Can an MS symptom come on suddenly and briefly?

[Nevi2017]

So I was in the hospital last night for an 'odd' episode. I'm female in early 30s. Good health.

I was standing in a shop, standing squarely, facing forward. Feet firmly planted. I had not just gotten up or anything. I had been looking at an object for a few minutes.

Suddenly (and it all happened in about 15-30 seconds) my left leg started side stepping repeatedly, making my stance wider and wider. In those few seconds my brain literally thought "why is my left leg stepping out to the side without me telling it to?". Then I realized what was happening. I was sinking down into my left side. A lady was walking past me and I felt embarrassed almost hitting her. I think my leg possibly was trying to support me but it was like it was weak and I slumped over the side and was weak for a moment. Like that side couldn't hold me up. I never fully collapsed but was able to catch myself but it was hard. I didn't feel like I was going to pass out. It was completely different. There was no darkness closing in around me. I've had that feeling once as a child. It was not this. It was like I didn't have command over my body for a moment and it was weak.

Afterwards I was very tired and light headed. I walked back to my car. Drove home (3 minutes away) and when I was about to get out, I reached for the handle of my car and missed it. I went inside. Sat down. When I got up my legs felt heavier a little for the next 20 minutes or so.

Later I decided to go into the hospital and get checked. When he gave me normal routine exam, touch his fingers my nose etc I passed perfectly. They ruled out a stroke and the doctor was very adamant that it could be MS and said I would need to get a follow up with a neurologist. They dismissed me having a stroke but I'm not entirely sure that they checked thoroughly. I only received EKG and a blood test. No scans (MRIs etc). So I'm a bit worried.

My question: does this sound like something people get with MS? Can it come on so suddenly and go away so suddenly? Or is this not indicative of MS.

Since yesterday no symptoms but tiredness and occasional lightheadedness. last week, without any other symptoms, I was short of breath all week for no reason. Then it was gone.

Thanks so much

Nevi

[TinaP303]

Your episode sounds unsettling. Please do follow up with a neurologist as soon as you can. Did the ER department refer you or make an appointment? If at all possible, get in with a MS specialist. You don't mention your location, so not sure what the availability is, but chances are it's good that you can find one. Keep us posted as to what you discover.
As to your question - I'm not sure, I've not had any episodes like that, but everyone is different.
Best Wishes.

[jreagan70]

the doctor was very adamant that it could be MS and said I would need to get a follow up with a neurologist. They dismissed me having a stroke but I'm not entirely sure that they checked thoroughly. I only received EKG and a blood test. No scans (MRIs etc).

Hi Nevi:

No, what you experienced is not typical of MS. MS symptoms don't come and go suddenly. So for the doctor to be "very adamant" that it could be MS is a bit puzzling. If the doctor felt that strongly about MS being a possibility, s/he could easily have gotten an MRI while you were there. You didn't even get a CAT or an EEG to check for other possibilities, so it isn't clear what the doctor's opinions were based on. So please don't let MS occupy your mind simply because that's the one thing that was said to you by a doctor who may not even know what the signs and symptoms of MS actually are.

Yes, you should be evaluated by a neurologist. While your episode had a neurological component and MS is a neurological condition, it could have been caused by any number of things that can have symptoms come and go that quickly. There's no indication right now that the neurologist needs to be an MS specialist, any more than the doctor needs to be a stroke specialist.

What is needed now is just basic testing. With no testing to back up any specific cause, there's no advantage to pigeon-holing yourself with a particular subspecialist right at the start, which could actually delay finding answers. You can start with a general neurologist and move to a subspecialist or a different kind of specialist if you need to later. For now, one step at at time.

[Nevi2017]

Thank you so much for your replies.

So MS symptoms usually maybe 24 hours then?

I feel worried now that I could have had a TIA (mini stroke) and because of my age and good health was not properly tested for this. hmm.

[JerryD]

I think that someone mentioned MS a bit too soon! I am not a doctor but I am surprised that no one is talking about blood tests! I suggest that you get a bunch of blood tests, including vitamin D and vitamin B-12. I suspect that you are low in vitamin D. Many people have low vitamin D levels. Also you should be tested for Lyme disease. There are many blood tests that need to be run to rule in/out MS. Good luck

[jreagan70]

So MS symptoms usually maybe 24 hours then?

