These symptoms come and go but are
becoming more frequent.

Loss of coordination at times which includes dropping things that I thought I had a grip on to
the inability to walk a straight line. Furthermore, I walk about a mile every day.

At times, which will last for several seconds, stinging behind my left eye has occurred. Recently this
has happened in the right eye (but it has not happened together). This is happening more frequent.

For the last several months, I noticed  stabbing pains which seem to move around my body mostly
on my arms, legs and feet occurring from the inside out. Often a burning sensation usually in
one spot also occurs primarily in my left hand.

My most resent symptom, joint pain which began this week is occurring in my elbows, knees, spine and
ankles. Really painful to the touch and it is hard to walk. I don't think it is due to the
spinal tap that I had 2 weeks ago.

I have undergone tests  including nerve conduction tests,  a TEE,  a stroke blood workup, B-12 levels,
hearing and vision check, carotid ultrasound & 2 MRI's, spinal tap . All normal.

Brain MRI did note areas of increased signal in the periventricular white matter in the left
parietal area which was interpreted as nomal for my age. No spinal MRI or Viral tests were done.

Should a spinal MRI be Done as well? Or viral testing? Is Ms a possibility? Can you have Ms and
a negative MRI? Should I go to a major university for a second opinion? What other
tests/diagnosis should be considered or ruled out? What other conditions may mimic MS?

Thank You
Related Discussions
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Depending on the clinical suspicion for other causes of your symptoms and the exam findings, we usually check B12, thyroid, autoimmune panel looking for diseases such as lupus, inflammatory markers such as sed rate, lyme disease, and RPR for syphillis (syphilis). All of these can be mimics of MS. Other tests that can be helpful include somatosenory evoked potentials especially if numbness and sensory change in the limbs are prominent symptoms.

The normal MRIs and spinal tap are somewhat reassuring that everything is ok.  You'll have to talk to your physician to see if spine MRI is warranted.  A second opinion at a major academic center for a fresh look is a consideration. GOod luck.
22 Comments
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Let me begin by saying that I am an attorney and come from a prominent family, conservative by nature. I am stating this because I do not want to be perceived as a "crazy" for my following comments.  I am struck by your symptoms because they are nearly identical to mine, in nature, progression, location, etc..I can't comment on the time factor because I don't know when yours started but mine started approx. at the beginning of September upon returning from speaking at a conference in Seattle.  Since then I have undergone nerve conduction tests, standard blood test for the items that were mentioned, as well as having undergone a myleogram.  All my tests showed up fine. Unortunately, I did not react well to the myleogram in that when the procedure was done, my left lower leg where I already had been experiencing spasms convlused so badly that it locked while I was on the table. Then I developed a spinal headache, received a blood patch which did not take, and have had a new array of symptoms since then. Now, it is as if, I am getting so much swelling that it is causing a numb feeling all the way up  to my chest at times.  Additionally, I feel a painful swelling presure in my head as well as around the band on my neck where the dye at settled upon my being tilted downward during the exam. My doctor said that these were all symptoms which would dissipate in time but (1) I am wondering if this is true (2) could it be that the hole has not close? and if so what do I do about it? Finally, I wanted to respond to this woman because I have noticed that on various sites there are a great deal of people suddenly who are describing the exact same syptoms (symptoms) that we are but are clinically coming up with no diagnosis.  In light of all of the cruise ship incidents lately, as well the anthrax incidents including the various decontaminents used, could it be possible that there is some type of virus that is hitting us that is not being detected? Normally I wouldnt venture out into such commentary, but I am telling you there are suddenly a lot of people complaining about the same things I have and listing them in the same progression.  PLease think it over and let me know your thoughts on it.  Thanks.
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Avatar_n_tn
Dear Melis,  

Have you undergone a spinal MRI?  You mentioned a myelogram, but there are also many spinal cord/brainstem abnormalities that can cause some of the symptoms described here.  Unfortunately, some of them are difficult to see on MRI as well, so that's not a definitive test by all means, but there are some things it can catch. It can also be tricky to decide which parts of the spinal cord need to be imaged.  

It's a little hard to get the full picture from the notes you both describe here.  I don't want to presume too much and seem like I'm trying to send you down a path that doesn't fit.  So I'll just leave it there for now.  

Take care,
Annika
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Avatar_n_tn
Hi all, after the birth of my daughter, I started having strange symptoms. Tingling in hands feet, tightening in my tendons. Can MS cause your tendons to tighten up and stay tightened? Doctor did MRI of brain to check for MS but it was normal. He said he thought I was fine. I`m curious...
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Avatar_n_tn
Dear TabA,

Did you have an epidural during your delivery?  If so, were there any complications - such as a spinal headache, or a CSF leak requiring a blood patch?  

