Need some answers

[Bri941]

I am 32 with two children. Last couple of years I have had severe neck pain on right side. I also get loss of coordination, dizziness, major headaches, hand tremors, muscle spasms, muscle twitching( leg jerks), blurred vision, and stabbing pain behind right ear, and leg and arm weakness, always fatigued.  I have been dx with Hashimotos which levels are being managed with levytyroxine. I also take Prozac for anxiety, and primidone for tremors which don't seem to work. I have had a MRI of cervical spine which said I have a benign vertebral hemangioma at C7. Herniated discs with compression of thecal sac on C3-C4, and C7-T1 also compression of the thecal sac. My gp don't think my severe pain is caused by this reading of MRI .I don't know what to do next since gp says I am fine... What do you all think?

[Bri941]

Thanks for your answer... :)

[Dr Sharma]

Hi there.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. 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. Take care.
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