Worried I have Ms

[Katandjc]

Hi all
I'm a 25 yr old female with psoriasis arthritis .

My symptoms are as follows

Nov onset of bladder probs

March tingling in left arm , then tingling/ numbness in feet and hand . Plus pins and needles all over body. I suffered some on and off vertigo during this

April-addition of shaking legs , twitching and some stiffness

May -now I have numbish hands , pins and needles and buzzing throughout body . My legs get stiff sometimes .
Since onset my symptoms have been quite changeable .
Does Ms come out like this ? I am seeing a neuro in 6 weeks . A doc said it would be an unusual presentation ,but obv no one with Ms is the same .
Thanks. X

[SNOOPY]

Hello Katandjc and welcome to MSWorld.

Multiple Sclerosis presents differently for each person.

If you are on any medication for your psoriasis arthritis you may want to check medication side effects. Sometimes medications side effects can cause symptoms which makes us believe we have a health problem.

A good source to check medication side effects is Medline:
http://www.nlm.nih.gov/medlineplus/druginformation.html

Have you been to a Urologist to discuss your Bladder problems?

Best wishes on your upcoming Neurology appointment.

[JerryD]

I understand that you are worried about getting a diagnosis of MS. But worrying will not help you, it will hurt you ! Try to remain calm about these physical changes. Maybe you have some low vitamin levels like low vitamin D. Or some other imbalance in your body chemistry. MS has many mimics. Your doctor must eliminate all of them before you will have a confirmed diagnosis of MS. good luck

[jreagan70]

I'm a 25 yr old female with psoriasis arthritis

Hi Katandjc:

Are you taking one of the biologic TNF inhibitors -- Enbrel, Humira, Remicade?

The TNF blockers have a rare side effect of producing demyelination in the nervous system.

Demyelination causes the same symptoms, no matter what causes the demyelination. MS is a demyelinating disease, and demyelination caused by a TNF blocker can produce exactly the same symptoms as MS.

There is some debate about whether this demyelination is actually MS or should be treated like MS, because it's caused by the medication and not the immune system, as MS is. The general recommendation is that the TNF blocker be discontinued. Then it's possible for the demyelinated areas to heal and the symptoms to go away. Your rheumatologist and neurologist may have to work together to determine what the best course of action is for you, and what to do about the demyelination if the symptoms don't get better if you come off the medication.

Did you discuss your symptoms with your rheumatologist? Is that how you got the neurology referral?

Your rheumatologist should be very well aware of this side effect, even though it's rare. It's premature to use the term "MS" for this kind of demyelination, because, as I said, it hasn't been established yet that this kind of demyelination is actually MS. Because of this effect, the TNF inhibitors are now not recommended for people who already have an established demyelinating condition like MS.

Here's what you can/should do:
For whichever medication you're taking, go into the actual prescribing information (it's that huge piece of paper that comes with the medication, or you can find it online at the medicine's website) and find section 5, Warnings and Precautions. There will be a paragraph called Neurological Events or Neurological Reactions. That's what this is about.

If you haven't talked about your neurological symptoms with your rheumatologist yet, please tell him/her about them as soon as possible.

At your neurology appointment, tell the neurololgist right away, at the beginning of the visit, that you're taking one of the TNF inhibitor medicines for your psoriatic arthritis. It's a really good idea to take the paper copy of your medicine's prescribing information, or a printout from the website, with you to the appointment in case the neurologist isn't up on TNF inhibitor meds (don't be surprised if the neurologist is a general neurologist and has no idea what you're talking about). It might even happen that you end up seeing a neurologist who is more familiar with the demyelinating diseases (like a neuroimmunologist or MS specialist).

While this neurological side effect is rare, it isn't rare for the people who develop it.

If you're not taking a TNF blocker, MS is the more likely possibility. It would just be unusual for someone with psoriatic arthritis to not be taking one nowadays. And with their association with this albeit rare neurological side effect, the possibility of medication-related demyelination moves to the top of the possibility list, above MS itself.

It may take quite awhile to get everything sorted out, so be prepared.