I hope you can help as i am desperate for a solution....I started with pain in my outer left thumb on january 31st--just sore,i thought i overworked it at work. The next night the pain was worse and my hand went numb-pins and needles...the next day feb 1st-I was weak in left arm,numb to shoulder--the pins and needles terrible in my fingertips and hand...3 days went by...by tuesday morning-the numbness went down my left leg-stopping at my knee-I went to er. They checked my arterie-all was okay...I went to orthopedic doctor next day...he checked my arm and neck-I felt weird sensation down both legs when he pushed my head forward---he sent me for mri of neck and spine--still waiting for response. Here it is, now almost two weeks with no use of my left hand, my thumb wont move-and the pins and needles are excruciating-especially at night--I also have a low grade fever-and i am very tired-my left arm is very weak.The numbness in my leg comes and goes...please if you have any thought of what i should have checked-what it could be-please help. I am otherwise healthy,healthy weight 145 at 5 7"-35 years old...the whole thing has me a wreck...sincerely andrea
How are you feeling?
I am sure you are not in best of your health.
Your symptom of slowing evolving pain, tingling and numbness suggests that you have got neuropathy. Neuropathy could be due to nerve dysfunction. Nerve dysfunction in your case appears to be due to some kind of vascular compromise or compression injury at the spinal level.
When I say vascular compromise, it can be thrombosis or ischemia or stroke like thing in cerebral vessels.
When I say compression injury it could be at the level of cervical spine and also at lumbar level.
You have associated fever now which suggests it could be due inflammatory descending paralysis.
You need to wait for the report of MRI as what does it suggests.
Meanwhile you can meet a neurologist and also another orthopaedician for further evaluation.
Keep me informed about further development.
Hello....I got the results of my mri...they said i have slipped discs of c5 and c6. I also have bulging discs, which they didn't specify where...the orthopedic sent me into panic mode by telling me three people including himself believe it is ms based on the mri report. I went to a neurologist yesterday who did a eeg---they said i scored between 110 and 113 and that 125 to 130 was the danger zone for ms==but that didn't mean i don't have ms. I now am scheduling an mri with and without contrast of my brain to be sure. My major symptoms as of now are....left hand numb,thumb sore and doesnt bend,hand can't grip so basically is useless,numbness runs severe to elbow,then lessens but travels up arm and down front and left side,down leg ending at knee cap? The back of my leg does not feel numb nor does my butt. My hand is still cold, but not as cold as days before when it would actually turn blue. I'm so concerned that this is nothing more than carpel tunnel as the thumb started hurting at work when I had to rip over 4000 price tags? I know they saw "stuff" on the mri...and there's definitely something wrong with my neck because my other symptom is when I put my chin down to chest I get a weird feeling down both legs? Does ms produce these symptoms? I am more confused and concerned obviously now more than ever, I thank you for your response...I appreciate any input and help here. Looking forward to hearing from you-sincerely andrea
Multiple sclerosis is a chronic remitting disorder characterized by multiple white lesions in the CNS separated by time and location. The most frequent presenting symptom is unilateral weakness or ataxia. Headache is common, ill defined paresthesias are noted, Visual symptoms like diplopia, blurred vision are also present initially.
MRI is the neuro-imaging of choice, small plaques of 3- 4mm can be identified, particularly those located in brain stem and spinal cord.
MS can cause changes in sensation, muscle weakness, abnormal muscle spasms, or difficulty in moving; difficulties with coordination and balance; problems in speech or swallowing, visual problems, fatigue and acute or chronic pain syndromes, bladder and bowel difficulties, cognitive impairment, or depression.
The initial attacks are often transient, mild and self-limited. The most common initial symptoms reported are: changes in sensation in the arms, legs or face (33%), complete or partial vision loss (optic neuritis) (16%), weakness (13%), double vision (7%), unsteadiness when walking (5%), and balance problems (3%); but many rare initial symptoms have been reported such as aphasia or psychosis.
Your symptomatology as of now do not sound like you are having MS, but there are definitive guidelines, on which the diagnosis of Multiple Sclerosis is based. There are definitive lesions (suggestive of MS) on MRI also.
Once internationally accepted criteria’s are satisfied, then diagnosis of multiple Sclerosis can be made.
About your other symptoms I think you are right in thinking it as Carpel tunnel syndrome.
What is the quality of your pain and/or symptoms (e.g., sharp, electric, dull, aching, numbness, tingling, etc.)?
Patients with carpal tunnel syndrome will complain of pain, numbness, tingling, and electric sensations in their first three digits.
What are your occupation and hobbies? Do you ever have symptoms at night that awaken you from sleep?
Keep me informed.
Thank you for all the info....my left hand has constant numbness and it is VERY cold. In the morning when i get up, if i do not keep it raised,it actually turns blue-but it is constantly frigid. I do not doubt they found the c5 and c6 to be slipped-I just think this may be two seperate issues. My left leg is numb-basically all the way down to foot. I just don't know what to think. I am going to my general doctor today and am going to ask for lymes disease test? I do live in heavy woods....I don't know...maybe rull one thing out. My hand last night seemed to start moving a little better-my nailbeds-especially the thumb-feel as is they were wacked by a hammer-super sensitive...it does wake me at night.
