Brief Answer:
Consider Vascular disorders

Detailed Answer:
Good evening. Thank you for your questions. Very sorry you are having to deal with these sorts of issues but let's take a look at things together for a moment.

MRI scans are extremely sensitive to detecting strokes, even stroke like syndromes that are based in the brain. Lesions as small as 1 mm. can't escape the scanner and therefore, I feel confident telling you that whatever is happening on the left side of your body is highly unlikely to be originating in the head.

Having said that.....has the MRI scanner taken a peek at the spinal cord? If I were your physician I would've likely ordered a scan of the lumbar spine with gadolinium contrast to be sure that nothing over the LEFT SIDE of the spinal cord could be causing problems.

As far as the mild degenerative changes at C5/C6 these are normally seen in all persons in your age category and are never considered to be significant enough to cause measurable symptoms much less what you're referring to in the leg which to my taste sound very VASCULAR in nature. The degenerative changes you're reading about can and will certainly involve other parts of your skeleton as time goes on, however, it is nothing out of the normal or ordinary and should not prompt further concern, worry, or even testing on your part. We are all suffering from such osteoarthritic changes. Having said that- please don't be shy about Googling the latest information on GOOD DIETS and GOOD EXERCISE regimens that have been found helpful to apply in cases where folks are interested in treating those "arthritic" aches and pains.

BTW, speech problems would have nothing to do with the noted changes at C5/C6. I cannot say at this time what is causing any speech problem since you've not really described it in the detail I would need as a clinician to know what category of problem you're experiencing in that regard. However, negative MRI is very encouraging to rule out a brain focus.

An additional imaging study I would have likely ordered given your symptoms would be an MRA which looks at the arterial system of vessels that feed the brain...and I would include the neck as well. I would do this study at least for completeness in order to complement the MRI that was done but also to be sure we are not dealing with some form of vascular malformation that could be subtly causing symptoms you describe.

I would recommend a consultation with a vascular doctor in order to get some type of Doppler ultrasound of the lower extremity on the left to be sure arterial blood flow is normal and being adequately maintained since this would be an important point to consider given your symptoms of color and temperature changes of the limb to include weakness and spasms.

Cheers young lady!

If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 19 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Diagnosis of MS unlikely if MRI's are negative

Detailed Answer:
Thank you for your return comments. If you've had 2 MRI's and both are negative then, the likelihood of this being MS which has been progressive over the past 3 years with the types of symptoms you're describing is virtually impossible. Neither is a spinal tap necessary to rule out MS any more so I would not recommend one of those at this time unless definite plaques or very suspicious demyelinating lesions suddenly show up that weren't there before. I would definitely make sure that the imaging studies of the brain and spinal cord were performed with gadolinium contrast.

There is something to consider, however, that can cause a deterioration in speech ability slowly and could present as you've described and that is an entity called PRIMARY LATERAL SCLEROSIS (PLS). This entity can cause motor problems with speech as well as voluntary muscle problems. It's usually presents in patients between 40-60 and usually has a protracted course so progresses rather slowly.

In addition to the MRI/MRA studies it would be entirely reasonable to get electrical studies of the left leg (arm also if affected) in order to distinguish a neuropathy/radiculopathy vs. an UPPER from LOWER motor neuron type of disease process. With your presentation I think it is much more likely to find pure UPPER MOTOR NEURON dysfunction rather than either LOWER MOTOR or MIXED disease.

Again, I would only pursue these additional lines of thinking if initial vascular studies and metabolic studies are negative.

Once again, my gratitude if you could CLOSE THE QUERY and include some positive comments along with a 5 STAR rating if you feel my suggestions have helped provide you with information of utility? Again, many thanks for posing your questions and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 40 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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