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279234 tn?1363105249

I've Been A Bad Girl: Venting On A Neuro From Another Forum

As many of you know, I'm a resident of Limboland. I have researched, and researched, trying to find out what the heck I have, and it all comes back to MS. Several of my doctors believe I have it, but so far I have no neuro standing beside me on this one. Recently, I started to research Parkinson's Disease because my aunt was just diagnosed. I thought maybe, I could have this, since some of the symptoms overlap. Comparing the 2 diseases, MS was a closure match, at least from my perspective, but I'm no doctor.

I went on another forum to get a perspective from a doctor that deals with Parkinson's Disease and neurological disorders. I gave him the run down of some of my symptoms, and this is when my temper flared, the horns came out, and I guess the little devil in me still exist. Here is the back in forth conversation...This is the reason why us limbolanders can't get a break. This is what they teach, rather than listening. What do you think?

"Anon_7154 posted:
I am a 36 year old female. I am a mother of 3 and I have been happily married for almost 14 years now. The problem is, I have what the doctors are calling a neurological condition, but they do not, or can not give me a name to what is going with me.

It started in 2007 and I have gradually gotten worse. My left side is mostly effected. My symptoms are left side spasticity, left sided weakness, on & off symptoms of left sided eye muscle weakness (which sometimes cause double vision and a noticeably deviation), bladder incontinence issues, bladder spasms, a slight tremor in my hands when doing things, sexual disfunctions..etc.

I walk with a limp, because my left ankle will no longer bend completely up or completely down. I sometimes have to use a cane because my muscles will give out quickly with long use. My GP believes I have MS, and so does several other doctors. I have been tested and re-tested for MS mimics, heavy metals, vitamin deficiencies, and nothing has came up.

I have an abnormal neuro exam (hyper-reflexes), numbness, etc..The only thing that the doctors have found were 4-5 non specific lesions in the white matter of my brain and a vitamin D deficiency. My neuros are at a loss. They are right now just treating my symptoms. I'm on Baclofen for the spasticity, and Neurotin for the pain, and vitamin D.

What should I do when my doctors can't find the answers and I see a decline in my health? I went from walking normally in 2007, to walking with a limp in 2008, to needing a cane. I went from eye muscle weakness in 2008 that I could only see, to eye muscle weakness that everyone could see.

I would like any suggestions that you could give me on this matter. I did go to an MS specialist, but he said he could not diagnose based on my MRIs. I always thought that MS was a clinically diagnosed disease and not based off of MRIs since they can not see everything. All I want is a diagnosis, and maybe some treatment, for whatever this is. "

His Answer: A Duke Neurologist
Dear Anon_7154,
I am sorry to read of your difficulties. Please know that, while not finding any abnormalities is frustrating, it suggests that it is possible for you to recover.

Neurology is a medical specialty that concentrates on finding a location in the nervous system to explain medical symptoms. Determining one anatomic location to explain all of your symptoms is difficult. In these instances trying to localize one major symptom is a reasonable step. Left sided weakness in the leg (only) may be from a problem in the spinal nerve root, spinal cord, brainstem or brain. Imaging with MRI and a test called an EMG/NCV will help. If your weakness also involves the arm, an EMG/NCV and spinal imaging below the neck is not needed. Spasticity suggests an increase tone in the limbs, and is associated with what we call an "upper motor neuron" problem. These tests will also help with that. I do not put much importance on the increased reflexes - unless they are greater on one side than the other, and numbness is not something that really helps with a work-up. Your doctors may wish to do a spinal tap.

The bladder dysfunction you describe usually requires both sides of the brain to be involved, so successful treatment is more likely to be found with a urologist. Ask for a referral.

Sexual dysfunction and a slight tremor are more likely to be a result of stress from your medical problems or other factors.

Intermittent double vision would occur from a rare disorder that does not fit with your other symptoms. Ask your neurologists if they have ruled out Myasthenia Gravis. I am confident they have done so.

