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Should I be reassured? MS symptoms and normal exam
Hi all - I am finally posting to this forum after a couple weeks of vigilant reading.
I gave birth to a beautiful baby 6 weeks ago - no epidural or medical intervention at all. At 2 weeks postpartum, I developed a rash from neck to ankles that resolved in a week - dermatologist said this was an "autoimmune process" but she reassured me that it was a common problem that doesn't have long term sequelae.
Then, things were wonderful until about 1 week later (3 weeks postpartum) when I began experiencing a variety of symptoms: numbness and tingling of both hands, followed by sunburn-like pain (no skin change) on the back of my left neck, arm and forearm. The tingling and burning then occurred in my right foot and has eventually spread to the entire back of my neck, both arms, and midway down my back. These symptoms vary in intensity but are present everyday for most of the day. I also have some significant but less persistent burning on my thighs, sides of thighs, front of neck, palms. All symptoms are worse at night and interfere with my sleep. Sometimes in the day, I am unable to sit still because of the discomfort. Again, the skin is not red or even particularly sensitive.
Labs have all been normal including thyroid panel, B12, ANA, folate, CBC, RF, CRP, ESR, vitamin D, electrolytes. The only slight abnormality was an elevated ASO Ab (265, should be <200) which I don't think explains this. I have a history of postpartum thyroiditis that resolved after my first child was born without treatment. Otherwise, no medical conditions or medications. I am anxious about my symptoms but not depressed. I did not have anything like this with my first child.
I have visited two PCPs (insurance issue) that both said they suspect MS. One went as far as to say a 50% chance.
Finally yesterday I saw an MS expert at an academic medical center. He gave me a very thorough neurological exam, which he said was "perfect". He said that my symptoms are a postpartum phenomenon that will go away with time. He did not think I needed an MRI or should have any reason for concern. While this should possibly be relieving, I have spent the past few weeks believing I have MS and his answer feels dismissive and unsatisfying.
My questions for your wonderful group:
1 - do my symptoms seem suggestive of MS?
2 - how reassuring is a "perfect" physical exam?
3 - would an MRI be indicated and should I push for it?
4 - other ideas?
Thanks in advance!
I gave birth to a beautiful baby 6 weeks ago - no epidural or medical intervention at all. At 2 weeks postpartum, I developed a rash from neck to ankles that resolved in a week - dermatologist said this was an "autoimmune process" but she reassured me that it was a common problem that doesn't have long term sequelae.
Then, things were wonderful until about 1 week later (3 weeks postpartum) when I began experiencing a variety of symptoms: numbness and tingling of both hands, followed by sunburn-like pain (no skin change) on the back of my left neck, arm and forearm. The tingling and burning then occurred in my right foot and has eventually spread to the entire back of my neck, both arms, and midway down my back. These symptoms vary in intensity but are present everyday for most of the day. I also have some significant but less persistent burning on my thighs, sides of thighs, front of neck, palms. All symptoms are worse at night and interfere with my sleep. Sometimes in the day, I am unable to sit still because of the discomfort. Again, the skin is not red or even particularly sensitive.
Labs have all been normal including thyroid panel, B12, ANA, folate, CBC, RF, CRP, ESR, vitamin D, electrolytes. The only slight abnormality was an elevated ASO Ab (265, should be <200) which I don't think explains this. I have a history of postpartum thyroiditis that resolved after my first child was born without treatment. Otherwise, no medical conditions or medications. I am anxious about my symptoms but not depressed. I did not have anything like this with my first child.
I have visited two PCPs (insurance issue) that both said they suspect MS. One went as far as to say a 50% chance.
Finally yesterday I saw an MS expert at an academic medical center. He gave me a very thorough neurological exam, which he said was "perfect". He said that my symptoms are a postpartum phenomenon that will go away with time. He did not think I needed an MRI or should have any reason for concern. While this should possibly be relieving, I have spent the past few weeks believing I have MS and his answer feels dismissive and unsatisfying.
My questions for your wonderful group:
1 - do my symptoms seem suggestive of MS?
2 - how reassuring is a "perfect" physical exam?
3 - would an MRI be indicated and should I push for it?
4 - other ideas?
Thanks in advance!
Still, the MS specialist saw no cause to follow up. Have you considered asking a dermatologist?
Thank you so much for your detailed insight!
However, I do want to clarify that this is not at all skin sensitivity. No touch, temperature, cream, other sensation, or anything seems to affect it. The appearance and feel of the skin are completely unaffected by anything external. It feels like a deep sunburn that really just feels neuropathic (ie, not skin or muscle).
However, I do want to clarify that this is not at all skin sensitivity. No touch, temperature, cream, other sensation, or anything seems to affect it. The appearance and feel of the skin are completely unaffected by anything external. It feels like a deep sunburn that really just feels neuropathic (ie, not skin or muscle).
