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Neurology (Expert Forum)
Left Sided Difficulties
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Left Sided Difficulties
by Compulibrarian, Jun 03, 2006 12:00AM
I'm a forty two year old female. I have hypertension, GERD and hypothyroidism. I developed left sided numbness and a protuding artery in my forehead some months ago. The artery pops in and out and the numbness comes and goes. I was sent for a Brain MRI and CT scan of the sinuses. THe CT came back normal. The Brain MRI had a venous angioma, a nodule of unknown origin, spinal fluid and some scar tissue. The dr. seems to think the angioma was the cause of my problems. Then the artery popped out and I was sent for an MRA they found what they thought was an aneurysm then I was sent to confirm and now its not. All of the tests for MS have come back normal except I know have to have the Visual Evoked response. Also, my ANA is only very slightly elevated. As is my kidney function. My question is should I have them pursue Lupus I do have joint pain from time to time, or simply go and take the Visual test because the neurologist doesn't think its MS. Since the first MRI I have sprouted another nodule, but they want to wait six months to check it again. Does the ANA increase slowly over time or does it go up and down? Also, do you think its worth it to take the Visual Test since all the MS tests are coming back normal. Sorry this is long. Thanks for your help
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jun 11, 2006 12:00AM
Unfortunately I cannot make many specific comments about your case, there are too many things I do not know about your condition and tests
Numbness that is localized right underneath a blood vessel could be from local irritation of that area. Numbness that is on the oppiste side of the body to a brain lesion could be from that brain lesion or a seizure triggered by that brain lesion. In the case of a possible seizure, an EEG might be indicated.
A slightly elevated ANA is usually not significant, and does not indicate Lupus. Other antibody tests are more specific for Lupus. These tests are very likely to be negative if you have no signs and symptoms suggestive of lupus (called the pre-test probability of the test). Numbness and joint pain alone is not very specific for lupus. ANA does not usually change much over time, in the elderly it can be falsely positive purely due to old age.
A visual evoked potential is sensitive to optic nerve dysfunction that can occur sometimes in MS. It is just one part of the diagnossi of MS, and even if positive and there were no other signs of MS, this would not make the diagnosis.
Good luck
Numbness that is localized right underneath a blood vessel could be from local irritation of that area. Numbness that is on the oppiste side of the body to a brain lesion could be from that brain lesion or a seizure triggered by that brain lesion. In the case of a possible seizure, an EEG might be indicated.
A slightly elevated ANA is usually not significant, and does not indicate Lupus. Other antibody tests are more specific for Lupus. These tests are very likely to be negative if you have no signs and symptoms suggestive of lupus (called the pre-test probability of the test). Numbness and joint pain alone is not very specific for lupus. ANA does not usually change much over time, in the elderly it can be falsely positive purely due to old age.
A visual evoked potential is sensitive to optic nerve dysfunction that can occur sometimes in MS. It is just one part of the diagnossi of MS, and even if positive and there were no other signs of MS, this would not make the diagnosis.
Good luck