Please know, that if all of this has been done, it is likely that there will not be an easy diagnosis. Also, please know that I do not wish to offend you or any other reader, but in some cases these multiple, unexplainable neurological symptoms stem from childhood abuse. If this is the case I am sorry, but it is important to discuss this with your family and your doctors. You have no blame for those incidents. If there are none of these issues, it may still be a stress related illness, and it is important to ask your doctors if they think this is the case


My Reply:
My doctors have ran the test you have suggested, and they have ruled out MG.

My sexual dysfunction and tremor, in my opinion, is not due to stress from my medical problems. When I get a tremor in my hand, it is when I am reaching for an object, or putting on make-up, playing guitar, etc..This is when the tremor happens.

My sexual dysfunction consist of, lack of sensation, or less intensity when having the big "O". This has in turn, given me a lack of interest, but I still make love to my husband because I want to make him happy.

I assure you that I had a happy childhood, and I am currently happy , despite my health conditions. The problem with dealing with doctors over these last 3 years is, if they can't find the hard evidence through MRIs, LPs, etc..they then tend to blame your mental status. They want to say that there must be something wrong with you mentally, or you have stress. They do this, or assume this, without even knowing your history(mentally). To me, this is wrong.

I'm not saying that stress can't cause things to go wrong in ones body. Everyone, to me, has certain levels of stress in everyday life, but I assure you that my stress levels are controlled and I am a happy-go-lucky person. Life is too short to stress over things you can't control.

My problem is, that I have several doctors, my GP, opthamologist, urologist, that say that my symptoms do fit with MS. My local neuro has said the same thing. My local neuro has perform an EMG and said that my slight foot drop must be coming from the central nervous system since I passed the EMG with flying colors.

My understanding of MS, according to the MS society, is that it is a clinically diagnosed disease and not everyone has a positive MRI, but they still can be diagnosed. 5% can present without a positive MRI. Why couldn't I be that 5%? In the meantime, while my doctors are debating, my health status is declining, without treatment.

My doctors have already cleared me as far as my mental status, by the way. I'm not offended by your suggestions, but I think too many doctors are thinking this way, rather than listening to their patients. To me, all this does is confuse the patient, and delay a diagnosis when a neurologist plays psychiatrist.
    



    

12 Responses
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572651 tn?1530999357
Hi Bio - actually we have had several members be questioned about their childhood by psychiatric experts (and some neuros) - probing for the trauma that causes these people to have this disorder........  pretty sad, isn't it?  - L
Helpful - 0
378497 tn?1232143585
OMG. Child abuse? That's a new one.

Bio
Helpful - 0
279234 tn?1363105249
My local neuro could diagnose, if she wanted to. I think the whole issue, is those non specific lesions that I have.  I have 4-5 lesions in the centrum semiovale superiorly, in the subcortical area, measuring 2-3mm, and they have issues with them being that small, and the fact that they are non specific ( I guess that means they can't determine what caused them by there size, shape, etc..) My opinion about this whole mess is, they've eliminated everything, and by everything, I mean everything you could possibly think of, so why couldn't they diagnose based on my history, abnormal exam, and my somewhat abnormal MRI. That's what I don't get.

I've been told by my local neuro, they are waiting for something to change on my MRI. My issue with this is, that the MRI can't see everything, especially in the spine, and that is where I think most of my issues are.

My aunt was also just recently diagnosed with Parkinson's, and I have read about the difference in tremors. Essential tremors can come from different sources. The most common one with Parkinson's Disease is the "Resting Tremor". This tremor will show a “pill-rolling” action of the hands that may also affect the chin, lips, legs, and trunk, can be markedly increased by stress or emotions. An Essential Tremor can be caused by many factors, and can run in families. Essential tremor is not associated with any known pathology, but I've read the ET tremors can be apart of Parkinson's Disease as well. The one that is most common with MS, is the Intentional tremor. This tremor is a slow, broad tremor of the extremities that occurs at the end of a purposeful movement, such as trying to press a button or touching a finger to the tip of one’s nose.

