Can this mimic MS symptoms?

[clledl3]

In the process of elimination right now. Latest tests include:

MRI of L-spine w/o contrast, w/o comparison. & Chest X-ray (3 seperate occasions of stabbing chest pains. I am/was a healthy 25 yr. old female with no prior heart problems. Don't smoke, drink or do drugs)

X-ray: Normal

MRI Impression: Mild circumferrential disc bulge at L4-L-5 w/o central canal stenosis and mild bilateral neural foraminal stenosis. (I have no back pain. In July for 2 days I had debilitating lower back and hip pain, could barely walk. gone as quick as it came)

Q: Could the 'mild bilateral neural foraminal stenosis' cause: (these sx's have all occurred on seperate occasions. When they're bad, they're bad, when they're mild, I am mostly functional, minus fatigue)

-massive fatigue, shooting nerve pain (R arm), eye pain(3 sep occasions) accomanied by blurred vision which clears up almost entirely, tremors, hyperreflexia(noted by neuro, told was stress), brain fog, headaches, numbness in R arm, urinary urgency and incontinence, constipation, vertigo, legs hurt to touch (at times)....Note: MRI of head-normal, mastoiditis seen(no sx's)

Seeing I don't see my neuro until next month and he said he'd call if anything came back abnormal. i.e. blood tests, x-ray MRI (L-spine), I called his office and asked if we could order that full neck and spine MRI.(as everything else came back normal) Receptionist called back and said neuro said no need for it. I pay him on cash basis b/c he does not accept my insurance...
Q: Should I request to speak with him directly and ask what his plans from here are or should I just collect my things and get a second opinion? If he thinks this is tress-related I'm out the door. Any advice would be GREATLY appreciated.

-Kristin

[clledl3]

MRI of brain is normal (though it wasn't focused on the optic nerve, does this matter?) and I'm hoping the neuro-ophthalmologist can give me some answers. I know that a clear brain MRI is a good sign so that is definitely encouraging. I am fairly certain I will move on to a different neurologist and Chicago is not far so thanks for the heads up!

-Kristin

[COBOB]

This doc seems worried about your l-spine and surgery, so I doubt he deals much with MS patients.  Given the distributed nature of your symptoms and eye complaints I think you should have been referred to a Neuro-Ophthalmologist and sent for a Brain MRI.  In general, brain fog and eye issues with a normal ophthalmoscopic exam mean look in the head (not the lower back.) But that may be just me.

There a plenty of other Neurologists in IL.  Not sure if you are in Chicago or not, but you could always make an appointment with the Neurology Clinic at Rush.  I wouldn't say anything about MS.
Tell then about the dizziness, confusion, and pain and let them figure it out.

Bob

[clledl3]

I sooo appreciate the feedback!

He was sincerely nice, kind of suggested the whole stress issue from the beginning, even told me some people have had surgeries b/c of their "symptoms" and in the end it was all in their heads...how bout that? lol
No, he did not do a full neuro exam.
When I went into more details about and stressed my eye episodes, he looked at them, said my eyes looked fine, but that I could see an ophtho if I wanted (I made an appt. for Jan with a neuro-ophtho).  I didn't really get any definitive answers...at all, I'm kind of a pushover :(

Q: Is there a tactful way to insist upon a spine and neck MRI? Should I request to speak with him directly and ask WHY he feels it isn't needed? Obviously all of my blood work came back normal and my chest x-ray and L-spine aren't the issue. Wouldn't a spine and neck MRI be the next step? Is there anything else I should request?
Sorry for all the Q's, I am just amazed to get answers and I love it!
Thanks again!!

All the best,
Kristin

[Sumanadevii]

Well, I hate to insert myself into this...It is so so out of character for me (lol) but she has two things running against her...age and the fact that she is female.  There are way too many doctors that discount complaints of females putting it off to depression or anxiety.  There are even more that discount young people...after all they are too healthy and young to be ill.

I don't have any more to add.  Cobob sums it up nicely.  I just wanted to put my two cents worth in...

[COBOB]

I think your Neuro has a bit of tunnel vision.  Seems many do.  He is looking at a lumbar MRI which so the structural lumbar problems and he may be assuming some type of cauda equina  (horse tail nerves) compression. That could explain leg issues, but kind of misses many of your other complaints.   If your neurologist observed your tremors, that is almost an automatic MRI of the brain.  

Did he perform a complete neuro exam including toe to heel walking, Romberg's test, etc?  If not, I'd take a copy of my MRI and find a new Neurologist.  This on seems to be stuck on your legs issues.  That is just my opinion.

Now, there could be a few reasons for that. The description: "eye pain(3 sep occasions) accomanied by blurred vision which clears up almost entirely" leads to a bunch of questions.  How long did the pain last?  Was it in one eye or both?  If your neuro is not asking questions like this, that should not instill much faith in you.

[clledl3]

Thanks again for replying. I so appreciate the answer.

I have not gotten an MRI of the neck and T&C spine, I requested a full neck and spine MRI, but my neuro said it wasn't needed. Is it wise to request it again? Or should I get a new neurologist?
I believe he is leaning towards these symptoms bieng stress-related which I will not accept.

Again thank you so much for taking the time to give me advice/info. Take care

-Kristin

[COBOB]

Stenosis at L4-L5 is not going to Arm pain, eye pain, brain fog.  It could cause pain in the front of the legs and to about the belt line on the back.  The innervation of the bladder detrusor occurs below L4/L5 @ S3-S4, so an injury at L4/L5 might cause bladder symptoms.

If there is no lesions in the  Brain and Spine MRI, the only thing you can really do is try to get your imaging done on a 3.0T MRI.