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Neurology (Expert Forum)
Further Testing?
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Further Testing?
by yedwyn, Oct 08, 2004 12:00AM
My situation is: I suffered with viral like symptoms for several months, including dizziness, fatigue, naseau, chills, etc. Dr. thought infection but antibiotics did nothing. White count, thyroid, iron all normal. Muscle twitches started in the third month and I felt weak on left side. MRI came back normal. Referred to a neuro who ran an emg and gave a diagnosis of cervical radiculitis. Leg was perfectly normal during exam, only fascics in arm. My questions are:
1. Does the neuro exam and result effectively rule out something like ALS?
2. I went to the hospital er with extreme joint pain about a month ago - ana and sed rate came back normal. My GP says this rules out Lupus and other CTDs - is this correct?
3. Went to GP a week ago for knee pain and was told that my knee joints are "lax"- they continue to be painful but are not swollen or red. Does this point to Lupus or anothe CTD?
4. My muscles continue to twitch and sometimes visibly shake for a moment, particularly my bicep - should the emg be redone, should bloodwork be done? The neuro took no blood at my visit.
5. I have a history of pins and needles numbness in my hands and feet, periods of flu-like illness and diagnosed Raynaud's syndrome as well as psoriasis. My ANA was "slightly positive" during my pregnancy two years ago but other bloodwork showed nothing. I am frightened that my Dr. is being unduly resistant to the idea of Lupus. What further tests would rule out/confirm this disease?
Thank you for your time. I am a 31 year old mom in need of some help.
-M.C.
1. Does the neuro exam and result effectively rule out something like ALS?
2. I went to the hospital er with extreme joint pain about a month ago - ana and sed rate came back normal. My GP says this rules out Lupus and other CTDs - is this correct?
3. Went to GP a week ago for knee pain and was told that my knee joints are "lax"- they continue to be painful but are not swollen or red. Does this point to Lupus or anothe CTD?
4. My muscles continue to twitch and sometimes visibly shake for a moment, particularly my bicep - should the emg be redone, should bloodwork be done? The neuro took no blood at my visit.
5. I have a history of pins and needles numbness in my hands and feet, periods of flu-like illness and diagnosed Raynaud's syndrome as well as psoriasis. My ANA was "slightly positive" during my pregnancy two years ago but other bloodwork showed nothing. I am frightened that my Dr. is being unduly resistant to the idea of Lupus. What further tests would rule out/confirm this disease?
Thank you for your time. I am a 31 year old mom in need of some help.
-M.C.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Oct 11, 2004 12:00AM
Without examining you and taking your history I cannot make an accurate diagnosis. I am not sure how the cervical radiculitis diagnosis was established. However, if the only abnormality is in your left arm, then a diagnosis of ALS cannot be made. I am not a rheumatologist, who specializes in Lupus, but it would be unusual to have a negative sed rate and active lupus. There are other auto-anitbodies which can be checked. They include anti-nuclear, anti-double stranded DNA, and anti-smith to name a few. Perhaps a consultation with a rheumatologist would be good. You should also discuss with the neurologist the change in your muscle symptoms. Good luck.
Head, Face, Neck
Unexplained hair loss
Headaches, mild or severe
Twitching of facial or other muscles
Facial paralysis (Bell's Palsy)
Tingling of nose, cheek or face
Stiff or painful neck or creaking
Jaw pain or stiffness
TMJ – sudden onset
Sore throat
Loss of sense of taste
Difficulty Swallowing
Eyes/Vision
Double, blurry or dim vision
Increased floating spots
Pain in eyes, or swelling around eyes
Over sensitivity to light
Flashing lights
Optic neuritis
Ears/Hearing
Decreased hearing in one or both ears
Buzzing or clicking noises in ears
Pain in ears or sound sensitivity
Ringing in one or both ears
Pressure or feeling of fullness in ears
Digestive and Excretory Systems
Diarrhea
Constipation
Irritable bladder (trouble starting, stopping)
Frequent urination that is not normal
Upset stomach (nausea or pain)
Musculoskeletal System
Joint pain or swelling or tenderness
Stiffness of joints, back, neck
Muscle pain or cramps
Bone pain
Respiratory and Circulatory Systems
Shortness of breath, cough
Chest pain or rib soreness
Night sweats or unexplained chills
Heart palpitations or extra beats
Heart blockage
Neurological System
Tremors or unexplained shaking (especially at night)
Burning or stabbing sensations in the body
Weakness or partial paralysis/stroke-like symptoms
Pressure in the head
Numbness in body, tingling, pinpricks
Poor balance, dizziness, difficulty walking
Increased motion sickness
Lightheadedness, wooziness
Sudden jerking of fingers or entire limbs
Psychological well-being
Mood swings, irritability, rage
Unusual depression
Disorientation (getting or feeling lost)
Feeling as if you are losing your mind
Overemotional reactions, crying easily
Too much sleep