I think in my opinion, (but I'm no doctor) sounds more like the Intentional kind. I totally agree is was an idiot. :-)
Helpful - 0
848718 tn?1257138801
Wow! Well, I'm glad that although this guy pissed you off (and rightfully so!), he didn't dampen your spirits. You're among the lucky ones to have good docs in your corner (even if they don't have the expertise to diagnose MS for sure).

Just curious -- if your local neuro thinks it's MS, why hasn't s/he diagnosed it? It doesn't *have* to come from an MS expert, does it?

My neuro -- who is an idiot so I don't know that she knows anything about essential tremors either -- says that it's tremors during movement/activity that are labeled essential tremors. She claims the more "important" ones, like the ones that get you diagnosed with Parkinson's and such, are the ones that happen when you're at rest. Although she said there was no link between essential tremors and eventually developing Parkinson's, I've seen some studies cited on websites that say that early Parkinson's is often initially diagnosed as essential tremors. I share that simply because it's something of interest to me since I apparently have essential tremors and my father was recently (last year) diagnosed with Parkinson's.

Hang in there! And trust your instincts -- that guy was definitely an idiot. :-)
Helpful - 0
279234 tn?1363105249
I thought you guys/gals might like to see what some specialist out there are thinking. It's funny how they jump from medical to psychological in one fast swoop. I think they should stick to their jobs (neurology) and leave the psychiatry to those specialist.

I thought for a minute, maybe I just didn't explain myself correctly, or something on that lines, and that's why he turned and analyzed everything piece by piece. I have so many symptoms, but I only listed the worse and most bothersome. My neuro exam is abnormal, but it's not just hyper reflexes. I can't walk a straight line, my finger starts to shake when I try to do the finger to the neuro's finger test, I can't stand on one leg or hop, I can't do the close your eye test without swaying etc.

My tremor happens when I'm in motion, trying to do fine motor skills (that's how I like to refer to it). When I'm applying eyeliner, I need a steady hand. My hand will start to shake, uncontrollably, the closure I get to my eyelid where I want to apply. It's not shaking until I get to the eyelid. Now I've applied eyeliner to my eyes practically all my life, and at this time, I'm not thinking of my medical issues, I just want some dang eyeliner on DUH!.

supermum_ms- LOL You have to watch making me laugh like that. I have a prolapsed bladder, and I just might pee my pants..Oops I think I just did! Just kidding , but really that was too funny:) I was a little polite in a since, because I figured if I said what I wanted to say to him, and believe me, I had several choice words, this would just add to his theory that I was stressed/ depressed and my symptoms were from that. I decided to fight with what I knew to be true. I through some knowledge back at him, letting him know he wasn't dealing with someone that didn't know some things, and I wanted to let him know that he was not doing his job and playing another.

doublevision1- I'll check with my neuro in June and see if this was done. I've had 2 EMGs. One by a previous doctor, and one performed by my current neuro (she also has a sub specialty in EMG). I know this last one hurt and I actually had bruises from the procedure, but everything was not even close to being borderline, from what she said. Her comment to the whole thing was..it must be coming from the central nervous system, but I'll check and see.
Helpful - 0
382218 tn?1341181487
Just thought I would add that the blood test to detect MG can produce false negatives especially early on in the disease when antibodies are not yet present/detectable.  I have read that a 'single fibre EMG' test is often most sensitive in detecting MG, following a normal 'standard' EMG.  

Check out:
http://www. womenshealth .gov/faq/myasthenia-gravis.cfm#e

Might be worth a discussion with your neuro.  

I learned a bit about this a few years ago when MG was one possible explanation for my symptoms, which turned out to be due to MS.  Among other things, I have had the same double vision/eye muscle weakness as you describe.
Helpful - 0
987762 tn?1671273328
COMMUNITY LEADER
Hmmmmm, if you were being a bad girl you were rather polite, more than i would of been, i thought you sounded calm but i can imagine steam coming out your ears lol!

It sort of sums up stupidity quite nicely, that leap at the end was the clincher, he's definitely suffering from D.U.M.B and i hope he gets help soon. He did show his ignorance early on, attributing sx to different problems when everything you mentioned clearly fits MS, thats like saying its a girl but she's got a penis, so lets ignore that abnormality cause it doesnt fit with my dx.

