Dear Dr. Sharma. Thank you for taking the time to comment on my post. I truly appreciate it. I actually had a very thorough eye exam at a University Medical Center today. The exam was normal. I don't have a neurology appt until August....
Hi there, you have various neurological symptoms along with significant weight loss. An ophthalmologist’s examination of the eye is required to rule out local pathology and an otolaryngologist needs to check you for tinnitus. If these are not localized issues and part of a spectrum of symptoms, you need to consult a neurologist for investigating for demyelinating disease called multiple sclerosis where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. the various causes of significant involuntary weight loss are malignancies, gastrointestinal malignancies, nonmalignant GI disorders like anorexia, dysphagia, malabsorption syndrome, hyperthyroidism and uncontrolled diabetes, depression and bipolar disorders.Take care.