periphery vs. central

    
      Re: periphery vs. central
    


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Posted by CCf Neuro MD *!* on December 19, 1997 at 11:26:52:

In Reply to: periphery vs. central posted by carlene on December 18, 1997 at 19:21:55:

: Hello again, and "thank you" again for providing answers to my question.  I posted below (as an "undiagnosed" patient), and have other questions that relate to what's going on with my body.  I wanted to know the difference betweeen symptoms experienced that might be from peripheral nerve type disorders, versus those brought about from central nervous sytem disorders, such as ms.  I know peripheral system includes legs, arms, etc., but does it also include your face, ears, etc.? I have sensations (pain and burning) from head to toe (yes, even including the ears! How strange!).  My second question is whether or not you can have sensory symptoms in your arms, legs, parts that are part of peripheral system, but be CAUSED by a central nervous disorder. Hope that all makes sense.  I have tried to ask it in a way that makes sense.   I've just been doing tons of reading and this is something I can't find explained anywhere!  Also, per your response to my previous post, I understand that ms may not be the diagnosis I will ever get, and that it isn't typical for my symptoms. My neuro even said that, even though the only testing he has done was an "office exam" (no mris, spinals, etc.).  I am having trouble actually believing that it is NOT ms, I guess because #1 no one has told me any other alternatives, (even rheumatologist says he doesn't know what it could be ), #2., I've "sensed" something wrong for over a year now (have been really fatigued for that long).  I guess what I am asking is what will it take for me to believe these doctors?  I asked my doctor what he wrote in my chart, and he read it off:  "I told the patient that ms was a possibility, although unlikely".  Does this mean I have been diagnosed as "possible ms" because he SAID the word possibly, or is that meaningless?  I hate to be so trivial, but this whole ordeal is impacting my life in ways you can't imagine.  I really need some help, and guidance or re-assurance.
  Thanks again for your quickness in responding to my prior post, and for sharing your information and knowledge with everyone on here.  It is so wonderful to be able to read and learn from this site.
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The issue of central as opposed to peripheral central nervous system disease is a very complex one as the same symptoms in the same area are frequently due to either  central or peripheral disease,
The decision is made on the basis of the pattern of symptoms combined with a knowledge of the anatomy involved.
For instance numbness or weakness in a single limb  may quite easily be peripheral, whereas if both limbs on the same side are involved it suggests a central course in the brain or spinal cord. On examination brisk reflexes are associated with central disorders, reduced reflexes with peripheral disorders.
Symptoms in the face may be due to either depending on whether the outer part of the relevant nerve  is involved as in Bell