Test Results from Recent Hospitalization

[Sarahsmom46]

Several members suggested that I put my test results out there to see if anyone can offer insight on this still unexplained illness. Looking back to things that were happening before this illness occurred, I have been having problems with tripping for no reason, and just general clumsiness.  Other than that here is my story...

Back on May 15th I got up and ready for work as usual.  Symptoms were as follows:  Legs legs felt heavy and a bit weak upon waking that morning and while walking to work from subway.  Next couple of hours were fine until the following occurred; uncomfortable upper belly constriction feeling that wrapped around to my back, severe queasiness like you get from being car sick not like I ate something that upset my stomach, difficulty in focusing on an email that I was reading on the computer, and difficulty in trying to write because hands felt weak and numb.  I tried to go out to get some fresh air and as i started walking towards the door my legs started to shake.  Long story short, things went down hill quickly from there and within an hour my supervisor made the call to the paramedics to come as I had collapsed and could not get back on my feet.  I was taken to the ER and was admitted within a few hours.  I was in the hospital for 6 days and in acute inpatient rehab for 16 days.  I had difficulty in standing, could not walk without assistance even a few feet and had pain in my legs.  Here is a progression of tests and results that were ordered by the neurologist and other specialists that saw me that I got from copies of my chart:

Chest Xray - Normal

Blood work - normal except: 94% neurtophils, 6% lymphs day 1 and 14.4 day 5, CPK - 150, ESR 18, glucose 107, chloride 110+, CO2-18, BUN-18, total protein - 6.2, CK isoenzymes - MM band 100, Serum electropharesis - 5.7, Albumen 3.0, and B12 low normal

CSF Studies were normal for CMV, HSV, Lyme, HIV, SLE, Ebstein-Barr, acid bacilii, AFB, yeast or mold.
CSF studies with abnormal results:  Glucose - 49, Protein - 69, Oligoclonal bands - 2 in serum and 2 in CSF remarks were "the oligoclonal band assay detected 3 or less  IgG in the CSF, which are not present in the serum. This is a negative result".  What is wrong here?  Is there a mistake in the wording?  This was verbatim from the report.  

CT head - normal

MRI spine - Cervical Spine, C5-6 central and left-sided shallow herniation extending into left neural foramina.  C6-7 moderate diffuse disk bulge of questionable significance, correlate clinically. No abnormal enhancement   Thoracic Spine - T7-8 disk space there is punctate central herniation in opposition to spinal cord. Correlate clinically. No stenosis. No abnormal enhancement.  Lumbar Spine - no significant abnormalities throughout lumbar spine.

MRI Brain - Punctate hyperintense T2 and FLAIR signal within the periventricular and subcortical white matter consistent with chronic small vessel ischemia versus gliosis.  Note:  Neurologist discussed differential for these findings and said she was going to treat empirically for MS while we waited for the CSF bands test to come back.  If CSF came back normal we would stop the steroids.  I had a 6 day course of 1g Medrol by IV which were not discontinued after the results came back.

Echocardiogram - Mild mitral and tricuspid regurg, borderline EKG, abnormal diastolic relaxation (mild), mildly enlarged left atrium at 5.5, otherwise normal.
Doppler lower legs - Normal

Neurological Exam:
CRANIAL NERVES: ll-Xll are not intact. Nystagmus on primary gaze and end-gaze. Impaired medial gaze in left eye. Right lower cheek is numb to pinprick, but facial motion is symmetric.
MOTOR: Less than 3/5 weakness in lower extremities. 3+/5 weakness in upper extremities.
SENSORY:  There is no in back or front (?).  Intact pinprick in legs with 10% in toes, 25% in calves, and normal in thighs. DTRs 2+/5 in arms and legs with down going toes.
COORDINATION and GAIT:  Reduced hip flexors, knee extensors, plantar and dorsal flexors, Ataxia is present.

EMG - Normal study
SSEP/BAER - Results Pending

IMPRESSION: Acute Paraparesis, question of demyelinating changes on brain MRI.  Evaluating for acute postinfections transverse myelitis.

I think I got everything.  Oh and by the way, the only other thing that happened less than a week prior to this illness was that I had a traumatic dental apicectomy surgery on one of my molars, which resulted from 2 failed root canals, 4 cycles of antibiotics due to abscess and continued infection that started in January 08.  

Thanks so much for any light that can be shed on this.  I don't really want to be a medical mystery, so maybe we can put our heads together and find a logical answer or at least find the right path to walk down.  

Julie (Sarahsmom46)

[Sarahsmom46]

Hi Ladies,

Thanks so much for your kind remarks.  This has been a challenging adventure for sure, but you both are right that I have been fortunate to have doctors who can think outside the box.  I am living in Washington DC and have access to many medical schools in the area.  My neurologist is young and just got board certified a couple of years ago from George Washington Univ. Hosp.  He said that he wants me to refer me to an MS specialist he knows at GW as he wants to rule out conversion to MS.  However, I would like to see if he would refer me to the MS center at John's Hopkins instead.  It is only a 45 minute Amtrak ride away.  I wonder what you guys think about going to an MS center at this stage?  Have you been to an MS Center and if so what was your experience with them?  Thanks again and I hope you are having an enjoyable Sunday evening.

Hugs,

Julie

[Rena705]

Hey girl...glad you took the advice to post your tests that you have had done and the results!  I am going to put in a special request that Quix have a look at this when she gets a minute and I hope that she may be able to shed some more light on your situation!

Lots of Hugs,

Rena

[Heather3418]

Dearheart, all of this must be overwhelming for you.  I am thankful to see that you truly have good physicians that have done all the appropriate testing.  I must admit that even though I have been through all of this kind of testing over my 13 years since my dx of MS, I am still at a loss to understand the exact meaning of the results.

I know that someone on the Forum will come along that will be able to decipher some of these results.  I'm sorry I can't.

So this post is to offer you my shoulder and friendship, but most of all understanding for what you are enduring.  As I have said so many times on this Forum, we all learn something from every post.  I am so glad you shared this with all of us.  I will be watching this thread, in hopes of learning more.

Bless you Julie.  You're a tough cookie.  I am grateful that you have a doctor that seems to be doing everything he can to learn more.

Heather :>)