vague symptoms...early MS?

My symptoms began in Jan. with a tremor in my left thumb one morning for a few hours.  I had fallen on my left side while ice skating a few days before this incident.  My doctor thought the tremor could be from taking Paxil, so I quit that.  The tremor came back 2 weeks later for a few hours.  Two weeks later, my left foot had an almost constant twitch in the arch, and a mild cramping in my toes and a very mild pins-and-needles feeling sometimes.  The twitching lasted a week, went away for a few days, then came back for awhile.  2.5 weeks later, I felt a twitching in my upper left arm, then my arm suddenly had pins-and-needles down to my hand. I went to the ER, where they tested me for my heart.  All was fine.  My doctor sent me for an MRI to rule out MS.  The report says "there are several punctate hyperintense foci in the frontal subcortical white matter bilaterally.  There are approx six of these in each frontal lobe.  They measure of up 3mm in diameter.  No hyperintense foci are seen in the corpus callosum or immediate periventricular white matter on FLAIR sagittal images."  It goes on to say that the appearance is nonspecific, and the foci do not have the most characteristic appearance and location of MS.  These foci are seen in increased incidents in patients with migraine, and they are often idiopathic.
Before the MRI, I started to take Celexa and clonazepam .5mg because I was so upset.  My symptoms disappeared.  Sometimes my arm has a jerky motion as I reach for things, but not often.  The day of my ER visit, I had a great deal of stress on my neck.  Is MS likely?

[CCF-Neuro-M.D.-JT]

Please keep in mind that I have never personally examined you nor have I reviewed your history and diagnostic testing in detail. It's also very difficult to form an accurate opinion without seeing the MRI.  But what I can say is that your symptoms do not sound like a typical case of MS (not that there really is a "typical case", but the symptoms are vague and do not localize to a particular region of the central nervous system) and the MRI report is not strongly suggestive of it either.  The twitching may be represent benign fasiculations which are little muscle twitches that many normal people (including myself) get at rest and increases after physical or emotional stress. It comes and goes and does not mean anything serious in the setting of an otherwise normal neurological exam. Interestingly, I've seen patients who had mild trauma involving their arm that resulted in this odd thumb twitching that went away after a few weeks. Not sure what that means or if that's the case with you.

If your symptoms become worse or you experience more neurological problems, consider a second opinion or further diagnostic evaluation. Good luck.

[cadie]

The information on your MRI report sounds almost identical to mine that was taken a year ago.  The first question that was asked of me was whether or not I suffered from migranes (migraines).  If you do, this may well be the reason for the appearance of the lesions, however, if you don't suffer from migranes (migraines) then you should inquire as to why they are there.  They are not likely related to the fall you took while ice skating, even though the twitching and numbness may be. From what I have read, however, a positive diagnosis will not be given for M.S. until the person suffers two incidents that last more than 24 hours and are located in seperate parts of the body.
  Unfortunately I am one of the not so lucky ones who has M.S. but I had to go through many blood and neurological tests and about ten years before a definitive diagnosis was made and it wasn't made until I had a severe flair up.  
  My advice to you is to: 1.) Keep tabs on your unusual symptoms (keep a journal) You may think they are not important, but they may be crutial later.  2.)Learn about the symptoms but keep in mind that M.S. is really weird and can do strange things to a person, and just because you are not having the "typical" symptoms of M.S. doesn't mean it isn't M.S.  But it also doesn't mean it is. 3.)  Be persistant with your health care provider and don't be afraid to seek another opinions.  4.) Be patient.  If it is M.S. all of your symptoms will likely disappear and you will go on with your life not even thinking about this episode. Until possibly years later being reminded by the return of the weird sensations.  5.) Try not to worry.  Stress will make any situation worse.  Thinking about the "what ifs" will take away from your quality of life.  Even if it is M.S., you will not die from it.  You will only be challenged in new and unusual ways which can be quite humorous at times.  
Best wishes for a clean bill of health!

[Andrea`s_mommy]

Hi, I`ve been having vague neurological symptoms since Sept. 2002 after the birth of my baby. I`ve had a few tests done which have all came back normal. One test I had done recently was an Evoked Potentials- lowers- test. It came back normal also. Does anyone know if an evoked potentials comes back normal, does that help point strongly away from a diagnosis of MS? Thanks....

[bethsnana]

Hi everyone, I have been experiencing a few episodes of strange "thumb twitching" in both thumbs.  This usually happens late at night and I ususally notice it most when I am reading and holding the book in both hands. My hands do not shake when held up in front of me.  Do you think this could be a warning sign of MS. I am terrified since reading that this could be a symptom (not able to sleep, eat or relax).  I plan to see my physician next week, but just wanted someone with maybe the same reaction to let me know their feelings. Thanks so much! Good health to everyone!!