My job is an office job-nonstop use of my hands--for computer or for ripping and tearing 1000's of things in a day. That is how this all started...after I got done ripping 4000 things (which they're tough to tear)-I had pain in my outer left thumb--numb and pins and needles the following night....and it just went from there...forearm feels very tight...upper arm is weak...but then it progressively went down my leg which is why I suppose they suspect ms? I am just at a loss--I've never in my life been in bad health and as I've said-I am fairly in shape for 35-healthy weight , etc.
I will go for brain mri next week-and find out results of eeg and brain mri in combination from neurologist on february 26...so thats d-day for ms. I will keep you posted and I really do appreciate your input and help with this....thanks again,andrea
Night-time symptoms that wake the patient from sleep are a classic sign of carpal tunnel syndrome.
Patients who work at a desk, type, or who perform other repetitive activities that involve simultaneous wrist and finger flexion are prone to develop carpal tunnel syndrome.
Most of your symptoms do go in favor of Carpel Tunnel Syndrome.
I think that is what the diagnosis I am looking at, but having said that you definitely need to be evaluated for other accompanying disorder.
Keep me informed if you have any queries.
ok, so here's where i stand now....I just left primary doctor and I had him take blood to check for lymes disease, he then said he wanted to also check and rule out all auto immune diseases. I'm happy with that because my symptoms fall in alot of dieases....so now at least the blood work is done and i will find that out early next week....I will also have the brain mri done next week and then on the 26th find out about ms.
My primary read me the mri of my cervical spine, and it actually said c4,c5 AND c6 were either bulging TO LEFT or slipped to left....which i guess would explain numbness down entire LEFT side. He said NO WHERE did it say they found lesions...it said "lesions possible" but could not detect. I guess the brain mri will say it all?!!
Oh well...I'll let you know about the blood work when i get it....also I asked about carpel tunnel, and he said that "shouldn't" go up my arm to the shoulder-he thinks the discs are the problem
I'll keep you up-dated, until then....andrea
It is nice that you are so quick in your responses. I might be wrong in saying about Carpel Tunnel Syndrome, but all your symptoms are pointing towards that though your spinal disc pathology is always there in back of my mind.
Well if you are thinking about auto-immune disease, then have they done ANA, ANCA test?
Keep me informed if you have any queries.
Sorry....Don't know what I hit....anyway,I don't know what ana and anca tests are...all I know is he said he wanted to rule out thyroid,diabetesII,lupus and a bunch of others--something also called edme-or emde--I forget-has symptoms similiar to ms. Today mentally I'm a little better--hand has been awful today. I know from what I looked up the c5 and c6 affect the outer part of your thumb and thats where my pain is the worse...also it sometimes feels as if myindex and middle finger have cotton candy stuck between them at the base of the finger?! I know-strange analysis, but this whole thing is strange! Anyway, I too appreciate your time and concern in answering my questions...the mri of my brain is scheduled for monday....I will get back to you as soon as all my blood tests are done...do you think I should ask if he did ana and anca?
we'll talk soon...sincerely,andrea
I am sorry but you should not ask whether he has asked for ANA or ANCA or not. You should ask him what all investigations have been sent and upon knowing that above mentioned investigation have not been sent, then you can ask him to send.
Keep me informed.
ok here's the update so far....all bloodwork came back good--no problems. So now it's narrowed down to my neck or ms is the problem. I will get the results of the brain mri tuesday the 26th. They did it monday with and without contrast.
My hand today is not as cold and I can actually make a loose fist-which is huge because last week my thumb couldn't even bend! I can pick light things up with my hand even....my forearm is very weak though anf because my fingertips are still so numb I can't grip very hard...but it is an improvment.
well, I'll keep you posted...let me know if you have any new thoughts.
It's good that you are feeling better.
It's nice that your investigations for connective tissue disorder have turned to be negative.
I still feel that you are having nerve compression at the neck level which is causing such symptoms.
It could be either spinal disc pathology or Carpel tunnel syndrome.
Keep me posted.
Well....one month later exactly from when it all started in my thumb...and here's the diagnosis I received today- it is ms. My neurologist said the lesion on my (or near my c4), in combination with my brain mri (that they noted "a few") lesions --confirms to them that I have ms. I am, to say the least, still in shock....hasn't quite hit yet, I think I reacted worse when the orthopedic said he "thought" it could be ms than actually hearing today that "i do" have ms. Now I go back next week as I have to decide now which injection I want to give myself for the rest of my life...weird...not quite real yet. I was just told at 1pm today...I then went to the mall to "pretend" it didn't all really happen....but it did...and I have to deal with it..I thank you for all your input and just for being there to help ease my mind at times. If you have any input on the injections, and where you think I should go from here, I welcome it. Well....I'm now a new statistic...and thats what I feel like.
I am surprised and a bit unnerved to hear it that you are being diagnosed with MS. Did you ask them how have they diagnosed it? What criteria's they have followed?
Diagnostic Criteria for MS are as follows;
1) Examination must reveal objective abnormalities of the CNS.
