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Ask Dr. Bob Your Own Question
Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5401
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I've developed the following symptoms suddenly 3.5 years

Customer Question

I've developed the following symptoms suddenly 3.5 years ago: loss of balance and non rotational vertigo. I also suffer from fatigue and cognitive problems which started several years before this. 2 years ago I began to suffer from generalized weakness.
This becomes acute if I undertake average intensity exercise for more than 25 mins three times a week. I have hyper-sensitivity on my feet and other parts of my body. I've had several MRIs of the brain and spine over the past 3 years. The first showed 3 small
white spots. The most recent showed 7 to 8 spots. At my intervention and after speaking to the radiologist, my Neurologist said the change in number was due to changes in scanner type and software sophistication (slice thickness). He says there is no evidence
of disease process and I do not have MS. Other consistent findings: High IFG1 (30 ref range for age 26), high normal blood glucose (100 ng ml), high insulin (varies between 14 and 17), reactive hypoglycemia. Vitamin D supplementation helps but must be taken
daily to be effective. I can not tolerate more than 400 iu as this increases my susceptibility to upper respiratory tract infections and causes fluid retention. Low level laser therapy of the spine seems to improve symptoms. High dose caffeine (300mg) improves
symptoms but can cause insomnia. Vit B12 injection improves symptoms but causes insomnia. Can you suggest any diagnosis or treatment.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Bob replied 1 year ago.
Have you had an LP?
Customer: replied 1 year ago.
No I have not. I have heard they are not definitive either way, so do not want to take the risk of the test if it's not going to add much.I should of mentioned I was given a diagnosis of Meniers disease 1 year after the initial symptoms started. This was based on a positive ECOG (of the inner ear) which showed hydrops. The test was undertaken by an ENT who specializes in balance / inner ea problems. However I am not convinced my symptoms are consistent with this condition.
Expert:  Dr. Bob replied 1 year ago.
The white spots you mention on MRI are very common. While usually a sign of small vessel ischemic disease, the number and pattern can sometimes point to MS. In equivocal cases, an LP can be helpful, particularly if there are oligoclonal bands present. In addition, the LP often shows something that may not have been strongly considered such as Lyme disease or neurosyphilis. It might be worth discussing this with your neurologist. As for the Meniere's disease, this certainly would not explain your cognitive issues, fatigue and generalized weakness.