Oh and this little pearl (not) "while not finding any abnormalities is frustrating, it suggests that it is possible for you to recover." I know a women who 'just' had migraine (no such thing as just, idiots) it took 3 years for her brain tumor to show its self and her family miss her. Ignorance with a medical lisence is dangerous to your health!

Cheers.......JJ
Helpful - 0
147426 tn?1317265632
and to quote the beloved Colonel Potter "Oh, horse hockey!"

Well, this is scary.  This man knows little about MS or the big MS Mimics of Sjogren's, Neurosarcoidosis, Lyme (and on-and-on).  When symptoms do NOT fit with a single anatomic location a physician's thoughts should NOT move to conversion disorder (or PSTD from childhood abuse) but to those known neurologic disorders that hit many different areas of the brain at a time.  Sheeesh!  Boy is he going to miss every case of MS that comes by.  This is too bizarre.  It probably does belong in Lies My Neuro Told Me.

Urinary problems come from damage to both side of the brain.  Well, yes, they can.  They can result from damage to anywhere along the very complex neural chain or areas that control urination.  They are FAR more likely to result from spinal cord lesions.

Double vision can result from many lesions involving the three cranial nerves that move the eyes (III, IV, VI) from lesions in or between the optic nuclei.  MG - Myasthenia Gravis is another disease that can do this, not the only one or the most likely, given your symptoms.

Well, I guess all you did was waste your time and uncover another neurologist who is woefully undereducated.  I think that he may have taken the "nonspecific lesions" and equated them with a "negative MRI".  What nonsense!  As you know, that very mistake is what delayed my diagnosis for 2 years.  If you take the "classic MS MRI" you can point to lesions all over that, taken alone would be "nonspecific" or atypical of MS.  Does that mean that those lesions are not part of the disease?

Man, my diagnosing neuro was thrilled to find my measely, nonspecific UBO!  He knew I had MS, and only wanted to see a single lesion that was consistent.

Sorry for the aggravation.

Quix
Helpful - 0
293157 tn?1285873439
well, this doesns't really surprise me.... wow... add this one to the book.
take care and hope you find answers soon
wobbly
Helpful - 0
984138 tn?1359813073
i dont belive he said childhood abuse could cause these things  if that was the case probably half of america would be walking around wobbly,shaking and with limps! no one has a perfect life!..i could see how stress could cause some/ like tremoring ( i tremor worse when im stress but also tremor and twitch when im perfectly fine) i was prescribed proponal when i was 17 like he said for the tremor because it was extreme head tremor snd only took it for about 6 months then i stopped and it was gone for about 6 yrs then came back when i relapsed but left in 3 mnths...

I wish u the best and hope you find that one doctor that will listen and wants to look into it  I believe thats the hardest part not just find a good rated doctor but finding one that actaully WANTS to look into it and is interested in finding the answers...keep fighting like you are and dont settle just always remember there is that one doctor out there and it may just take awhile but i pray you will get there sooner then later!
Helpful - 0
562511 tn?1285904160
Most of his statements should be added to the Lies My Neuro Told Me.

What a load of horse manure.  

Helpful - 0
279234 tn?1363105249
His final Reply:
Dear Anon_7154,
I am sorry that no one has found an explanation for your neurological symptoms. I also apologize if you perceived me to be playing a psychiatrist, and would like to jump back to my very first statement: "while not finding any abnormalities is frustrating, it suggests that it is possible for you to recover."


As for my Neurological suggestions: the tremor you describe in your last note is most likely an enhanced physiological tremor or Essential Tremor (ET). ET is typically an action tremor that often runs in families, and may be treated with primidone or propranolol, among other medications. Some patients report marked improvement with a small amount of alcohol - half a glass of wine or so. For more information, you might want to look at the International Essential Tremor Foundation website.


One last suggestion: Consider an appointment with an MS Society recommended Neurologist. If you make an appt., take all of your records. This may help lead to a firm diagnosis or allow you and your family to no longer worry about your symptoms resulting from MS.
Helpful - 0
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