First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms that you describe are non-specific and you have had some good tests already to evaluate for the most obvious potential causes. Several diseases/categories that I did not see represented are seizures/epilepsy, vasculitis and Wilson's disease.
There is a category of epilepsy called Rasmussen's encephalitis that is more common in children, but can have adult onset as well. This disorder causes focal seizures that affect one side of the body and at first the symptoms can be strange with twitches/tremor, weakness, and sensation changes that can evolve into more recognizable seizures, speech problems and problems thinking/memory. In the later stages this condition will show up on the MRI and white matter changes afecting one side only and atrophy of one side of the brain (the left in your case would give you right body symptoms), but early on in the disease the MRI is often interpreted as normal. I would suggest an EEG of the brain (brain wave test) to look for seizure activity that is sleep deprived (to make sure you sleep during part of the test-this makes the test more sensitive).
Another possibility is vasculitis (or inflammation of the blood vessels in the brain). This could be caused by many different things, and we often do not find a cause. Many patients with advanced vasculitis have strokes that show up on their MRI, but it may be negative early on. To look for vasculitis a cerebral angiogram should be done (it is like a heart cath, but they will squirt dye into the arteries of your brain to look for narrowing, etc).
Finally Wilson's disease is a disorder of Copper metabolism that allows copper to build up in many different organs, including the brain. These patients often present with depression/psych disturbances and are found to have tremor and ataxia. Testing for this rare disorder involves a simple blood test for ceruloplasmin and copper as well as liver function tests.
It is very frusterating to patients with disabling problems to go through many tests and have them come back 'normal'. Many times after you have exhausted the tests that your doctor knows or cares to order, it is time to go to major academic center and to have your case reviewed by an expert in the field that can provide further guidance.
I hope this has been helpful.
The important thing to remember: just because a dr. discounts you or doesnt know an answer, does not mean nothing is wrong; it means they don't know the answer or the symptoms. You must be your own advocate. Good luck!!
From a diagnosis standpoint - its certainly odd what you describe, however do not take a normal MRI to necessarily mean just that. In my experience sometimes things are missed, it happened to me last year. A pineal gland tumor was seen on CAT scan and not reported, brain MRI was reported as clear but I had no contrast, then when my symptoms worsened, they did a repeat MRI again no contrast, they saw the tumor and it was reported, then they did a recheck of me and added contrast to the MRI, 6mths later and once again they saw the tumor (not grown thankfully) but with the contrast they also saw that one of my carotid arteries (fairly essential for good brain function :-) was twisted. My EMGs have also been normal, but I have definitive heart, lung and adrenal disease, that has shown in bloodwork and formal testing. For a time I had some what I called a sensation of cold air conditioning on my scalp and when my adrenals are really bad, I seem to walk through mud, its hard to walk and stay upright and I am completely and utterly fatigued.
Have you seen a rheumatologist? They are often good at tracking down other reasons like Lupus or immunological probs that can cause things like you describe. You could also request a muscle biopsy and make sure they take a really good look at your bloodwork. The rheumatologist I saw was helpful but did not come up with anything new ideas, but one Dr did wonder if I had inclusion body myositis (there is a milder version called polymyositis) from the history and the test results he reviewed, which you may want to look up. I have so far refused a muscle biopsy, its only useful really if you have acute symptoms, but bloodwork for muscle enzyme levels can help establish if its a useful idea or not. If they are elevated (mine were but then dropped back to normal) by the time a muscle biopsy was suggested. I am seeking my third opinion in NY in two wks time and its 17mths since my acute symptoms.
I hope that helps, and please don't give up, its miserable when you have no answers and are suffering.
GL and maybe those are some new ideas to consider.
Fiona
The neuro doesnt think its a pinched nerve since my right arm and leg are affected. My shoulder is often stiff and in pain but that started after my initial clawing/hand weakness issues.
My MRI was w/ and w/o contrast on neck and brain. Brain was "normal" and neck was "good" whatever that means haha.
Did you ever find the source of your "walking through mud" because it sound like my walking through water. its not necessarily pain as much as it is the feeling of resistance. And what about your air conditioning on your scalp? Was your entire scalp cold or just little spots that migrate for a few seconds. My cold spray legs feels like tiny drops of cold water misting on my legs but migrating over an area but only lasting for a few seconds. Do they know what causes your problem w/ that feeling?
The air conditioning feeling, was weird, it was superficial on the scalp itself, the neuro figured it was nerve related and asked about shingles/rash or similar but I had not had anything like that. The sensation lasted on and off for about 4 mths and then left. At the same time, I had tongue fatigue, sounds weird, but my tongue would get tired eating food, I would have to stop eating and wait then restart chewing. That lasted about 6 mths and then has since resolved for the most part.