I apologize for bringing this issue up so often, but I am really concerned at the number of women who begin having pain and neurological symptoms around the period following childbirth.  I don't mean to imply anything specific is going on with you, but I am very interested to know how many of the women who are writing in with similar complaints did have complications with their epidurals.  There are known complications that can follow the accidental release of blood into the CSF during epidural placement.  These complications (usually involving scar tissue inside the spinal canal) are currently reported in the literature, but are described as "rare."  However, since there's a delay in the amount of time it takes for scar tissue to develop, and the accurate diagnosis of these late problems can be quite difficult, perhaps these disorders may be less rare than are currently thought.  

I don't mean to send anyone in a misleading direction, but would be interested in hearing your experience.

Sincerely,
Annika
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I did have an epidural. It had to be placed twice. I did not have a headache or need a blood patch. I too have wondered if the epidural could have caused this, however I really don`t think it did. At least I sure hope not...
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Avatar_n_tn
Hi I had another question... After the birth of my daughter, my tendons tensed uP on my left foot when I bent down. I also had a numbing sensation on the ball of my heel. Could this be considered muscle spasticity which is associated with MS?
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Avatar_n_tn
I was put on amitripline 10mg for sleep problems, I was also put on Paxil.20mg.  I gain weight and wanted to go off the paxil. The dr increased the amitriplint to 20 at bed time.  I started developing signs of MS.  Burning in my mouth, numbness, all of it.  I was sent to the neurologist.  The MRI showed no MS, but, a small tumor.  The dr there increased the amitripline to 30mg. The symptoms got wrost, I couldn't function.  I figured that I got worst with each increase.  Today 6mos later I am on no meds at all.  I have mouth burning, numb jaw and chin and tightness around the eyes.  Some burning around my butt, where ever the membrane are thin I burn.  My nose to.  I have had soo much blood work and no one has an answer,DO YOU OUT THERE????  Please?
deedee092358
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Dear Deedee,

A small tumor?  Where?

Annika
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Avatar_n_tn
Small Tumor on the left side of my brain.  It is the right side of my face that is tingling and numb.
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Avatar_n_tn
Dear Deedee, since the motor and sensory signals from/to your brain are crossed (as they are in all of us - right goes left, left goes right), the normal state for all people is that motor/sensation control centers in the brain are in the opposite side as the side of the body they control.

So I guess I'm wondering why this isn't just a clear-cut tumor story.  There are several places in the brain this tumor could be, and which could cause the symptoms you are having.  I wouldn't be able to tell without seeing the MRI (and I'm not exactly an expert on that either... but your neurologist should be!).  

If it were me, I'd be checking into all the possible ways the tumor you do have could conceivably be causing your symptoms.  Tumors are rare, and they sometimes have funny symptoms that are not what the doctors would expect.  I'd really exhaust that option before starting to really investigate all the other possibilities.  

I have less experience with brain tumors than spinal tumors, but in that area, the early symptoms can be all over the map, and not what one might expect from the classic medical teachings.  I just wouldn't leave off the tumor as incidental until I'd done some serious digging.

Find out what part of the brain the tumor is in.  Find out what functions of the brain normally live there.  Your doctor should be able to tell you both of these things.  You can also ask if this is the kind of tumor that can risk causing increased pressure in the brain (sometimes that can happen even if the tumor is small).  

Good luck,
Annika
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The DR report says images of the brain show no evidence of a white matter abnormality to suggest demyelinating disease.  Post enhanced scans are avilable, however, and these show a less than 1 cm rounded area fo enhancement adjacent to the anterior faulx extending into the medial left frontal lobe. No abnormalities are evident on the other pulse sequences.  The appearance would be most consistent woith a meningioma in the absence fo underlying maliganancy in which case I suspose dural metastatic disease might be considered but seems much liss likely.  The lesion follows ghe signal of he brain on other pulse sequences which supports the diagnosis of meningioma.
Does this help?? Deedee
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Dear Deedee,

It's a little hard to piece together the report, and I'm assuming the word is "falx," not faulx.  In that case it sounds like the mass is at the top of your head,  near the "falx cerebri", which forms the midline division between the two halves of the brain.  This is a favorite place for meningiomas to form.  The are made of cells not from the brain itself, but from the coverings ("meninges" ) of the brain.

Whether it's responsible for your symptoms I wouldn't be able to tell.  The main sensory cortex of your brain is near this area (meaning, the strip of the brain's surface where all information about sensation from the body must pass through), just at the border between the frontal lobe and the parietal lobe (there are only four main lobes, and the parietal is the one on the side/back).  There'a a more detailed map that tells you that sensation from the face is processed a little bit further down the side of the brain than near the top/midline, but honestly, I think the people who will be best at figuring out if the tumor could be responsible for your symptoms are those who have actually seen patients like this.  My own experience as a patient is that real biological entities sometimes affect the nervous system in a more convoluted way than one might predict just by looking at diagrams of the brain.  

Meningiomas are usually benign.  If it were me, I'd want to be getting some more information about this tumor from someone who is used to seeing patients like this.  Perhaps your neurologist does see lots of tumors. If not, one option, I suppose, is to consult with a neurosurgeon.  Seeing a surgeon doesn't necessarily mean you're asking to have it removed, just that you're trying to find out what the significance of this tumor might be, and what your options are.  Meningiomas are not always removed, because they can be small and slow-growing.  This one does sound very small.  Perhaps your neurologist felt it couldn't possibly be responsible for your symptoms.  Again, I wouldn't know.  It's true that the picture doesn't totally fit, but I'm hardly an expert on what symptoms a meningioma can cause in this area.