Not exactly. A minimum of 24 hours is necessary for an episode to even be considered an MS attack. The effects of an MS attack typically last from weeks to months. MS attacks never come on suddenly and they don't come and go in 24 hours.

I feel worried now that I could have had a TIA (mini stroke) and because of my age and good health was not properly tested for this. hmm.

That's a more realistic possibility, because it is typical of TIAs to come on suddenly -- within minutes -- and last only a short time, sometimes coming and going in just an hour or two. An atypical migraine can also cause the kinds of signs and symptoms you experienced -- coming on within minutes and resolving in a few hours.

It makes more sense to start looking for causes that do act the way your episode acted, rather than MS, which doesn't act like that. Your neurologist will work through the possibilities. If you feel like you aren't getting satisfactory answers, don't hesitate to see a different neurologist and get another opinion.

[Carolinemf]

While I do agree that in my case attaches usually lasted one week + before the started to ease.
I don't agree that they don't come on suddenly.

My first major attache occurred as follows- went to bed like normal . Woke up at 6am with both legs and right arm completely paralysed , left arm only able to fling side ways enough to wake husband.
Had to be carried to toilet and supported. Spent the next fortnight in hospital being stuck with pins.

Several years later very similar only when i awoke I couldn't speak- not a word!

Had other attaches of course but these two in particular occurred very suddenly with no real warning other than feeling a bit tired and this could have been explained away by other things.

[jreagan70]

Had other attaches of course but these two in particular occurred very suddenly with no real warning

While those episodes seemed "very sudden" to you, relatively speaking they were not sudden. They came on overnight -- which is over the course of several hours.

The sudden episodes that people describe that they're concerned are MS attack come on over the course of about 10 minutes. MS attacks NEVER onset in 10 minutes. TIAs, strokes, migraines, and seizures can and do onset that fast. Demyelination never occurs in 10 minutes to cause the degree of symptoms being described.

In the relative terms that apply here, 10 minutes is considered sudden, 6 to 8 hours is not. We're talking here about absolute, medical suddenness, not perceived suddenness.

The other giveaway that these truly sudden onsets are not MS attacks is that the recovery is also sudden -- sometimes in as little as 1/2 hour (as with an ocular migraine), frequently within a couple of hours. In MS, nerves NEVER remyelinate in minutes with symptom resolution in a couple of hours.

[Carolinemf]

Hi JReagan,
generally I agree with you whole heartedly.
But in this case i believe you may be assuming some points.

For example- I don't know if my attaches i mentioned previously came on over hours or minutes because i was asleep so neither can you.And I did feel fatigued and had other slightly peculiar indicators before (and after) similar to Nevi. The attach just didn't occur while I was standing/engaged in activity.

I have experienced other extremely brief symptoms similar to nevi that came and went in minutes ,while standing, that I have often thought very peculiar and just plain irritating.
I was at work and an extremely hot spark like sensation shot up the right side of my face and across to the centre of my forehead.This only took possibly 10 seconds and then as this quite unpleasant sensation started to ease my left leg completely gave out and i fell. This too only lasted maybe 15 seconds , like a weird short circuit in my electrical wiring. I experienced these 'mini attaches' several times for about 2 days and learned to lock my leg stiff till it passed so i didn't fall again.
This was most likely one part of an overall attache that may have had other symptoms and lasted longer than I had time to monitor but to me at the time it came out of nowhere and was quite scary just like walking to and getting into bed then waking up paralysed.

Sometimes if you are still reasonable active and busy you may dismiss or miss the small indicators of a upcoming attach like increased fatigue etc until something notice worthy 'gets' your attention suddenly. So I'm sorry but i still don't agree that some symptoms can't 'present' very suddenly.
All the best.

[Carolinemf]

As well:you posted this and other very positive comments on another thread

MS doesn't strike all over the body, from the eyelids down to the legs. Muscle pain and twitching everywhere is not MS. So it makes complete sense that your MRIs are clear for any sign of MS. In addition to not presenting like MS in 2015, you apparently haven't had any presentation since then that meets any of the official diagnostic criteria for MS. Not only no fatigue, heat intolerance, or weakness, but especially no loss of sensation or motor function -- particularly episodic -- which are absolute hallmarks of MS.
And recommended the original poster should seek psychiatric evaluation.

