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Neurology (Expert Forum)
MS/Lupus?????
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
MS/Lupus?????
by Compulibrarian, Feb 14, 2007 12:00AM
Hi
I'm a 43 year old female and I have had MS type symptoms for over a year. I had a clear LP, my brain MRI shows two hyperintenstities, venous angioma, spinal fluid, and scar tissue. My bloodwork shows no signs of anything. I was diagnosed with BFS ( constant muscle spasms and numbness),complicated migraines, also was told I had an aneuyrsm then told I didn't was told I had MS then told I didn't now told I could possibly have MS. My question is my BUN level was slightly off and I do have joint pain from time to time. Could it possibly be Lupus. When I go into a tanning booth I break out in hives. There is usually only a couple. I have hypothyroidism whichis under control, high blood pressure which is under control and GERD which is under control. I have recently had a few episodes where my speech gets strange either I cant think of simple words or nonsense comes out. The neuro thinks its stress. Could it be mini strokes and is there a test that would tell me if I were having TIAs because he didn't order any bloodwork until April. But my question is since my kidneys are off, my joints pain and are stiff and the "mini stroke" episodes should I see a rheumotologist to see if this is Lupus or should I stay with the neuro and pursue the MS option. I was tested for Lupus and the ANA and SED rate came back high just not high enough that was last year. THank you for your time.
I'm a 43 year old female and I have had MS type symptoms for over a year. I had a clear LP, my brain MRI shows two hyperintenstities, venous angioma, spinal fluid, and scar tissue. My bloodwork shows no signs of anything. I was diagnosed with BFS ( constant muscle spasms and numbness),complicated migraines, also was told I had an aneuyrsm then told I didn't was told I had MS then told I didn't now told I could possibly have MS. My question is my BUN level was slightly off and I do have joint pain from time to time. Could it possibly be Lupus. When I go into a tanning booth I break out in hives. There is usually only a couple. I have hypothyroidism whichis under control, high blood pressure which is under control and GERD which is under control. I have recently had a few episodes where my speech gets strange either I cant think of simple words or nonsense comes out. The neuro thinks its stress. Could it be mini strokes and is there a test that would tell me if I were having TIAs because he didn't order any bloodwork until April. But my question is since my kidneys are off, my joints pain and are stiff and the "mini stroke" episodes should I see a rheumotologist to see if this is Lupus or should I stay with the neuro and pursue the MS option. I was tested for Lupus and the ANA and SED rate came back high just not high enough that was last year. THank you for your time.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 26, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms and story that you present are complex and there is much data that I do not have. Given the two hyperintensities on your MRI and the multiple symptoms that you describe I would suggest a full workup for mutliple sclerosis (MS). I would suggest a repeat MRI of the brain and cervical spine with GAD contrast, lumbar puncture with (IgG index and oligoclonal bands-unless the full panel of this was done on your previous lumbar puncture), and visual evoked potentials (to look for past evidence of optic neuritis)/ somatosensory evoked potentials (to look for functional defecits in your spinal cord).
As far as the 'mini-stroke' episodes, their is no test for TIAs, but they are evaluated by MRI to look for evidence of stroke and if nothing is found and the episode completely resolves, but the event was thought to be vascular it is called a TIA (transient ischemic attack). The traditional definition of a TIA is a focal 'stroke like' symptoms that resolves within 24 hours. However many such episodes will show up on modern MRIs as a stroke. The 'more modern' time frame for TIAs is more on the order of 20 minutes to 1.5 hours. Although there is no test to positively diagnose a TIA, I would suggest the MRI with MRA (magnetic resonance angiogram) to evaluate for strokes and any constricted vessels.
Your concern about Lupus is unlikely to be related to the symptoms that you have described, but I would recommend that you see a rheumatologist to further decipher this issue. A first step would be to test for antibodies against some of the common antigens including double stranded DNA, anti-smith ab, anti-ro, anti-la, etc. Your concern over your kidney function should also be addressed, and I would defer the workup for possible Lupus and Lupus related kidney disease to your rheumatologist.
I hope this has been helpful.
The symptoms and story that you present are complex and there is much data that I do not have. Given the two hyperintensities on your MRI and the multiple symptoms that you describe I would suggest a full workup for mutliple sclerosis (MS). I would suggest a repeat MRI of the brain and cervical spine with GAD contrast, lumbar puncture with (IgG index and oligoclonal bands-unless the full panel of this was done on your previous lumbar puncture), and visual evoked potentials (to look for past evidence of optic neuritis)/ somatosensory evoked potentials (to look for functional defecits in your spinal cord).
As far as the 'mini-stroke' episodes, their is no test for TIAs, but they are evaluated by MRI to look for evidence of stroke and if nothing is found and the episode completely resolves, but the event was thought to be vascular it is called a TIA (transient ischemic attack). The traditional definition of a TIA is a focal 'stroke like' symptoms that resolves within 24 hours. However many such episodes will show up on modern MRIs as a stroke. The 'more modern' time frame for TIAs is more on the order of 20 minutes to 1.5 hours. Although there is no test to positively diagnose a TIA, I would suggest the MRI with MRA (magnetic resonance angiogram) to evaluate for strokes and any constricted vessels.
Your concern about Lupus is unlikely to be related to the symptoms that you have described, but I would recommend that you see a rheumatologist to further decipher this issue. A first step would be to test for antibodies against some of the common antigens including double stranded DNA, anti-smith ab, anti-ro, anti-la, etc. Your concern over your kidney function should also be addressed, and I would defer the workup for possible Lupus and Lupus related kidney disease to your rheumatologist.
I hope this has been helpful.
For SEVERAL years (and I can't stress the SEVERAL enough) my husband has been having bizarre neurological symptoms. They began when we were living in Texas while he was attending seminary. Things have progressed and worsed over the years and we seem to constantly get nowhere with family doc, neurologist, rheumatologist, etc. I am going to list a short summary of the issues and explain what we have been told. If anyone can point me in a direction PLEASE let me know.
1) diagnosed with Fibromyalgia because of consistent body pain
2) began having severe migraines
3) later during the time of a migraine, his right I would close and the right side of his mouth droop (just like Bell's Palsy).
4) after a while of these episodes, ENTIRE right side of body would go numb. Sometimes it will last a day, sometimes a week, sometimes MONTHS.
5) these episodes do sometimes occur immediately after ejaculation.
Family practice doctor has done CT, MRI, Carotid Artery studies, lumbar punctures, etc. All show negative for most major disease.
FP Dr says now "Hemiplegic Migraines" and it is impossible to tell when they are going to come on, cannot treat the hemiparesis once it begins, etc. Neuro says it's not that but doesn't say what it is.
My thoughts, based on HOURS of reading are: MS, Lupus, ALS, or Myesthenia Gravis. His maternal grandfather did have MG.
My husband is actually in the hospital right now with the symptoms. The doctor ordered yet ANOTHER MRI and carotid study. I found a blood test that can be done for MG so I am going to request that they do it while he is in. I will be checking this board tonight and tomorrow so if ANYONE has ANY ideas, similarities, places to begin, etc. PLEASE let me know. As my login says I am a wifeataloss!!!! We are going on 9 years of this and basically getting told NOTHING! And we haven't even used the same doctors this entire time!