Doctors Lounge - Neurology Answers
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Forum Name: Neurology Topics
Question: Unexplained symptoms-ms or depression
|mmb - Mon Nov 07, 2005 9:45 am|
I am a healthy 30 year old female with a history of migraine headaches that had been kept at bay for several years until now. Several months ago, I started having blurry vision in my right ear, problems with hearing/ringing in my right ear, speech problems, and intermittant numbness and tingling on my right side. Migraines came back with a vengance going from maybe once a year to at least once a week. Problems with speech involved stuttering & stammering for words & 'backwards speech' (ie: Go to the store- I would say store to the go without even realizing it) I was also having problems with concentration, focusing & memory- usually I am a very organized person- now I have extreme difficulties daily. Upon a visit to the er for a migraine- a cat scan was done to rule out stroke or tumors- it was normal. I then went ot a neurologist who said that everything was normal & I was being hyper sensitive. He said it was either depression or ms and I could have an mri 'to help me feel better' but he believed it was unecessary. In the past I had been prescribed antidepressants for concentration & extreme fatigue symptoms, but the meds never helped the focusing problems & I went off the meds because they never helped. I feel like I'm crazy & that maybe I have become a hypochondriac; however at the same time, I feel like I'm being robbed of my life at 30 with these problems. When I researched ms, almost all of my symtoms seemed to be covered, however the neuro exam said I was normal. Could depression be causing these symtoms or do you think I should continue investigating ms? Thank you for your time.
|Jackie E. Pool, LPN - Mon Nov 07, 2005 12:38 pm|
I know it is difficult to not have a definitive diagnosis. Your symptoms are indicative of several disorders. Your primary concern appears to be MS. Unfortunately there is no definitive "test' For a diagnosis of MS.
At the present time, there are no specific blood tests, imaging techniques (e.g., magnetic resonance imaging (MRI) or computerized axial tomography (CAT) scan), tests of immune function, or genetic tests that can, by themselves, determine if a person has MS or is likely to have it in the future.
The diagnosis is a clinical one, made on the basis of a person's medical history, an assessment of the symptoms experienced and reported by the person, and the existence of signs detected by the physician (but not necessarily noticed by the person) during the neurological examination. Both symptoms and signs are necessary because symptoms are subjective complaints that can vary tremendously from one individual to another, while signs are more measurable, objective observations.
Examples of symptoms that are commonly reported by people with MS include problems with vision, walking, bladder control, fatigue, and uncomfortable sensations such as numbness or "pins and needles." Common signs that can be detected by the doctor during a physical examination, even if the person has never noticed or been troubled by these changes, include altered eye movements and abnormal responses of the pupils, subtle changes in speech patterns, altered reflex responses, impaired coordination, sensory disturbances, and evidence of spasticity and/or weakness in the limbs.
In order to make a definite diagnosis of MS, the physican must find the following:
plaques or leasions in at least two distinct areas of the central nervous system white matter (brain, or spinal cord)
evidence that the plaques have occurred at different points in time; and perhaps most importantly,
that these plaques in the white matter have no other reasonable explanation.
In other words, MS is a diagnosis that can be made only after every other possible explanation of the signs and symptoms have been ruled out."
You need to be sure to distinguish between "symptoms" -- those things that you as a patient report; and "signs" -- measurable objective findings that the doctor will find when he examines you.
There are also several other disorders that could cause the symptoms you are having. CFS and FMS, to name a couple. I think you should continue to pursue this with your doctor until you are comfortable with the diagnosis.
Jackie E. Pool, LPN
|mmb - Mon Nov 07, 2005 1:26 pm|
Thank you for your fast response. I will have my family doctor look into that. Hopefully, someone will figure it out. Thanks again.
|sneakerlady - Mon Nov 21, 2005 12:59 am|
Also, it's worrisome to me that your physical symptoms are on the right side of your body and you are having speech problems. Speech is controlled by the left side of your brain and the right side of your body is controlled by the left side of your brain.
Did you get tested for epilepsy? If you have health insurance, go ahead with the MRI.
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