Any Opinions Please?

[Nightsurfer]

Hi - I've been getting strange symptoms the past couple of months including:

leg weakness (both legs)

muscle tone on legs and arms doesn't seem what it was 2 months back

difficulties with balance - not noticeable to other people but doesn't feel "right". Was diagnosed earlier in the year with an inner ear disorder (in June) but unsure that this was a correct diagnosis. Balance returned to normal for a while then went "off" again at end of August

some muscle twitching in both calves and left arm, and I think on my back

occasional numbness/pins and needles and burning sensations

headaches/sweats.

low white blood cell count (lymphocytes)

I've now had two MRIs: firstly the brain a month back and last week the neck down to the base of the spine. Neither revealed anything abnormal (except expected wear and tear on the spine for a 44 year old man). Neuro exam was apparently pretty normal, though another doctor (not a Neuro) I saw noted brisk reflexes on the knees.

does this sound anything like the path anyone else had? I've been convinced I have MS in some form, I know that the MRI results would suggest not though I believe there are a small number of cases where MRIs don't reveal any lesions with MS.

Does this sound like MS?

thanks!

[JerryD]

Have you done the blood tests for vitamin deficiencies (vitamin D and B-12) ? How about Lyme disease ? There are hundreds of MS mimics!
Your story does sound familiar ! MS is difficult to diagnose but by excluding other deficiencies, through testing, doctors will get some diagnosis. You must stay vigilant and adamant to get all of the tests . Good luck

[SNOOPY]

Hello Nightsurfer and welcome to MSWorld.

Neuro exam was apparently pretty normal

I've now had two MRIs: firstly the brain a month back and last week the neck down to the base of the spine. Neither revealed anything abnormal

You said you have leg weakness and balance issues, but your Neurological exam was normal?

A normal neurological exam and normal MRIs would make Multiple Sclerosis less likely. Those with Multiple Sclerosis usually do not pass a Neurological exam, there is usually some deficits when tested. Many conditions can cause the same type of symptoms as those seen in MS.

low white blood cell count (lymphocytes)

Blood work is testing for other conditions, not MS. There is no blood test that can indicate MS as the problem. You should discuss with your Physician what your low white blood count might mean for you.

[Nightsurfer]

Any Opinions Please?

Many thanks for the responses that have been given to me.

You said you have leg weakness and balance issues, but your Neurological exam was normal?

Thats right - the balance issues aren't constant and come and go. When I was having the Neuro exam my balance felt relatively ok. Even when it's playing up I suspect that a Romberg Test or Heel to Toe walk would probably look just about ok. I mentioned it to the Neuro though.

leg weakness again is something I think has happened rather than anyone saying to me "you have leg weakness". It also doesn't look like the muscle tone is what it was. I drew the Neuros attention to this, he took a look but didn't seem to think anything was wrong.

the only visible sign I can show to other people are muscle twitches, though the other symptoms I've described feel very real to me.


A normal neurological exam and normal MRIs would make Multiple Sclerosis less likely. Those with Multiple Sclerosis usually do not pass a Neurological exam, there is usually some deficits when tested. Many conditions can cause the same type of symptoms as those seen in MS.



Blood work is testing for other conditions, not MS. There is no blood test that can indicate MS as the problem. You should discuss with your Physician what your low white blood count might mean for you.[/QUOTE]

[SNOOPY]

Hi Nightsurfer,

What you are experiencing are symptoms, Symptoms are those things we experience and feel. When undergoing testing for symptoms your Drs. are looking for signs that could account for your symptoms.

Signs are those things that can be detected by an exam or testing.

the balance issues aren't constant and come and go. When I was having the Neuro exam my balance felt relatively ok. Even when it's playing up I suspect that a Romberg Test or Heel to Toe walk would probably look just about ok. I mentioned it to the Neuro though.

leg weakness again is something I think has happened rather than anyone saying to me "you have leg weakness". It also doesn't look like the muscle tone is what it was. I drew the Neuros attention to this, he took a look but didn't seem to think anything was wrong.

Your Neurologist did not find a "sign" of weakness. If a person with MS has leg weakness it can be detected by Neurological exam. We not only experience the weakness but our exam confirms it as such.

The same thing with balance. A balance issue can be detected upon exam even when the person thinks their balance is pretty good. Once again, you did not show any "sign" of a balance issue.

This doesn't mean you are making up symptoms but it might mean that Multiple Sclerosis is not the cause of your symptoms.

JerryD asked a very good question. Have you been to your Primary Care Physician for blood work or other testing? Vitamin/mineral deficiencies can cause many symptoms. The National Multiple Sclerosis Society lists many of the conditions that can cause symptoms similar to MS and should be ruled out. http://www.nationalmssociety.org/Sym...ns-to-Rule-Out

I think I read where muscle twitching is seen in about 80% of the population. The cause for this can be stress/anxiety, caffeine, some medications, after affects of exercising, and there were others.