This sounds just like my doc at the time telling me i was making my self sick.
Most ms does present symmetrically and often on one side - buuuttt as i have said previously I was completely paralysed with sensory emparment from the eyelids down to the legs so in my experience it can strike all over the body.

maybe this isn't so much from Lesion load - of which i don't have a huge number , though they are quite large- but more from overall brain atrophy which appears to be a more significant concern with me.??

[jreagan70]

Hi caroline:

You're mistaking "symptoms" with being synonymous with "demyelinating event" and symptoms in established MS as being the same as in the initial demyelinating event. They're very different entities.

"Symptoms" also includes pseudoexacerbations, which can come on in minutes and clear up in a short time. You're including symptoms that come from pseudo events. But there can't be a pseudo event unless the affected nerves have already been damaged in a previous true demyelinating event. It's impossible for a pseudo event to be the initial presentation. That's what the OP was describing -- an initial event that lasted only moments. So no, that's not how an MS attack initially presents. That's simple anatomy and physiology.

In established disease -- which is what you're describing -- the nerves have already been damaged, and pseudoexacerbations -- symptoms not based on demyelination -- can be common. That's not what the OP was describing.

Also, in established disease, lesions and/or atrophy accumulate and the damage can, of course, affect multiple areas of the body at the same time, affecting both sides.

With the random nature of MS lesions, the odds of the so many lesions that would be necessary to affect hundreds of nerve tracts from top to bottom occurring at the same time, and the odds that multiple lesions would occur in exactly the same places on both sides of the body at the same time, are astronomically small. (A transverse lesion -- which by definition affects both sides of the body at the same time -- would be too obvious to miss and would have characteristic signs and symptoms -- still not body-wide unless it occurs in the brainstem.)

Mathematically, the odds of that being the initial strike are infinitesimal. (The odds of it occurring in any attack are infinitesimal.) Plus, just observationally, we know that MS doesn't onset that way. And certainly a presentation that would necessitate multiple lesions cannot correlate in a person with an MRI that's devoid of MS lesions. Again, that's just simple anatomy and physiology.

Both of those posters were describing initial strikes, and MS doesn't onset that way. Nor does it continue that way in the absence of any of the characteristics of MS.

What you're describing are the effects of established MS. And that's absolutely how established MS can act. But that's completely different than the initial onsets the other posters were describing.

[Carolinemf]

Nevi, please don't let my philosophical difference of opinion about minor points worry you unnecessarily. The previous advice to seek more tests and info is also what i believe to be your best course. And I wish you well. There are many mimics of ms and these need to be ruled out.
I am only interested in clarity of phrasing/wording.

JReagan. Sorry but I believe again that you may be ASSUMING with some things. This may not be initial onset.
Nevi hasn't even had an mri yet.
She could be like many of us post diagnosis (with damage) who gain an explanation for peculiar symptoms that go on for years previously -and suddenly it all makes sense. established disease??

She states- last week, without any other symptoms, I was short of breath all week for no reason. Then it was gone.- this could possibly be the onset of the initial demyelinating event cuminating in the symptoms she is most concerned with occurring then tapering off toSince yesterday no symptoms but tiredness and occasional lightheadedness. Thats 9 or 10 days of unusual occurrences and could cause perceived suddenness.

When you wrote the following-(A transverse lesion -- which by definition affects both sides of the body at the same time -- would be too obvious to miss and would have characteristic signs and symptoms -- still not body-wide unless it occurs in the brainstem.)

Mathematically, the odds of that being the initial strike are infinitesimal. (The odds of it occurring in any attack are infinitesimal.) Plus, just observationally, we know that MS doesn't onset that way. And certainly a presentation that would necessitate multiple lesions cannot correlate in a person with an MRI that's devoid of MS lesions. Again, that's just simple anatomy and physiology.

Both of those posters were describing initial strikes, and MS doesn't onset that way. Nor does it continue that way in the absence of any of the characteristics of MS.

What you're describing are the effects of established MS. And that's absolutely how established MS can act. But that's completely different than the initial onsets the other posters were describing.- That is also what I was describing. My very first noticeable attache was when I awoke completely paralysed. The only symptom previously was fatigue, nothing else (very fit and strong) which could be attributed to other factors. So it may have an infinitesimal chance of occurring but I must be just special I guess.

All the best.