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Suspicious Combonation of Symptoms
Uncertain if this is the appropriate community to post this but per the advise of another participant on this forum, I elected this page first. I'm a mother, 44 years old, and have experienced suspicious symptoms for nearly 6 years. First onset was in 2007, three months of vertigo, fatigue, excessive tiredness though obtained sufficient sleep, slurred speech, numbness and tingling in left arm and leg. Additionally, flu-like symptoms and overall tiredness mirroring the same as nauseousness. After an evaluation from an ENT, he immediately stressed his concern of MS, and ordered an MRI (brain and cervical spine). I immediately scheduled an appointment with a neurologist and walked the MRI films in with me. The neurologist confirmed no "significant" findings on the MRI of which I remained suspicious considering my debilitating symptoms. Shortly after, and with symptoms persisting, I located another neurologist to review the findings and evaluate me further. He ordered additional tests such as, evoked potentials, nerve conduction studies, and a skin grating test along with an MRI of my thoracic and concurred that no findings suggestive of MS were present but indicated he was suspicious of my symptoms. Again, this was all conducted in 2007. Third time is a charm right? Visited with a third Neurologist nearing the end of 2007, who is an MS Specialist. After a thorough examination and reviewing my MRIs, and all other testing, she indicated no presence of MS, but also quickly stated that she saw a lesion, but in her words, "it is in the wrong place and not the correct shape for MS."
Regardless of feeling horrible, I had to grit my teeth with hope and prayers that this suspicious undetermined episode would pass....... and it did after three months. In 2012, these suspicious symptoms recurred representative of what I experienced in 2007. They nearly mirrored with the exception that new symptoms such as muscle cramping especially in my two middle toes on both feet, hip soreness / left leg and arm weakness, and blurred vision this time. And here we go again, sought medical care with a neurologist in a different state this time around and had an MRI of the brain accompanied by the cervical spine, an LP (ouch...never again thank you very much), but no nerve conduction studies or evoked potentials this time around. The findings were inconclusive with the exception of a bulging disc and a diagnosis of degenerative disc disease (C2 C3-C4-C5-C6). A biking accident in my youth was the culprit in which I landed a few broken bones in which I have some arthritis which I expected later in life with these types of fractures.
In current day, and approximately three months ago, I began to feel quite oddly again. Vertigo, blurred vision, muscle stiffness and pain in neck on both sides, shoulder pain this time around, mild slurred speech, unexplained fatigue, numbness and tingling in both hands and bottom of feet but mostly felt in left hand and foot, left eyelid twitching, mild facial numbness primarily focused on left side. Every morning I wake up hoping these symptoms subside but they are very apparent every morning and remain.
My question is this... Has anyone experienced a combination of both MS and Disc disease? My PCP suggested I see a spinal surgeon and an internist, but I'm more of the thought that a neurologist would be better suited in this area of symptoms. When I conveyed this chronological history since 2007 to my physician, he did not comment on anything other than sharing a large neurology group for setting up an appointment if I so choose. The earliest I can be seen is august 3rd. I've contacted 4 independent neurology practices, and not one can see me before that date. I've relocated out of state 4 times in the last 5 years but have all results from each physician. Very frustrating, even with my name on a cancellation list, I must remain idle with suspicions.
Thoughts or shared experiences on this issue? If this is not the appropriate forum for this question please do not hesitate to inform me. I'm new at this and just attempting to locate others who may be of the same position.
Regardless of feeling horrible, I had to grit my teeth with hope and prayers that this suspicious undetermined episode would pass....... and it did after three months. In 2012, these suspicious symptoms recurred representative of what I experienced in 2007. They nearly mirrored with the exception that new symptoms such as muscle cramping especially in my two middle toes on both feet, hip soreness / left leg and arm weakness, and blurred vision this time. And here we go again, sought medical care with a neurologist in a different state this time around and had an MRI of the brain accompanied by the cervical spine, an LP (ouch...never again thank you very much), but no nerve conduction studies or evoked potentials this time around. The findings were inconclusive with the exception of a bulging disc and a diagnosis of degenerative disc disease (C2 C3-C4-C5-C6). A biking accident in my youth was the culprit in which I landed a few broken bones in which I have some arthritis which I expected later in life with these types of fractures.
