Some Questions...

[Pat to Kathy]

I'm a 33 y/o female vegetarian.  Was in good health until we got back from Mexico vacation (Nov.), when I got a stomach bug that then went into other symptoms that keep coming and going: all over muscle aches (while resting), heavy feeling muscles during activity, fatigue, headaches, worsening of allergies, some random tingling, muscle and eyelid twitches, stiff/sore neck, bladder "spasms", unrefreshing sleep, sporadic low grade fever (highest has been 99.4),etc.  After weekend in Wis. last fall noticed strange mark on back of hand.

The following are the tests I've had (all negative or w/i normal limits):

2 brain MRIs w/contrast, 1 cervical MRI (moderate bulging disk), NCV and EMG (neck, lower arm and lower leg), ANA, SED, CRP, RF, Lyme, micoplasma, CPK, metabolic panel, ASO, HIV, HEP. B & C, CBC, thyroid panel, blood glucose (fasting), 1 stool analysis for ova/parasites, etc.

Received a B-12 IV recently.  Couple of days prior to IV extremeties were falling to sleep quickly and fingertips/toes felt like they had chalk on them, feeling was slightly diminished.  The day after IV, part of my R foot (from big toe up @ 3") felt heavy/numb, but that feeling came and went.  Lasted @ 1-1/2 days.  2 days later I had muscle aches everywhere (back, arms, legs, neck, etc.)  Leg pains were the worst, especially at night: they ached like "growing pains", but also I had intermittent pains in specific muscle areas (quad, hamstring, calf, etc.) Also had stiff neck that hurt to turn to left.

If this were MS, would BOTH legs be aching?  How long would the numbness last during an attack (and would it be the entire foot)? Could the B-12 IV cause this?  I've also been getting strange headaches in the back of my head.  Pain comes and goes;  sometimes scalp is even sore.  Again, MRI was clear.  Could the headache cause the numbness?

My neurologist's preliminary diagnosis is FM/CFIDS. Still wondering about Lyme, MS or some sort of infection (fever).  Also scared about polyarteritis nodosa (some symptoms match mine). What do you think?

[CCF Neuro[P] MD, RPS]

Dear Pat:

Sorry to hear about your symptoms.  Your widespread symptoms with limited remission and exacerbation and the normal MRI would make MS doubtful.  The normal sedimentation rate and CRP would also make PAN unlikely.  Your generalized symptoms make chronic fatigue or fibromyalgia more likely candidates, although it does not sound like you have classic pressure point tenderness for fibromyalgia.  I would be more likely to pursue the chronic fatigue syndrome as a possibility.  Unfortunately, there is no standard test to diagnosis this entity.  It is based on a clinical spectrum of symptoms and history.  

Sorry, I am not much help.  I do not think you have MS or PAN.

Sincerely,

CCF Neuro MD

[Pat to Kathy]

Forgot to include on original post that mark on the back of my hand (in October)looked like the rash typically associated w/lyme (did not know that then).  First Lyme test was taken several weeks after 7 day antibiotic course (for UTI).

[Pat (one last comment)]

Thank you so much for the reply.  My mind has been eased.

Could Lyme be the cause, even w/negative test (which was taken immediately following antibiotics for UTI)?

FYI - trigger point exam by neurologist yielded some tender trigger points, especially in neck/shoulder/back areas.

[Pat (one last comment)]

Thank you so much for the reply.  My mind has been eased.

Could Lyme be the cause, even w/negative test (which was taken immediately following antibiotics for UTI)?

FYI - trigger point exam by neurologist yielded some tender trigger points, especially in neck/shoulder/back areas.