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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 64984
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Hi, I could really use some help, I really dont know where

Resolved Question:

Hi, I could really use some help, I really don't know where to turn now.

I'm a 49 year old female with an unremarkable medical history, up until 3 years ago when I underwent 2 spinal operations in 18 months. Since my last operation in May 2012 I started to experience a range of subtle symptoms which at the time I put down to possible menopause and the pain releif drugs I was taking.

The fisrt things I noticed were tingling and pins and needles in my legs and arms, mostly left side, also in my face and neck, occasional difficulty swallowing and dizzy spells and loss of balance and blurred vision. These symptoms started to get worse and I started having falls, dropping things, getting confused and slurring my speech.

I had a brain MRI, there were a number of Lesions present and a comment suggestion Demylation but the neurologist was very dismissive and said it was my age and that I was suffering from stress and dismissed with a prescription for anti-depressents.

I know myself and my body well enough to know 100% that these symptoms were not triggered by stress, I sought a 2nd opinion which concluded I am suffereing from Migraine Auro without headache, either Dysphasic Aura or Hemilplegic Aura. When I went back to my neurololigist he dismissed this out of hand and is still saying I am suffering from stress. However finally... he has referred me for vestibular testing as my worst symptom is constant dizzyness and confusion, I can't walk in straight line now, have to use a stick to keep me steady, if I close my eyes when standing up I fall over, I also have very weak legs and have lost sensation in my left lower leg and foot (but we know the loss of sensation is due to nerve damage from my spinal operation). I feel caught in the middle between differing medical opinions, my GP suspects possible MS and agrees that the symptoms were not stress triggered but my neurologist just won't listen. This has affected my life/career and i am still not receiving any kind of treatment because I have not been diagnosed yet. I appreciate thee are many types of neurological problems that are difficult to diagnose but I just seem to be getting no where.

I also had some positive anti-nuclea blood test results but again the neurologist dismissed these as nothing and didn't even bother investigatigation which is a worry as there is a family history of blood related disorders (my mother had thrombosythemia and suffered many strokes).

Can someone tell me what I should do next, I hate feeling like this and I am getting worse but no one will help me! Any advice/pointers would be gratefully received.

Many thanks :-)
Submitted: 4 years ago.
Category: Medical
Expert:  DrRussMD replied 4 years ago.
Hello from JA
Lesions in the brain suggestive of MS are not normal, and this is not due to stress.

Please type in the summary section of the MRI report
Customer: replied 4 years ago.


Hello,


 


I don't have the scan results with me currently so I will come back to you tomorrow. The neurologist says the lesions are NOT suggestive of MS, but the GP still thinks MS is a possibility. I have a radiologist report and and another interpretation of the scan from the neuro I sought a 2nd opinion from. I will send both of these tomorrow.


 


Thanks


 


 

Expert:  DrRussMD replied 4 years ago.
OK
I will be here
Customer: replied 4 years ago.

Hello again,


details of MRI reports as requested - the scan was done in May 2013 without contrast.


 


1st from imaging consultant. - A few non-specific bright T2W and FLAIR white matter lesions are seen in each cerebral hemisphere. Lesions seen bilaterally in the insular subcortical white matter and a few small lesions involve corona radiata on each side. These lesions are non-specific in appearance. Thay are not necessarily of clinical significance, however Demyelation is a possibility.


 


2nd - reveiw of same MRI from 2nd Consultant Nuerologist I saw who diagnosed Migraine Aura - showed 3 high signal lesions on FLAIR and 6 or 7 on T2 in the hemisphXXXXX XXXXX matter (half the ones in T2 were peivascular spaces). The cervical thoracic cord appears normal.


 


Something I didn't mention yesterday is that I also get quite a sever tremor and random buzzing nerve pain in various parts of my body.


 


I also mentioned some positive blood test results which are "positive anti-nuclear antibody which is centromere pattern of 1:640."


 


I have been told since that for these results anything over 1:340 should be investigated.


 


I have also had 2 EMG tests relating to the loss of feeling in my leg, these as expected confirmed deep nerve root damage at L5 which is irreversable.


 


Thank you for your time, I hope you can help.


 


Kind regards


Trudy


 


 

Expert:  DrRussMD replied 4 years ago.
OK
first of all I would be seeing a physical medicine and rehabilitation specialist. The L5 lesion might be irreversible, but it can be improved with the correct manual therapies.

Next I would see a different neurologist, the MRI could still be MS and this needs to be considered, along with a course of treatment.
However, if symptoms have never disappeared and returned with at least a month remission, it will be difficult to clearly diagnose MS.

Please let me know if you have further questions.
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