neurological problems

[michelle123456789]

First off thanks for your time on my question. I am a 39 year old woman who has generally good health. This last November i started having a mild vibrating feeling behind my knee and to my left foot while at rest which has since subsided. Since them I have what you would call twitching to every part of my body including feet, legs, abdomen, hands, arms, neck, and face and prickling pins and needles sensations to hands and feet which also subside with movement and immediatly after exercising if i rest they go like mad!!. Most of the time the twitches i experience are single fire twitches that feel like a painless rubberband being snapped under my skin (sometimes actually move me a little) at other times (much less often) they resemble an eye twitch which subside also when i move the extremity in question. I have seen a neurologist and had two WNL neuro exams, normal MRI of brain and c-spine, normal nerve conduction studies, and a 3 needle emg to left shoulder, right calf, and right hand which was all normal as well (no fasiculations seen)...no muscle wasting or loss of strength seen, however I feel as if I have low energy but I may be able to attribute that to the stress of my current situation.

Labs I have had drawn are b12-340, ferriton-58, thyroid 0.47, potassium, calcium,
magnesium,sodium, and cpk all normal range

The only medication I take is ambien.

Just wondering if there is something being missed here. Thanks again

[michelle123456789]

So you are saying that although my symptoms subside with movement they can still be indicative of MS? Also with the MRI being normal showing no areas of paler demyelination being reviewed by both a radiologist and neurologist are  you saying I should have them repeated? Thanks so much for your time on this.

Michelle

[Dr Sharma]

Hi there. Your ferritin levels are within normal range of 12-150 ng/mL, B12 levels also are in the normal limits of 200-900 pg/ml. thyroid hormone levels need to be checked with T3, T4, and TSH. These symptoms also need speculation for multiple sclerosis, despite so many investigations being normal. Consult a neurologist for investigating these. Multiple sclerosis is a chronic demyelinating neurological disorder where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. 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 locations. 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.