They have not suggested fibro to me, but I do have a whole heap of pain and a bunch of fractures in my spine from osteopenia/porosis, worsened by steroids and bloodthinners. My own explanation for it, which tends to be accepted by the Drs is that my posture has changed to accommodate the other symptoms of weakness, thus my muscles are compensating and complaining about it, hence the pain. My pelvic girdle and my shoulder girdle seem to be culprits and the weakest part of what is going on for me, but esp my pelvic girdle. Two neuros have noticed it, but neither can put a name to it, since I pass the EMGs and my muscle strength is now basically returned, but it was low initially. I am seeking a third neuro opinion in NY in two wks. I also have hand tremors, which were body tremors when I was acutely ill, its refined now to mostly my left hand, the tremors still worsen when I exert myself, the more exertion the worse the tremors.
Its unfortunate that you are encountering Drs that you feel are not totally believing your symptomology, frustrating to say the least. I think I have struck it well, in that I can be specific and talk medspeak when I need to do so, given my prof background. I also have definitive medical testing which has shown muscle weakness in my heart, lungs, diaphragm, muscle enzyme changes, which you absolutely cannot fake, so I guess that helps my stance and they found the pineal gland tumor, plus the adrenal function which is non existent.
My Drs are the best of the best and totally are supportive of me, having said that, we have an EXCELLENT relationship with my PCP and his staff, which I think is key. Still 17mths on, we still have no real answers, just pieces. I don't think I got hit with this randomly, I suspect a syndrome of some sort, but its a matter of figuring out what!
I am so sorry you are going through this, what did you think of the splinting idea? I would suggest you go to a good endocrinologist and see if that yeilds anything more, it could elicit something and you only have a few tubes of blood and some time to lose.
Gl, Fiona
Have you been tested for lyme disease ? Untreated lyme disease can also cause the symptoms you described... including the hand clawing.
Try going to a movement disorders Neurology specialist.
thanks for the suggestions, i'll bring them up next time i see the neuro doc
I do get rigid. like when i'm "walking through water" they feel stiff. I feel like I don't have much range of motion in my right shoulder either. i am tired in the morning and from maybe 2-7pm then i am of course not feeling tired when its bedtime so i lay there and lay there. I take stuff to sleep, but sometiems it takes a while anyway.
So, worriedmario, have you been diagnosed w/ anything? we seem to have similar issues. definitly keep me posted!
i'm going to a YOPD specialist on Tues. i also have weird stuff like facial numbness, burning tongue, fogginess, eye floaters, headaches, shock-like twitches, cold spots, hot spots, ear pain, eye pain, creepy-crawling sensations all over, shoulder pain, forearm pain and tighteness like someone tightened at my elbow and wrist (makes it hard to move my last 3 fingers on that hand), left leg feels delay (to the point of limping sometimes, mostly no one else can tell and i ask people to really watch me walk when the symptoms are present), i will over step some like i can't tell what position my foot is in, intermittent blurred vision, the slowness no one else can notice (even my thoughts feel delayed, i refer to this as "freeze frame mode" like my head is being cut off from the rest of my body). the latest symptom is facial pain and facial and neck muscle tightening (feeling like i'm getting a face lift or someone has there hands around my neck; very claustrophic feeling) with throat tingling and a feeling of a lump in my throat at that spot, i've had the scope and nothing was there.
it's all so overwhelming: i'm a stay at home mom and it all started toward the end of my last pregnancy. i do have a slightly positive ANA. they told me i have fibromyalgia too.
this sucks; i totally live day to day. happy to wake each morning. we have very small children and we are such the perfect little family. this has really dampered our lives. LOL, chris
I do get random twitches but its just like my foot will jerk or my arm or leg but not constantly or anything. what does YOPD stand for, do you have that?
What exactly do you mean by "claw." Is it tight and stiff? I get a pain in my shoulder then by my elbow then the last 3 fingers and a very bad pain on my radius bone and my wrist and it feels tight down my forearm and fingers get stiff.
My left leg does the same thing: hip pain, tight thigh (pain), ankle pain, calf stiff and numb and tingling on the outer part, then stiff numb toes (last 3).
I also have vertigo that I forgot to mention earlier.
Sometimes it feels like my head is not getting any Oxygen: I get sooooooo foggy and numb and tight in the face and neck (very painful) , blurred vision, I get bladder spasms and hesitancy from time to time (the neuros. say that is just hormones, but whatever I never had it before). I get a dry mouth and then I will have excess saliva sometimes too and all the stuff I mentioned before....
My symptoms are very weird and I just don't seem to "fit" any one disease except MS but, I don't have any lesions. I do have that slightly positive ANA that has since gone negative but, it is not specific. I went back to the Rheumy last week for 10 tubes of blood so we'll see what they say.
They are starting to rerun stuff on my now.
How long have you had symptoms??
I am only 33 and this is just so bad. We are too young for this ****.