If anything, the tumor actually sounds like it's nearer the area responsible for sensation from the genitals (which is on the inner surface of the brain, the part facing the falx).  But who knows. It's certainly possible that you have a completely separate disease, and the tumor was just an incidental finding because they happened to look inside your brain.  

Good luck,
Annika

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Thank you so much.  I feel better about the tumor, I am going to go for a second opion.  The burning I think is called burning mouth and it will go away I hope.  Thank you for all your replys.  Donna  MERRY CHRISTMAS
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I have been reading various questions and responses on this site dealing with unknown neurological disorders. I thought I might as well throw my symptoms out there to see if anyone has an idea what may be causing my symptoms.
Seven years ago I developed double vision which I have with one eye closed.Four opthamologists have told me there is nothing wrong with my eyes.
Three years ago I began experiencing numbness and tingling in my feet. I know that it is peripheral neuropathy but have been tested for all the usual diseases only to be told there is no reason for it. I have had MRI's, Emg's and dozens of other tests. All negative except for slightly low iron stores. The days my feet are really bad the tingling spreads to my hands and gums.The pain in my hands is so intense that holding a paper napkin is like putting broken glass through my finger tips and my gums hurt so much i want to pull my teeth out.
My neurologist doesnt believe my eyes and feet are connected since the MRI showed no sign of MS. I have tried neurontin but hated the side effects.
Does  anyone have any ideas of things I could try or what would cause my symptoms.
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When was your MRI done? First MRI's can be negative for MS. Have you had one done of your spine? As far as the diplopia goes... have you seen a neuro-opthamologist? From what I have personally experienced - diplopia is only present when both eyes are open. If it is only there when one eye is open then the problem is with that eye - refraction error - probably the culprit. Prisoms can fix that. If you can't see an neuro-opthamologist, try a pediatric opthatmologist (not optomitrist) that see's adults too. They are usually very patient Doctors that take the time to answer questions. Sorry to hear that your in so much pain. I hope they can find something for you that works soon.

Best wishes
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my MRI was oct/01 and yes, it was also done on my spine. I havent seen a neuro-opthamologist but have seen a pediatric one. she was awful. she was the one that told me I was lying!.I know it sounds unlikey that I have double vision with one eye closed but I really do. The last few weeks my feet hurt more and more. i have begun taking an anti depressant. I am confused about how that will help my pain. Does anyone have info on this and what dosage is recommended. My dose is very low right now as I cant tolerate the spaciness. Thanks
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Don't give up on finding an answer. You know its not right and that its really there. Find yourself a good neuro-opthamologist, they really are the best people at finding out what is wrong. To bad about the Ped eye Doc - they usually take the time to explain things. My first experience with a neuro-op was terrible. He thought he was going to whip in and out, and I turned out to be just a little more difficult than he wanted. But the second one I saw is WONDERFUL! If I had let myself give up and not seek the second opinion from a different neuro-op I would just think I was nutty. Don't give up :)
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I have had numbness and tingling on the tip of my nose, along with all of a sudden pain, burning,and achs. My fathers side of the family has had a past history of ms. My Dr. is checking to see if I have autoimmune disorder.   I have also had a past history of dizziness, That the Dr.s at the time claimed to be anxiety. Now I wander if all these symptoms of anxiety might of went along with whats going on with me now.    I dont know much about MS ,I was to young to remember anything about what my grandmother went through. I have a hard time asking my family about any of it since it was a very hurtful memory. I dont know if anyone on this web-site could even answer any of my questions,Should I be worried? What exactly is MS? I guess all that Im looking for is just a little assurance that everything is o.k.         Thank you, the loner
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Hi, I`ve been having a mild dull pain behind my right eye on and off for a couple of months now. I`ve got really "shotty" vision, and have to get glasses changed regulary. But I really don`t seem to have any visual disturbance or problems with the color red and green. Could this be MS related or more of a sinus problem type thing? I feel like I have pressure if my sinuses under my eye during the pain... I began having MS like symptoms after the birth of my daughter in Aug. All of my tests came back normal at the neurologist. I was at the opthamologist in Oct. He didn`t mention any problems with my optic nerve then, but I didn`t either. He looked in my eyes. Is that something eye docs see right away?
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ONE YEAR AGO I GOT UP ONE MORNING AND HAD TINGLING IN MY FINGER AND HAHDS THEN IT WHEN ALL OVER MY BODY AND THEN IT RECEITED AND STAYED IN MY FINGERS AND HANDS COULD IT  BE MS I HAVE BEEN TOLD THAT IT IS MS. ANY COMMENTS.
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Why were you told you had MS? Did you have any MRI`s or other tests? Lots of things can cause tinglings and numbness. I`d see a neurologist if you haven`t already.
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