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Narcolepsy, Muscle Weakness, Memory Loss.Dr Suspects Multiple Sclerosis. Is This MS ?
Question: Hi, may I answer your health queries right now ? Please
My doctor suspects multiple sclerosis because of a single lesion in the prefrontal area (seen in t1 &t2, not seen on defussion scan) I am a 27y/o F w/ graves & hoshimotos, very high tpo antibodies >940 & very high thyroid immunoglubulin >3,000. TSI 89. Hx of Enteroviral meningitis. Presented with c/o increased sudden sleepiness (narcolepsy) x 9 months, 3 episodes of significant muscle weakness w/ difficulty walking lasting more than 1 week which improved with steroids the last time. Nystigmus. increased lower extremities dtr +4. Severe short term memory loss, processing words, transposing words, speaking, writing words. Continuous muscle twitching. severe muscle spasms in neck which causes migranes. Temporay loss of vision twice 3 years prior to 1st flair only lasted aprox 30 min. MRI report stongly suggest demylinating disease with a differential diagnosis of vasculitis. Negative routine blood work (except antibodies) and negative XXXXXXX (autoimmune vasculitis). The flairs I have are aprox 5 months apart are slow to come on and take longer to regain muscle strenght each time, cognitive impairments have not resolved. My Neuro appointment is not for several months. What is the likelyhood this is MS? Would this XXXXXXX diagnostic criteria for ms? Specifically what types of vasculitis would be used of a differential diagnosis. Thank you
My doctor suspects multiple sclerosis because of a single lesion in the prefrontal area (seen in t1 &t2, not seen on defussion scan) I am a 27y/o F w/ graves & hoshimotos, very high tpo antibodies >940 & very high thyroid immunoglubulin >3,000. TSI 89. Hx of Enteroviral meningitis. Presented with c/o increased sudden sleepiness (narcolepsy) x 9 months, 3 episodes of significant muscle weakness w/ difficulty walking lasting more than 1 week which improved with steroids the last time. Nystigmus. increased lower extremities dtr +4. Severe short term memory loss, processing words, transposing words, speaking, writing words. Continuous muscle twitching. severe muscle spasms in neck which causes migranes. Temporay loss of vision twice 3 years prior to 1st flair only lasted aprox 30 min. MRI report stongly suggest demylinating disease with a differential diagnosis of vasculitis. Negative routine blood work (except antibodies) and negative XXXXXXX (autoimmune vasculitis). The flairs I have are aprox 5 months apart are slow to come on and take longer to regain muscle strenght each time, cognitive impairments have not resolved. My Neuro appointment is not for several months. What is the likelyhood this is MS? Would this XXXXXXX diagnostic criteria for ms? Specifically what types of vasculitis would be used of a differential diagnosis. Thank you
Hello
Thank you for sending your question.
Your question is a good one and I will work on providing you with some information and recommendations regarding the symptoms you are experiencing.
From the details provided it looks to me like you had you are suffering from CNS and systemic vasculitis and multiple sclerosis is a close differential for this condition. As you know MS is a diagnosis of exclusion and if one can excludes the possibility of CNS vasculitis one should think of the possibility of MS in you. In view of thyroidits, muscle weakness and temporary visual loss in the back ground of headache's I personally would favor the possibility of vasculitis.
Vasculitis refers to a group of disorders that are characterized by inflammatory destruction of blood vessels. It can involve any blood vessel in the body and can cause problems even in the brain and the peripheral nerves. Treatments are generally directed toward stopping the inflammation and suppressing the immune system. Steroids and immune suppression drugs, such as cyclophosphamide are commonly used for these conditions.
So I personally feel you are probably suffering from vasculitis involving multiple organs in the body. You need to undergo blood tests for vasculitis, angiogram and if required biopsy of the skin or the blood vessel to confirm the diagnosis. Based on the sub-type of vasculitis, treatment protocols are decided. You need to see your Neurologist for a detailed work up and further management.
I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Thank you for sending your question.
Your question is a good one and I will work on providing you with some information and recommendations regarding the symptoms you are experiencing.
From the details provided it looks to me like you had you are suffering from CNS and systemic vasculitis and multiple sclerosis is a close differential for this condition. As you know MS is a diagnosis of exclusion and if one can excludes the possibility of CNS vasculitis one should think of the possibility of MS in you. In view of thyroidits, muscle weakness and temporary visual loss in the back ground of headache's I personally would favor the possibility of vasculitis.
Vasculitis refers to a group of disorders that are characterized by inflammatory destruction of blood vessels. It can involve any blood vessel in the body and can cause problems even in the brain and the peripheral nerves. Treatments are generally directed toward stopping the inflammation and suppressing the immune system. Steroids and immune suppression drugs, such as cyclophosphamide are commonly used for these conditions.
So I personally feel you are probably suffering from vasculitis involving multiple organs in the body. You need to undergo blood tests for vasculitis, angiogram and if required biopsy of the skin or the blood vessel to confirm the diagnosis. Based on the sub-type of vasculitis, treatment protocols are decided. You need to see your Neurologist for a detailed work up and further management.
I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank-you. I was able to get an appointment sooner with a local neurologist but will keep my appointment with the other for a second opinion. Vasculitis would make sense since I have multiple pelvic phleboliths. I will repost after the 1st appointment. Also they have ruled out XXXXXXX vasculits. Your response was helpful and appreciated.
Hello
Thanks for the follow up query
I feel it could be vasculitis related problems in you. So XXXXXXX your Neurologist at the earliest and get investigated.
Wishing you good health.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Thanks for the follow up query
I feel it could be vasculitis related problems in you. So XXXXXXX your Neurologist at the earliest and get investigated.
Wishing you good health.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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