In current day, and approximately three months ago, I began to feel quite oddly again. Vertigo, blurred vision, muscle stiffness and pain in neck on both sides, shoulder pain this time around, mild slurred speech, unexplained fatigue, numbness and tingling in both hands and bottom of feet but mostly felt in left hand and foot, left eyelid twitching, mild facial numbness primarily focused on left side. Every morning I wake up hoping these symptoms subside but they are very apparent every morning and remain.
My question is this... Has anyone experienced a combination of both MS and Disc disease? My PCP suggested I see a spinal surgeon and an internist, but I'm more of the thought that a neurologist would be better suited in this area of symptoms. When I conveyed this chronological history since 2007 to my physician, he did not comment on anything other than sharing a large neurology group for setting up an appointment if I so choose. The earliest I can be seen is august 3rd. I've contacted 4 independent neurology practices, and not one can see me before that date. I've relocated out of state 4 times in the last 5 years but have all results from each physician. Very frustrating, even with my name on a cancellation list, I must remain idle with suspicions.
Thoughts or shared experiences on this issue? If this is not the appropriate forum for this question please do not hesitate to inform me. I'm new at this and just attempting to locate others who may be of the same position.
Best Answer
Alex/sc
I guess it depends on the Neuro too.
My MS Neuro wanted brain, optic and c spine with contrast to help with an MS dx.
My Neurosurgeon wanted full spine to look at my disc problems.
Suppose it will depend what they think they are investigating - in any event they should tell the patient!
... and no pain control either. Pain Clinics are prob the better option there too.
Rolls eyes
I guess it depends on the Neuro too.
My MS Neuro wanted brain, optic and c spine with contrast to help with an MS dx.
My Neurosurgeon wanted full spine to look at my disc problems.
Suppose it will depend what they think they are investigating - in any event they should tell the patient!
... and no pain control either. Pain Clinics are prob the better option there too.
Rolls eyes
I do find it interesting that each physician holds contrasting reasoning for their decisions. That said, it creates doubt in the patient as to what the proper direction would be when you don't know which physician is correct in your case.
It's interesting as tremors (or some may coin them as shakiness) are one of the symptoms that come and go. Mine are subtle, but noticeable when it occurs.
It was probably my error for not inquiring further why the spine MRI would not be ordered.
It was probably my error for not inquiring further why the spine MRI would not be ordered.
Most people with MS only get brain MRIs only. You can ask your neurologist for one. They are more expensive than brain MRIs and usually inconclusive if you move at all. If you do not have tremors it should be okay.
Alex
Alex
Thanks everyone. This path is interesting no doubt and concerning. My only question here is this. The neurologist specifically stated that there was no need to order an MRI of the spine. This was after I inquired if one should be ordered considering the symptoms of my lower extremities.
I'm asking for the reason below.
This morning I had an appointment with an internist per the recommendation of the ER physician awhile back when these symptoms began. After providing my historical background and current symptoms, the internist asked, "have you discussed these symptoms with a neuroligist as this sounds more like MS".
I nearly fell out of my chair and almost had to chuckle considering what I just discussed with the neurologist the day before. :-)
I politely explained that I just saw a neuroligist and she did not see anything but a pituitary gland concern and an enlarged ventricle at this time.
I shared that after injuring about an MRI of the C-spine, that the neurologist did not want to order this as it was not necessary.
The internist shared that it's absolutely necessary to order an MRI of the spine considering my symptoms and was not sure why the neurologist did not want to order one..... I could not help but to shake my head a bit over the polar opposite in whether or not an MRI of the spine should be ordered. I can understand why some including myself are at our wits end when contradictions such as this occur.
So the questions remaining are:
1). Is it possible to have a clean brain MRI of no clinical findings of ms and not order an MRI of spine to further that non clinical finding?
2). Is it still possible to have lesions / abnormalities on the spine and not the brain? (I believe yes).