COMMUNITY LEADER
Hi and welcome,
Congratulations on the beautiful addition to your family, I am sorry this situation is otherwise interrupting such a joyous time in your life but I personally don't think MS would be the most likely culprit, because you definitely had an extensive rash prior to anything else. In a short space of time, whilst your sx's continue to be sensory they have spread and post post-partum skin rashes and sensitivities are not uncommon.
1 - do my symptoms seem suggestive of MS?
A - No, as mentioned above sensory sx's are not unusual during late stage pregnancy or post-partum, which would seem a more likely cause than MS. MS doesn't present with a rash, typically sx's do not spread or in a short time frame include additional areas of the body etc
2 - how reassuring is a "perfect" physical exam?
A - Very reassuring i'd say, because MS is suppose to be a clinical dx, and the test evidence supportive evidence of the clinical findings, so if you have no neurological clinical signs, I would have to believe that is great news.
3 - would an MRI be indicated and should I push for it?
A - There are many causes of sensory sx's and without anything to suggest there is a neurological problem, i can't see there would be a reason to do an MRI.
4 - other ideas?
If you google post-partum rash or skin sensitivity, you will find many discussions and articles related to the topic, you might find something informative reading through other women's skin experiences shortly after giving birth. I have a child with skin allergy's to everyday products, so I would probably be considering if my diet, bathing or hair products, washing powder etc was possibly causing an allergic reaction or irritation to sensitive skin.
I personally would not be concerned about MS at all, what you have described you are experiencing is, from my understanding, not very suggestive of disease and more suggestive of post-partum sensory issues and that is what 'I' would be focusing on to find some relief of the sx's.
Cheers...........JJ
Congratulations on the beautiful addition to your family, I am sorry this situation is otherwise interrupting such a joyous time in your life but I personally don't think MS would be the most likely culprit, because you definitely had an extensive rash prior to anything else. In a short space of time, whilst your sx's continue to be sensory they have spread and post post-partum skin rashes and sensitivities are not uncommon.
1 - do my symptoms seem suggestive of MS?
A - No, as mentioned above sensory sx's are not unusual during late stage pregnancy or post-partum, which would seem a more likely cause than MS. MS doesn't present with a rash, typically sx's do not spread or in a short time frame include additional areas of the body etc
2 - how reassuring is a "perfect" physical exam?
A - Very reassuring i'd say, because MS is suppose to be a clinical dx, and the test evidence supportive evidence of the clinical findings, so if you have no neurological clinical signs, I would have to believe that is great news.
3 - would an MRI be indicated and should I push for it?
A - There are many causes of sensory sx's and without anything to suggest there is a neurological problem, i can't see there would be a reason to do an MRI.
4 - other ideas?
If you google post-partum rash or skin sensitivity, you will find many discussions and articles related to the topic, you might find something informative reading through other women's skin experiences shortly after giving birth. I have a child with skin allergy's to everyday products, so I would probably be considering if my diet, bathing or hair products, washing powder etc was possibly causing an allergic reaction or irritation to sensitive skin.
I personally would not be concerned about MS at all, what you have described you are experiencing is, from my understanding, not very suggestive of disease and more suggestive of post-partum sensory issues and that is what 'I' would be focusing on to find some relief of the sx's.
Cheers...........JJ
I agree that the PCP can order an MRI. The question then becomes who will interpret the results? MS can be a difficult DX, even for MS neuros.
Kyle
Kyle
Your primary doctor can do a referral for an MRI. The doctor thought I was fine at first too, until the mri.. If the problems keep going and you are uncomfortable, trust yourself and your body.
Prayers!
Prayers!
Hi Liddy - Welcome to the forum!
I'm not a doctor, nor am I a woman. I have no idea of the impact of pregnancy and child birth has a a woman's body.
Now disclaimed, I agree with Alex. MS is first and foremost a clinical diagnosis. I would not necessarily trust the clinical diagnosis of a regular neuro, but you saw an MS specialist. There are things they are trained to detect that we wouldn't even notice. He seems confident that it's not MS.
You are only 6 weeks out from the delivery of your baby and 4 weeks from the first symptom. I would allow your body time to reset itself before pushing for an MRI. If your symptoms have not resolved in 6 months, then perhaps another discussion with the MS doc would make sense.
Just one man's (literally) opinion.
Kyle
I'm not a doctor, nor am I a woman. I have no idea of the impact of pregnancy and child birth has a a woman's body.
Now disclaimed, I agree with Alex. MS is first and foremost a clinical diagnosis. I would not necessarily trust the clinical diagnosis of a regular neuro, but you saw an MS specialist. There are things they are trained to detect that we wouldn't even notice. He seems confident that it's not MS.
You are only 6 weeks out from the delivery of your baby and 4 weeks from the first symptom. I would allow your body time to reset itself before pushing for an MRI. If your symptoms have not resolved in 6 months, then perhaps another discussion with the MS doc would make sense.
Just one man's (literally) opinion.
Kyle
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