For months I just kept trying to believe the fibro. dx. but, I seem to be progressing. My husband is in denial; he wants it to just be fibro.; well I pray that it is.....keep talking...this really does help. Thanks for your reply, Chris
def let me know what u find out cuz we are very similar. i dont get dry mouth.
i do get wicked bad pain where the radius meets the base of the thumb.
i get vertigo but im not worried so much about that its rare and like when i stand up from sitting i think a lot of people get that. my vision isn't as much blurred as it is double but not double double like one and a half not double... things that are white, i see one and a half of. i can tell which one is real and the other one is transparent. like white lines in the road.... i see one and a half of them. ping pong table stripes, i see the one on the table and one that is completly off the table. white cars look like sheriff cars that have lights on top.
did they explain why its not parkinson's? i never really thought of that because i'm not really shaky shaky. just a slight tremor in my right hand.
http://www.observernews.net/artman/publish/printer_1817.shtml
I read the article and called the gentleman. He was very friendly and mailed me the dvd very quickly. For a 76 PD sufferer he is in GREAT shape. His tips on exercising are the best. I have read a lot about exercise and good nutrition being able to slow down PD. Or in some cases reversing it.
Also, to those with the limp in their legs. Does your foot/leg kinda swing outward?
Thanks
and i'm glad you are only 6 months away from a dx, but six months seems sooooo long. stupid fibro dx masking everything. good luck!
are ya'll having any autonomic symptoms? such as: hypersalivation at times dry mouth other times, blurring vision at times, slower blinking sometimes or really delayed thoughts. just feeling like everything is in slow motion?
does you left forearm feel like the muscle is shorter and tight? i feel that in my arm and leg and in my face muscles too. even my left eye ball feels slower to move.
this is all tooooooooo crazy. we are too young. i was a cheerleader, dancer, marathon runner. not to mention, a mom of 2 tiny kids.
i am really scared and this has been going on 2 years and i'm still upset by the crazy symptoms because they are getting worse.
how long have ya'll had symptoms? back to the very beginning...mine started with tingling and restless legs.
i am so praying for a cure; even though, the neuro. the other day said very unlikely a cure for PD.
live life everyday, chris
I'm also having other symptoms. I wake up early and can't fall asleep again. Also, unusual constipation. I think my sexual functions have been affected a little, but not sure if it isn't just stress. Overall I feel weird and sometimes my thinking is slowed down. My symptoms get much worse, like my tremor and walking, when I'm under stress.
I feel sorry about you and the kids, but I think that in the end it's a positive. I'm expecting a child and if anything else that brings so much joy in this stressful time. The biggest concern is finances in the future. Here I'm just beginning a career with all these student loans and now I'm not sure what will hapeen next. I know that no matter what my wife is there and will be there. I would love to have more kids once we have this one, but the thought of hardship for my wife with me being ill is a big unknown.
Do you guys feel depressed? It seems like the worse the symptoms get it becomes harder emotionally. I feel fine when I'm around my wife but at work I feel down. I keep hoping for a miracle of some sort. I'm still shocked and just bummed out. I feel bad for my wife and everyone around even though I'm the one who is ill. I can tell that this will take a lot of family support if it is PD. Good luck to everyone
Do ya'll have any of these autonomic symptoms?....decreased blinking, hypersalivation.
How about feeling like your facial muscles are tightening?
Do your symptoms come and go sometimes from minute to minute?? mine do.
Try to Have a good day, Christine
My most bothersome symptoms now are the limping and tremor. Also, I am in a lot of muscle and joint pain especially at night. I read that the pain is rare for PD but more common in young onset PD. I'm sure that at some point all these symptoms rotate and hit you. It does seem like the symptoms can stop from in a heart beat at times. But as time goes on they don't seem to leave me anymore, they only get worse. Everyone in my family says I should stop thinking about it and that I don't even know if it's PD. Easier said than done.
Even if YOPD is rare, it obviously happens to people. How come doctors are reluctant to possibly diagnosis this disease if they can offer so few alternatives to this seemingly probable outcome?
He, after 2 years, has only seen me limp once and I ask him to watch me walk all the time when I feel like my left leg won't "catch-up."
Anyway, we are still praying it is just fibro. he really just doesn't think this is PD and we are going to the Muhammad ALi neuro's this week for their opinion. They said before it wasn't PD but, now we are bringing the other neuro.'s idea that it maybe young onset to the table.
I think it is but, he just thinks I have weird stuff and fibro. I really just think he is scared because we do have such small children and truely are the "All American" family; this shouldn't be happening to us!!!
Anyway, please keep in touch with me and your progressions/dx's.
Ya'll should go the the "YOPA" message board and post your symptoms. MOst of the people there have YOPD and will respond to you.
They will really help. They have helped me and a few ladies even called me.
Ya'll have a good rest of the weekend, Chris
Also- you mentioned going to the Muhhamad Ali neuro docs this week... have you gone yet? How did that turn out? I hope they had answers!
The Dr. at the Muhammad Ali clinic runs the MD part and said NO! PD. He said he used to run the Cleveland Clinic and he trained the Dr. who said this may be PD. Yes, he is a bit arrogant!
He wants to do more testing. I'll keep you posted. I go back July 5th for a follow up after further testing.
Please keep me posted too. Good luck and many prayers, Christine