Doctors Lounge - Neurology Answers
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Forum Name: Neurology Topics
Question: MS or Autoimmune Disorder?
|kristieh - Sat Oct 20, 2007 9:46 pm||
I am a 28 year-old female that presents with many different symptoms. My problems about a year ago. I had bouts of frequent urination that would come and go. I also have a history of chronic constipation, but with a change in diet, increase in water intake and Activa yogourt this seems to have gone away. Then when I was on vacation, I started to get reoccurring mild chest pains, weakness in my left arm (sleepy feeling) and pain in my left leg. About 3 weeks after this started, the chest pains started to go away and I started getting a warm sensation down my left leg (starting at the calf). About 2 months after that I started to get a burning sensation, slight numbness feeling and pain down my left leg. The pain always starts in my knee and then goes down to my foot and up to my lower back. The pain is worse when I kneel, especially in the knee area. I have had a few months of being extremely tired, but currently I am o.k. I also get feelings of lightheadedness, heart palpiations and muscular type chest pain and just overall mental fatique for no apparent reason. I have a positive straight leg test and pain when the left leg is raised to 30 degrees. I have had an MRI on the Lumbar which showed very early degenerative changes in the L5S1 region, but no nerve impingement. I saw a neurologist, who conducted an EEG which was fine. He also did an MRI with contrast which was also fine. My rheumatoid level was at 13 and my ANA antibodies were negative. All other blood work seems to be ok, except I have a history of lower potassium 3.3 - 3.4 and slightly higher billirubin of 23 and ALT at 46. The doctors say they have no clue what is wrong with me, but I am just really frustrated. The sciatic type pain is really starting to affect my everyday life. I do stretches everyday, take naproxen as needed (which sometimes helps), but nothing seems to cure the pain or other symptoms. As for family history, my sister as idiopathic generalized epilepsy. My dad has high cholestrol.
Can you help? I am really confused on what to do and just want to feel better.
|Dr. Tamer Fouad - Thu Nov 08, 2007 10:42 am||
Its even harder to tell over the internet. However, most of your symptoms appear to be very nonspecific and may even involve different systems. Multiple sclerosis (MS) is suspected when there are different neurological deficits seperated in time and space. At least that is the classical presentation. It can also present with progressive lesions or two attacks of the same lesion. These attacks may include mild nervous system symptoms but could also include other things such as weakness in a limb.
Given that your MRI is clear and that your neurologist is not suspecting MS at this stage at least, have you considered the possibility that this may be anxiety related? We are usually very careful to avoid saying anxiety except after we have carefully excluded any evidence of another cause. Anxiety could also be the result of your symptoms rather than the cause. As such you may even benefit anyway. This doesn't mean that you should stop following up. The only thing we can do at this stage is 'watch and wait'. What this means is given we cannot tell for sure from your current symptoms we will carefully observe your condition and act according to the developing picture.
In the mean time ask your doctor if he agrees that you may benefit from anxity therapy. In your post you mention mental fatigue. This should be treated and could be a sign.
Good luck and best regards,
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