Is MS considered a pyramidal tract problem?

[jameshatesfun]

My Neurologist is under the impression that I have an upper motor neuron problem, because I have hyperreflexia at the level of pyramidal tract disease, tremors, muscle spasms, possible thoracic outlet syndrome as indicated by arm/wrist pain, and a bruit over my right axillosubclavian artery.

Every time I've searched for these things it leads me to believe that my doctor believes I may have MS. Any thoughts or opinions on this?

[jameshatesfun]

Military coverage requires to get all referrals through my PCP. I had to get a referral to a civilian Neurologist, who then requested studies to be done, then had to wait for an appointment with my PCP to request the studies, get studies done then go back to my PCP to get the results of the studies and hand carry them to my Neurologist.

Unfortunately, poor communication between health care providers has limited me in terms of getting all of the studies that the neurologist had requested. My PCP is severely understaffed due to budget cuts and it has been difficult to see him when I need to. My neurologist had requested I get an MRI in June and I wasn't able to get it done until this week.

Thankfully, I will be able to get into see my neurologist right away.

[kwarendorf]

JHF - Does your military coverage require you to get a referl from your PCP before seeing a specialist? Your PCP is ill equipped to diagnose you. He should be willing provide a referral. He cannot help you! if you want to loop him in after the fact OK, but yiur focus should be on your neurologist.

Kyle

[jameshatesfun]

Kyle,

Seems like sound advice to me. To be fair, after five months of dealing with my Primary Care putting up roadblocks, I have been consulting Dr. Google...that's what brought me here, after all :)

I'll be careful and hopefully I just get some answers soon.

thanks for the advice!
James

[kwarendorf]

Hi James-

I would be careful tossing around names like Uhthoff and MS hug when meeting with doctors. Many docs are put off if they think you have been consulting Dr. Google :-) In my opinion you're better off saying that the symptoms you describe to them get worse when your hot.

In my humble opinion, the more they suspect you have been talking with Dr. G, the more likely they are to attribute your symptoms to stress or other psychosomatic cause.

Kyle

[jameshatesfun]

After reviewing common symptoms I did some research on MS Hug. A couple months ago, I had gone to the ER for severe chest pain, but my EKG, Chest XRAY, and lab work were all normal. I had no idea that this could be a symptom related to all the others.

I'll be meeting with my Primary and Neurologist during separate appointments at the end of this week to discuss results from a Head/Neck MRI. I will definitely present them with questions about Uhthoff's phenomenon and MS Hug. Hopefully they can get me in touch with the right doctor to look into ON.

thanks again,
James

[supermum_ms]

I think it would be in your best interest, to get an appointment with a nuero-opthalmologist and get the health of your eyes assessed! Temporarily loosing vision in one of both eyes is a classic sign of optic neuritis (ON), unilateral ON is one of the most common sx's proceeding a dx of MS. Uhthoff's (raise in temperature eg exercising, hot weather, infections) which is also a sign of MS, is a common cause of temporary return of a MSers sx's.

Visual issues associated with MS eg ON, diplopia, nystagmus etc commonly worsen during exercising due to the Uhthoff's phenomenon and remitt once the pwMS has cooled down and rested........the odds of dehydration being the most likely cause, over and above the possibility of it being bilateral ON, when you factor in all your other sx's and clinical signs, would imho be quite low and i really think with vision, it is better to err on the side of causation and get them assessed. What ever the results, it should help towards finding the condition that you are dealing with, so can't hurt in the grand scheme of things.

Cheers...........JJ

[jameshatesfun]

I had gone blind in both eyes, to the point that I had no idea that a coworker I know was there helping me. I don't recall if I felt hot or not. I wasn't sure if this was related to dehydration or not. I went to the ER, but by the time I was seen I had no symptoms.

[Poppy7402]

I see you've commented on going blind after a few minutes exercise - was this in both eyes or just one?  Were you quite 'hot' after this exercise too, as there is a thing called 'Uhthoff's phenomenon' in MS?

[jameshatesfun]

Thanks for responding so quickly. It's taken me several months to get my military doctors to actually order the tests for this, but I finally have a head/neck MRI scheduled; I'm just a little on edge about things due to the process it has been trying to get military medical staff to talk to my civilian provider. Hopefully, I'll have some more answers in the near future.

In some of the notes that I read, the neurologist seemed to think I may be having small strokes or TIA's, I had originally written that off as my doctor exhausting all possibilities; however, a few weeks ago I had an incident where I went blind for 10-15 minutes after light exercise. I am in the military and exercise regularly, this is something that has never happened to me.

It seems like the only thing that we know for certain is that there are problems. Thank you again for taking the time to respond.

[supermum_ms]

Hi and welcome to our little MS community,

I personally don't think your neuro is actually saying anything more, than what he has specifically stated and you know so far. There are many conditions that cause 'similar' sx's as MS and cause both upper and or lower clinical signs but they have a different causation, and without further tests i'd say the cause is yet to be determined. As far as i'm aware, Bruit is associated with vascular conditions and that 'maybe' a clue into it's associated conditions....

Cheers............JJ