You might look at your lifestyle such as do you get enough exercise, do you need to reduce your stress level, your diet, and do you drink enough fluids/stay hydrated. If you take any medications you may want to check side effects to see if they may be the cause of any of your symptoms.

[Skidder]

my thoughts

I thought I read somewhere that there should be a minimum of 8 lesions to be diagnosed as MS. For example, I have 24 on the brain and 6 on the t-spine as well as more on the c-spine MRIs. My nerve testing/reflexes are abnormal. Part of MS is the signals not making it from the brain in a timely manner, if at all.

With RRMS the lesions are more in the brain and involve inflammation. With PPMS (I have), the lesions are less likely to involve inflammation and tend to be on the spine along with banding in the LP. I'll state that I'm not a doctor.

Many things can cause the issue and mimic MS. You can also be having somatic driven symptoms (all in your head) if you think you have MS. I know while I was being diagnosed, I hoped for anything else. Once it was confirmed, I was amazed that I actually wished I had syphilis, HIV, or needed back surgery. If the tests are coming back negative, I'd be doing backflips of joy.

[SNOOPY]

Hi Skidder,

With RRMS the lesions are more in the brain and involve inflammation. With PPMS (I have), the lesions are less likely to involve inflammation and tend to be on the spine along with banding in the LP.

I am going to throw a monkey wrench into the quote above

I was diagnosed with RRMS. My MRIs were clear, my LP was positive and all other testing was negative. My Neurologist said based on my presentation, exam/evaluation the disease was affecting the spinal cord. He was correct. Years later my cervical spinal cord confirmed this disease likes the c-spine, at one point I had numerous c-spine lesions. This disease has, for the most part, left my brain alone, I currently have 3 lesions and that's with a 31 year diagnosis.

[Sally032460]

Hi Skidder,



I am going to throw a monkey wrench into the quote above

I was diagnosed with RRMS. My MRIs were clear, my LP was positive and all other testing was negative. My Neurologist said based on my presentation, exam/evaluation the disease was affecting the spinal cord. He was correct. Years later my cervical spinal cord confirmed this disease likes the c-spine, at one point I had numerous c-spine lesions. This disease has, for the most part, left my brain alone, I currently have 3 lesions and that's with a 31 year diagnosis.

Hi Snoopy,

I have a similar test story - clear MRIs, positive LP, other tests clear. No particular diagnosis yet as we try to rule many other things out. I'm wondering what shape your symptoms have taken, particularly at first - did you have any mobility issues, fatigue, or cognitive issues? Many thanks for your advice!

[SNOOPY]

Hello Sally032460 and welcome to MSWorld

Hi Snoopy,

I have a similar test story - clear MRIs, positive LP, other tests clear. No particular diagnosis yet as we try to rule many other things out. I'm wondering what shape your symptoms have taken, particularly at first - did you have any mobility issues, fatigue, or cognitive issues? Many thanks for your advice!

Sorry to hear you haven't received some sort of diagnosis. Hopefully answers will come soon.

I have had symptoms of MS since I was a child and I grew up thinking what I experienced was normal. When I was 23 almost 24 all **** broke loose. I had what would be termed as my first severe exacerbation.

I had many symptoms:
- LHermittes sign
- Bilateral leg weakness
- Pins and needles in legs
- Vibration/buzzing waist down
- Hand tremors
- Fatigue
- difficulty walking
- Pain

My PCP said he could not help me and handed me a referral to a Neurologist. I stayed in this condition throughout the diagnostic process (3 months). When diagnosed I was given oral prednisone. The exacerbation lasted another 6 weeks but it took me a year to regain my mobility and then I had my second severe exacerbation...and the cycle to regain mobility started again.

The disease has manly affected me from the waist down with mobility being my biggest struggle through the years, but I am still walking and sometimes use Trekking Poles for mobility aids. After that first exacerbation 31 years ago I have been limited in my walking to 2 miles. As many with this disease I have good and bad days so reaching that 2 mile mark is not always possible. Fatigue can and does play a role in how much those with MS can do, as is the case for me.

My story is just that --- my story.

Each person has a different story and disease course. We can share some of the same symptoms but the path the disease takes is different for all of us. If you receive a diagnosis of MS don't compare your journey with this disease with someone else's.

You may want to start a Thread of your own either in this forum (Limbolanders), General Q & A, or the "Tell us about yourself" forum. In that way others can get to know you and offer any suggestions, advice, or simply welcome you to MSWorld.

Best wishes