3). And in my case, symptoms etc... Why would the neurologist draw that conclusion to not order the MRI of the spine? Or better way to put it, I'm imagining she had some reason not to order a spine MRI but just did not share that explanation.
Perhaps some here could shed light on the above. Lastly, no doubt my DDD is playing a role in this also but want to try and pin point anything else of concern or rule out if possible. Anyhow, thought a few here would find a little humor in what happened this morning as it seems common. :-))
I'm asking for the reason below.
This morning I had an appointment with an internist per the recommendation of the ER physician awhile back when these symptoms began. After providing my historical background and current symptoms, the internist asked, "have you discussed these symptoms with a neuroligist as this sounds more like MS".
I nearly fell out of my chair and almost had to chuckle considering what I just discussed with the neurologist the day before. :-)
I politely explained that I just saw a neuroligist and she did not see anything but a pituitary gland concern and an enlarged ventricle at this time.
I shared that after injuring about an MRI of the C-spine, that the neurologist did not want to order this as it was not necessary.
The internist shared that it's absolutely necessary to order an MRI of the spine considering my symptoms and was not sure why the neurologist did not want to order one..... I could not help but to shake my head a bit over the polar opposite in whether or not an MRI of the spine should be ordered. I can understand why some including myself are at our wits end when contradictions such as this occur.
So the questions remaining are:
1). Is it possible to have a clean brain MRI of no clinical findings of ms and not order an MRI of spine to further that non clinical finding?
2). Is it still possible to have lesions / abnormalities on the spine and not the brain? (I believe yes).
3). And in my case, symptoms etc... Why would the neurologist draw that conclusion to not order the MRI of the spine? Or better way to put it, I'm imagining she had some reason not to order a spine MRI but just did not share that explanation.
Perhaps some here could shed light on the above. Lastly, no doubt my DDD is playing a role in this also but want to try and pin point anything else of concern or rule out if possible. Anyhow, thought a few here would find a little humor in what happened this morning as it seems common. :-))
COMMUNITY LEADER
There may or may not be something abnormal going on with your pituitary enlargement, your not pregnant and your under 50 so there are limits for it to be normal enlargement changes. The enhancing part is suspicious, possibly mass/growth (noncancerous - benign as most are) or vascular lesion related, keep in mind it may be something that doesn't come with a simple answer...
Related information:
http://radiopaedia.org/articles/pituitary-gland
http://radiopaedia.org/articles/pituitary-mri-an-approach
http://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/pituitary-gland-disorders/overview-of-the-pituitary-gland
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/pituitary-disorders/
At least it's a potential direction that's being checked out, and even if it doesn't turn out to be the right answer, hopefully you'll at least be closer, right?
Hugs.........JJ
Related information:
http://radiopaedia.org/articles/pituitary-gland
http://radiopaedia.org/articles/pituitary-mri-an-approach
http://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/pituitary-gland-disorders/overview-of-the-pituitary-gland
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/pituitary-disorders/
At least it's a potential direction that's being checked out, and even if it doesn't turn out to be the right answer, hopefully you'll at least be closer, right?
Hugs.........JJ
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Many of us can confirm that having MS does not give you a pass on other health issues. You asked about the combo of MS and spinal issues. Your's appear in your cervical spine, mine were in my lumbar spine.
During the 20+ years I've had MS I have had a ruptured disk at L3 and spinal stenosis at L4-L5. Fortunately the ruptured disk broke on its own and in so doing relieved the nerve impingement. The stenosis required surgical intervention. Neither had anything to do with my MS :-)
The dissemination in time component of the MS diagnosis is what the contrast helps with. In the presence of contrast lesions that are currently active, or have been active in the last 30-40 days will light up. If you have an MRI in which some lesions light up and others do not, you have proof of dissemination in time.
Another way to prove this is to have repeat MRIs, at least 40 days apart. If there are additional lesions in the second MRI you have proof of dissemination in time.
You have had a series of MRI over an extended period of time. The only lesion observed was not likely caused by demyelination. You have also been examined by multiple neurologist and had most of the typical MS testing. There does not seem to be any evidence of MS. It may be time to try looking down another path for the cause of your symptoms.
Kyle