2) Involvement must reflect predominantly disease of white matter long tracts, usually including (a) pyramidal pathways, (b) cerebellar pathways, (c) medial longitudinal fasciculus, (d) optic nerve, and (e) posterior columns.
3) Examination or history must implicate involvement of two or more areas of the CNS. a. MRI may be used to document a second lesion when only one site of abnormality has been demonstrable on examination. A confirmatory MRI must have either four lesions involving the white matter or three lesions if one is periventricular in location. Acceptable lesions must be >3 mm in diameter. For patients older than 50 years, two of the following criteria must also be met: (a) lesion size >5 mm, (b) lesions adjacent to the bodies of the lateral ventricles, and (c) lesion(s) present in the posterior fossa.
b. Evoked response testing may be used to document a second lesion not evident on clinical examination.
4. The clinical pattern must consist of (a) two or more separate episodes of worsening involving different sites of the CNS, each lasting at least 24 h and occurring at least 1 month apart, or (b) gradual or stepwise progression over at least 6 months if accompanied by increased IgG synthesis or two or more Oligoclonal bands. MRI may be used to document dissemination in time if a new T2 lesion or a Gad-enhancing lesion is seen 3 or more months after a single attack.
5. The patient’s neurologic condition could not be better attributed to another disease.
Once your symptoms have met these criteria’s then you should ask them what category they put into like whether it is definitive MS or Probable MS or At risk MS.
The treatment plan for each of them would change.
Keep me posted.
Sorry to not get back quicer...I too have been unnerved, therefore I went and picked up my mri of brain and mri of cervical spine...my eeg of brain came back "normal" in her words. So, instead of me trying to tell you what it said, I am going to take the time to "copy" their words on the reports, so.....here goes....
brain with and without contrast-
findings:there is no intracranial mass affect. there are no extracerebral collections. the fourth ventricle is midline. there are a few focal defects in the periventricular white matter bilaterally which are clearly abnormal in this age group. a few of these are perpendicular to long axis of ventricular system likely indicating the prescence of demyelinating diseease. there is a focal defect along the undersurface of the posterior bodyof the corpus callosum as further indication of the demyelinating process. the brainstem is not expanded. no internal signal aberrations are seen. the upper cervical cord is unremarkable as seen at the periphery of the field of view.
there is no evidence of pathologic contrast enhancement identified within the cerebrum,cerebellum.brainstem or regional leptomeninges.
impression: 1. no intracranial mass affect. no extracerebral collections.
2. a few focal defects are seen in the periventricular white matter bilaterally most likely demyelinating in etiology. no previous exams are made available for review, at such time that previous exam becomes available an addedum will be issued.
3. no evidence of pathologic contrast enhancement is identified within the cerebrum,cerebellum,brainstem or regional leptomeninges.
***the end for the brain mri*** next is the mri of cervical spine.....
findings: vertebral body signal and vetebral body height are preserved. there is no evidence of intraspinal or paraspinous mass.
at c2-3 there is some desiccation with mild disc bulging
at c3-4 there is some desiccation with mild disc bulging but no focal disc herniation is seen
at c4-5 there is desiccation with mild disc bulging to the left but no focal disc herniation is seen
there is disc degeneration with some loss of disc signal and disc height at c5-6. there is mild to moderate disc protrusion with shallow diffuse eccentric disc herniation to the left. clinical correlation is advised regarding the status of the adjacent left c-6 nerve root.
at c6-7 there is mild disc bulging to the left without focal disc herniation
at c7-t1 nothing abnormal is seen.
there is some heterogeneous cord signal. a few focal defects are distributed profusely most noticeable at c4-5. configuration is reminiscent of demyelinating disease. clinical correlation as well as correlation with brain mri would be useful.
impression:1. some heterogeneous cord signal with focal defect most noticable at c4, possibly demyelinating in nature and clinical correlation is advised.
2. mild disc bulge in the context of some desiccation to the left to some degree at c2-3, c3-4 and c4-5.
3. moderate disc degeneration with shallow diffuse eccentric disc herniation to the left at c5-6 and clinical correlation is advised regarding the status of the adjacent left c6 nerve root.
4. mild disc bulging to left at c6-7
so...now you have the info exactly as i have it. and as i said eeg of brain results were normal. Please. please give me your honest opinion on my mri's. I have already been told i have ms, already sent home with stacks of info so i can decide what injection i want for the rest of my lifre, so nothing you can say will shock me. but i would like your opinion....although I need it in "lamens" terms. I am a department manager at a supermarket and do not ubderstand all the official terms. I wonder if this is not ms, is it possible a car accident I had 18 years ago where I was driving and got hit so hard on the passenger side (where I was thrown to the left) did this to my neck. The car was totaled and i was not wearing a seat belt.....please...i went and picked up these results because i want to get a second and maybe third opinion....obviously i am a wreck and i just need to feel more definite about these results and diagnosis. any help i greatly appreciate and i know you spend alot of time answering me and i thank you.
thanks so much.....andrea
Can someone please give me their opinion on this? I see Jain md has someone else answering questios....thats fine...another opinion woud be great-I am going to start injections for ms this or next week....please let me know...
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