Need Suggestions To Rapidly Progressing Symptoms

[lyastra]

my 29 year old daughter has recently developed:  right hand tremor, left facial tic upper lip, nystagmus (at times quite severe), ice picktype headache lasting 30sec-1 min, abdominal pain, nausea/vomitting..  Hx of syncope and chronic kidney stones.  She is developing severe anxiety the longer we go without some kind of answer. Psychological causes have been ruled out.   Her current symptoms are progressing and getting worse.  She had 2 almost seizure like episodes about a month ago.  Per labs, thyroid fine, calcium borderline high, pth normal.  Absolute Neutrophils 9000, Abasolute monocytes 196.  These are not All of her symptoms, just the worst ones. We are having a lot of problems getting a doctor to do ANYTHING.  I would appreciate some ideas in which direction we should go.  She sees a new neurologist in a couple of weeks.    Any ideas would be appreciated.

[lyastra]

Thank you so much for your assistance.  We were kind of afraid that most of this was pointing to MS, she has an appointment with a neurologist next month.  It is impossible to get her in any sooner, even though at times she feels like she is going to have a seizure.  The information you game was great and I sincerely appreciate it.  We also just found that my daughter has an L5 Bilateral Pars Defect, but it hasn't been graded yet.  I was found incidently on a pelvic ct. She has severe Restless Leg type symptoms, could this defect be responsible?

[Dr Sharma]

Hi there. I understand your concerns. An urosurgeon needs to evaluate your daughter’s renal stones since the nausea and pain could be very distressful. Urinary obstruction and post renal failure need to be watched or. These multiple neurological symptoms could be due to a chronic demyelinating condition 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. You have many of these symptoms. 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 and a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Take care.