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Neurology (Expert Forum)
Possible MS?
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
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
Possible MS?
by RamsInfiniti, May 07, 2008 09:24AM
Hello. I am a 28 y/o male and definitely worried that I might have a major neurological issue. I know that my problems don't seem to be near as problematic as some of the people posting here, but I am still concerned ...
I am relatively healthy, but have gained about 60 lbs over the past 3 years and my exercise level has decreased ...
About one month ago, I developed parathesias in both hands and feet, followed by muscle weakness on the right side two weeks later. The muscle weakness is not a typical type of thing, as it like a dull aching pain in my neck, shoulder, arm, hand, and right leg. More like a burning fatigue type sensation. Not having any vision problems or any problems with clumsiness or decrease cognitive abilities ....
I seem to be alot better at rest. The paratheisas and pain begin when I am active in just about anyway. Heat does not seem to make it worse. Had an MRI done on the neck, and there were no problems. I am really worried here ....
I am relatively healthy, but have gained about 60 lbs over the past 3 years and my exercise level has decreased ...
About one month ago, I developed parathesias in both hands and feet, followed by muscle weakness on the right side two weeks later. The muscle weakness is not a typical type of thing, as it like a dull aching pain in my neck, shoulder, arm, hand, and right leg. More like a burning fatigue type sensation. Not having any vision problems or any problems with clumsiness or decrease cognitive abilities ....
I seem to be alot better at rest. The paratheisas and pain begin when I am active in just about anyway. Heat does not seem to make it worse. Had an MRI done on the neck, and there were no problems. I am really worried here ....
Doctor's Answer
by Lama Chahine, MD, Jun 11, 2008 02:52PM
, Jun 11, 2008 02:52PMTo: RamsInfiniti
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
It sounds like you have been having several symptoms, including weight gain, decreased energy, parasthesias in the hands and feet, and right-sided weakness. It sounds like your symptoms worsen after exertion.
Without the ability to take a full history and examine you, I can not assess whether or not you have multiple sclerosis. However, I will give you some more information about it and how it is diagnosed. Other conditions that cause weight gain, muscle aching, and easy fatigability include thyroid problems and depression, among several others.
Multiple sclerosis is a disease that primarily affects the central nervous system (brain, spinal cord, nerves from the eye, the optic nerves). Symptoms may be mild to severe, ranging from tingling and numbness to paralysis. In patients with MS there is a phenomenon whereby exertion, over-heating, or illness may make already-existing symptoms or deficits worse.
MS is thought to be autoimmune, meaning that the body's own immune system attacks myelin, the substance that surrounds nerves fibers and protects them.
MS is more common in women than in men, and can (but does not necessarily) run in families.
There is not one test alone or one symptomt hat can diagnose MS, but there are well-established criteria that help neurologist make the diagnosis. These include taking a thorough history, doing a thorough physical exam, conducting an MRI of the brain and sometimes the spine, and sometimes ancillary testing such as lumbar puncture and evoked potentials.
When a neurologist is considering the diagnosis of MS, the criteria he/she may use include (1) evidence of damage in at least two separate parts of the central nervous system (CNS) (2) lack of another explanation for the damage (3) specific MRI findings (4) specific findings on CSF (fluid taken from around the brain/spine through a procedure called lumbar puncture) (4) results of visual evoked potentials (a test of how the nerve from the eye, the optic nerve, is functioning.
Again, I can unfortunately not tell you whether or not you have MS, but seeing a neurologist to obtain a history and full physical examination may help you with your symptoms and may lead to a diagnosis.
I hope I have answered your questions, good luck.
It sounds like you have been having several symptoms, including weight gain, decreased energy, parasthesias in the hands and feet, and right-sided weakness. It sounds like your symptoms worsen after exertion.
Without the ability to take a full history and examine you, I can not assess whether or not you have multiple sclerosis. However, I will give you some more information about it and how it is diagnosed. Other conditions that cause weight gain, muscle aching, and easy fatigability include thyroid problems and depression, among several others.
Multiple sclerosis is a disease that primarily affects the central nervous system (brain, spinal cord, nerves from the eye, the optic nerves). Symptoms may be mild to severe, ranging from tingling and numbness to paralysis. In patients with MS there is a phenomenon whereby exertion, over-heating, or illness may make already-existing symptoms or deficits worse.
MS is thought to be autoimmune, meaning that the body's own immune system attacks myelin, the substance that surrounds nerves fibers and protects them.
MS is more common in women than in men, and can (but does not necessarily) run in families.
There is not one test alone or one symptomt hat can diagnose MS, but there are well-established criteria that help neurologist make the diagnosis. These include taking a thorough history, doing a thorough physical exam, conducting an MRI of the brain and sometimes the spine, and sometimes ancillary testing such as lumbar puncture and evoked potentials.
When a neurologist is considering the diagnosis of MS, the criteria he/she may use include (1) evidence of damage in at least two separate parts of the central nervous system (CNS) (2) lack of another explanation for the damage (3) specific MRI findings (4) specific findings on CSF (fluid taken from around the brain/spine through a procedure called lumbar puncture) (4) results of visual evoked potentials (a test of how the nerve from the eye, the optic nerve, is functioning.
Again, I can unfortunately not tell you whether or not you have MS, but seeing a neurologist to obtain a history and full physical examination may help you with your symptoms and may lead to a diagnosis.
I hope I have answered your questions, good luck.
Since then I've had:
Stiffness in both wrists
Feelings of tension in my forearms
Sharp tingling patches on my inner forearms and underneath my wrists
Stiff ankles and minor stifness in my upper calves from time to time
Feelings of weakness in my neck as the day goes on
Reduced ability to focus in my right eye (the extent changes constantly)
There are other symptoms but I think I can put those safely down to anxiety. On thinking back though, I realised I'd had a couple of minor attacks of Nystagmus in the past year, but always under exactly the same circumstances - it's late, I'm working on the computer, and the brightness of the screen triggers a left-right motion in my sight. Looking away stops it instantly.
At the moment I'm extremely worried that this might be MS, moreso because it came on so quickly and the symptoms have been more or less present since day one. Unfortunately my doctors seem remarkably unsympathetic, and the moment I said it was worrying me, stress became the number one candidate...
Stiffness in both wrists - only left
Feelings of tension in my forearms -left side
Sharp tingling patches on my inner forearms and underneath my wrists - left
Stiff ankles and minor stifness in my upper calves from time to time - left leg.
I am worried about MS aswell. I am f/26 and in good health. Keep me posted on ur progress. I hope everything works out ok.
I got back home and started feeling like ****. Makes me wonder if I am not having severe anxiety problems. I have always had anxiety issues, problems with sweating alot in even the slightest of tense situations. I've had alot going on lately, and I wonder how much that is contributing to my problems ...
Other than that, no other significant news. I might go back to my GP and see if he'll run some tests for Lyme, Lupus, etc ....
My GP had X-Rays done (didn't show much - just a little degeneration, quite normal for a middle-aged lady) then sent me for nerve-conduction studies (that checked out) and finally, on to a neurologist who ordered MRIs of my brain, cervical spine, thoracic spine, & lumbar spine.
The first thing the neurologist told me after he'd read my MRIs was "No Lesions