normal brain MRI

[LD]

I posted early with concerns about MS. MD thought viral labyrinthitis,neuro said symptoms of MS, but when MRI was normal,he prescribed Paxil, said I "lost my confidence". After researching Paxil, I declined that therapy.
I have never been depressed,had OCD, or a social phobia. I am a business owner and definately have not "lost my confidence"!
I am no longer having balance,vision, or vertigo problems, however, the cognitive funtions, speech/language, spelling, memory is causing me problems. It has been 1 month since the onset.

Can a viral infection cause such symptoms? I do not want unnecessary tests or drugs.   How much time should I allow for these symptoms to resolve itself? If I seek futher medical advice, what, if any, test should be done?

Thank you for your time.

[CCF Neuro[P] MD, RPS]

Dear LD:

It is difficult to tell you, as your symptoms are very non-specific (not like rhinorrhea, cough, achy muscles, low grade fever and what do I have question).  Yes, viral illnesses can cause symptoms as you describe.  Whether your symptoms are do to a viral illness I can't tell you.  The normal MRI is very encouraging that there are no masses in the CP angle causing your vertigo and hearing loss.  It is also an indication that you do not have meningitis, although a LP with CSF would give a better answer.  However, if there was no preceding viral illness, the question of viral syndrome is alittle weak.  Loosing the ability to spell simple words, memory of usual tasks, people and places, and the ability to use language is worrisome.  Symptoms like these can occur from things as severe as stroke, dementia, epilepsy, prion disease, multi-infarct dementia, mitochondria diseases, and many more illnesses to the simple things such as stress, anxiety, lack of sleep etc.  The job the physician is to find the etiology of the symptoms.  We usually start with the history and physical.  Having no insight to either of these, I am assuming that the two physicians have gone completely over these and are of the conclusion that the serious things are not present.

If it is viral then things should get better over time.  The time period would depend on which virus and the individual.  The usual is several months.

Sincerely,

CCF Neuro MD

[wade]

Just wondering if you could let me know what the "usual onset symptoms" of MS are?  I read alot about this in this forum, but I am unsure what they are.  

Thanks.

[aaron]

Hello,

First off I tip my hat to you for taking your time to spend helping all of us who post on here.  I have a Similiar question as the above.  Accept I have not experienced spelling or speach difficulty.  Just some ms type symptoms,(mood swings, fatigue, tingle, twindges,etc) normal Mri scan (scan was with contrast) Anyhow had a flue bug and about a month later things started, tingle, etc.  Im excluding Gulliane barr, due to the fact things have been ongoing for a few (3)months.  Have heard of viruses attacking the peripheral nerves, what type of symptoms would you have if this is the case? (do peripheral problems feel the same as central)? I've also heard LUPUS can create peripheral problems.  Can a normal blood workup (not including an ANA) give some indication of an auto-immune problem?  All my counts were perfect, right in the median of normacy.

Thank you Dr for your time. :)

[BBMike - wife needs help!]

Dr,

I have tried to post for a week now, im sorry to put this under this gentemans posting...


My wife is been having odd symptoms about 4 mo's after the birth of our son.  It started with some numbness in one extremity, but now its spread to entire face, down the back of one leg, on the back, the chest and she has intermittent blurred vision.  She has seen an Opthomologist, had a thorough eye examination, I mean complete!  All came back normal, slighly far sighted.  Had a standard blood workup, everything was normal, white and red blood count. (no infections)(no ANA yet) Perfectly normal MRI, seeing a specialist in a month.  We encounterd the emergency room for the facial numbness, Dr said NO MS because unusual for complete face and normal MRI.  Given Xanax 0.05mg, it does nothing, she took two on advice of Dr still no relief.  Since MS is highly unlikely at this point according to the ER Dr. I am worried about the nerves outside the central nervous system.  I have heard of peripheral neruropathy, but from what I read, it says its mainly limited to the hands and feet, sometimes the legs and arms and some muscle weakness. Also I might add she is NOT diabetic or harboring any illness,(untill now)!  She was prior to this a very healthy woman.  She has no real weakness but fasculations.  I also read that its uncommon for PN to manifest in the facial region.  Ive also read of Chronic peripheral problems, thats the only one she really sorta fits.  But the symptoms came on within a few months and seems so quick, and to cover so much of the body.  Some days better then others.  I am worried she is dying.  Im not a Dr but im searching the net to find anything I possibly can to help her while we await our visit to the specialist.  She has the responsibility to care for our 6mo old and our 5yr old on her own, no help whatsoever untill I get home from work.  She's able to do the main tasks, but playing with the older boy she cannot do, and she is very tired.  I have entertained the though of her pregnancy bringing something on.  We dont sleep much these days and I know she's extra tired. I have her taking multiple vitamins, mega C, she eats wonderfully,  Do you think she is suffering something terminal or serious? Im sorry for all the questions, I just dont know what else to do at this point. Our internest just shook his head and said see the specialist. I hear that Chronic periperal myelation disorder is rare and I want my children to have a mother.  HELP!

[CCF Neuro[P] MD, RPS]

Dear BBMike:

I am not sure I can help. Without seeing and examining your wife I am abit behind the eight ball.  Most of the time, peripheral neuropathies are due to the actual delivery itself and include only the lower extremities.  There can be some other neuropathies due to pregnancy but they are rare, such as carpel tunnel.  The extent of your wife's problem would suggest that this is not a peripheral neuropathy.  There are too many nerve root distributions and the onset happened too fast.  The general overall good health before this occurred also doesn't fit with a general neuropathy. Although there is always the possibility, I would think that this is anxiety or something along this line. Let us know what happens when your wife sees the specialist.

CCF Neuro MD

[CCF Neuro[P] MD, RPS]

Dear Wade:

Usually MS presents with muscle problems, weakness, fatigue, clumpiness with or without sensory symptoms.  When there are only signs of sensory involvement it is not the first disease that jumps to mind.  There are some cases where it is only found in the spinal cord and the only manifestation is one leg weakness, that is unusual.  There are patients who have no signs or symptoms and it is only with a bad headache and the MRI scan do we diagnose MS (extremely rare).  

CCF Neuro MD

[wade]

Thanks for the quick response.  There seems to be so much information for a disease that is so hard to diagnose.  When you say muscle problems, what would that be?   I have been to 2 neurologists, had an MRI and nothing has been established.  Just trying to figure out if this fits the "MS mold" or if it is something that is benign.

I have no muscle weakness, no visual problems.  The only thing detected was a slight postural tremour in my left hand.  I hadn't ever noticed it before the exam.  The reason I went for the exam was some intermittent tingling in the arches of both of my feet.

Any thoughts?

Much appreciated!

[CCF Neuro[P] MD, RPS]

Dear Wade:

Muscle problems would be weakness, spasticity, increased deep tendon reflexes, uncoordination, etc.  A slight tremor is usually not a firm symptom of MS. There are many things to give a postural tremor.  The vast majority of time it is due to essential tremor, or caffeine tremor.

CCF Neuro MD

[Milyriq]

A related discussion, Are there specific behavioral issues common in MS? was started.