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What Are The Symptoms Of Multiple Sclerosis Relapse?
Question: Thank you, it will not be fast for mr to respond to any of your ? since one of my fingers doesn't work
Brief Answer:
MS unlikely. More information on symptoms might be useful.
Detailed Answer:
I read your query carefully more than once and I am really sorry about the amount of issues you and your family have had over the years.
It is a little unclear though the manifestations of your relapses. Perhaps because you had so much to tell you do not say much about them, only that at the beginning you felt sick and flu like and got the fibromyalgia diagnosis. Then you mention fleetingly to have been at a hospital for seizures and that your final diagnosis is Lupus. Further you say to have had more and more relapses with pain for which you take extended release morphine and Norco. That is the whole information I could extract, but I am afraid the only symptom regarding your relapses you mention is pain and the emotional distress you have been due to your loss.
So please if there are other symptoms, such as weakness of the limbs, visual loss, double vision, loss of sensation, problems with balance and coordination. Those are the typical manifestations of a MS relapse, often relapses are different from each other as different brain areas are involved. Otherwise if only pain relapses I do not think it is a question of MS. Seizures which you mention are not a MS feature either.
In case you have such features please describe them, their evolution in time so that we can discuss about other possible diagnoses. Also being given these diagnoses I suppose you have had tests as well, so please share imaging reports, EEG (brain imaging and EEG should have been done for seizures), lab tests which I am sure you have had. Also some info regarding medications, use of antiseizure and antidepressive medication which are often beneficial for chronic pain and fibromyalgia as well.
I remain at your disposal for further question, but please providing more of the information which I mentioned.
MS unlikely. More information on symptoms might be useful.
Detailed Answer:
I read your query carefully more than once and I am really sorry about the amount of issues you and your family have had over the years.
It is a little unclear though the manifestations of your relapses. Perhaps because you had so much to tell you do not say much about them, only that at the beginning you felt sick and flu like and got the fibromyalgia diagnosis. Then you mention fleetingly to have been at a hospital for seizures and that your final diagnosis is Lupus. Further you say to have had more and more relapses with pain for which you take extended release morphine and Norco. That is the whole information I could extract, but I am afraid the only symptom regarding your relapses you mention is pain and the emotional distress you have been due to your loss.
So please if there are other symptoms, such as weakness of the limbs, visual loss, double vision, loss of sensation, problems with balance and coordination. Those are the typical manifestations of a MS relapse, often relapses are different from each other as different brain areas are involved. Otherwise if only pain relapses I do not think it is a question of MS. Seizures which you mention are not a MS feature either.
In case you have such features please describe them, their evolution in time so that we can discuss about other possible diagnoses. Also being given these diagnoses I suppose you have had tests as well, so please share imaging reports, EEG (brain imaging and EEG should have been done for seizures), lab tests which I am sure you have had. Also some info regarding medications, use of antiseizure and antidepressive medication which are often beneficial for chronic pain and fibromyalgia as well.
I remain at your disposal for further question, but please providing more of the information which I mentioned.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You are correct about my lack of a timeline and the onset of additional symptoms I filled that out the other day very quickly because it was one of those days that I just felt like is this all there is left for me? I do know that any depression is almost always situational. For example, every one is going to the movies. The thought of getting up and dressed, like I used to do, was not even a consideration. I was genetically gifted with excellent skin. I XXXXXXX very easily but I rarely burn. I don't have any wrinkles and people that I see that I haven't seen for a long time always comment on how I haven't aged. One of the things that one rheumatologist said was you don't have an autoimmune disease, especially SLE because you have no butterfly rash. He said I had osteoarthritis and I very well might. My mother has it but she does not have nearly as much pain as I do, with or without meds. However, about a week ago I took my dog to check the mail which is a 10 minute walk. By the time I got back my hip joints, this is new, hurt to bad that I was telling myself don't fall dow over and over. It is the area on the sides around the waist area. I have had aches more so in that area lower down and it is more of an ache, not sheer acute pain from walking. Also, the next day my face was covered in a rash. It did not really show because it had no color but it sound to put my usual nighttime face lotion on and they were small and actually in patches. Just a lot of them. When they started going away they did not disappear the came off if I scratched my cheek because it itched.
In 2011 I had a severe seizure and was in the hospitalized because when they would administer a seizure medication it didn't do much to stop them. When I started to become aware that I was somewhere that I did not have a clue as to where I was I started having a temperature which went up to right under 103 and I was projectile vomiting. I have had a left bundle branch block in my heart for hears and the mir or ct scan showed calcification of my carotid artery which was flag and responded to as an "unknown" symptom. I should have mentioned earlier that when I started running a fever and vomiting I was immediately put in isolation for possible meningitis. I had at least 5 spinal taps and one showed up asEpstein Barr virus but it was in the blood. There was a doctor there on my case that I liked who specialized in in contagious diseases. He was the one that ran the spinal for meningitis and put me on an antibiotic that is used to treat that before he even got the results bak. After two treatments of the antibiotic the Epstein Barr disappeared. He stayed on the case because he did not feel all that comfortable with the Epstein Barr showing up in my blood anger 7 days of labs then just disappearing. All my labs were flagged. Low potassium, red blood cell in the urine tests low white count with a SED rate of around 30 with 5 being the reference I had been admitted to another hospital here from seizures that I would not let treat my dog. One time the on-call doctor said to release me and when the neurologist was showing me the the paperwork I went into a 3 minute seizure while he was talking. When they got it stopped the other doctor said to go ahead and admit me. With the exception of the doctor that specialized in contagious diseases and the pain doctor who didn't have to ask if my beck hurt he just saw the scan and started me on paid meds iv then then switched to oral meds after I stopped throwing up. When I finally became conscious enough to care about brushing my teeth, etc. they ran some additional labs which were better but still had flags, they all huddled outside my room and argued what to diagnosis me with so they could discharge me. That was kind of funny. They mostly agreed on Lupus Encephalitis as the main diagnosis and put me on Keppra for seizures. It worked but in a previous hospital admittance I was on clonazepam for the seizures. It was much easier on my stomach so I was switched to that. I do see a Psychiatrist who mostly treats pain management. I mentioned the disability co and my son's death because the death of your child who you know is in pain and scared about his heart and alcoholism and wanted re-hab but I was 2 days late on getting to Los Angles for the heart doctor and I argued with this disability company to the point that they had no case but for some reason they wanted me to have to follow the ERISA guidelines they made me an employee of the Cal Soc. of CPA's in order to assert it was an ERISA claim. They basically followed a lon history of disability companies making up rules and XXXXXXX for you to break to the point of what the courts called "arbitrary and capricious." I basically did all the work on my sexual harassment case because it involved a lot of people and I had to write all the depositions and notes for discovery and other stuff. It was very new then and the lawyer I used reduced his rate by half. It was the largest settlement of any kind that firm had ever had. That along with doing was research for a large company made me more knowledgable than most clients. I guess I wanted some idea of what it might be because it was different and it was in addition to the regular symptoms. It was also a very sudden onset. I was in XXXXXXX and I had to hire someone to pack and ship my stuff to California. I probably have had 15 hospitalizations in 2010 and 2011 from seizures. It was just that last one that made me stop and try to do something. I am still on medication for low thyroid but not potassium. The other meds are the ms contin and clonazepam. I am going to schedule an appointment with a pain treatment doctor who is moe hands on so he can run some new labs and have my hips checked out. If something comes to mind please let me know. In the mean time I will get my labs and ex-rays to you. Thanks. XXXXXXX One other thing, I have ocular migraines in my right eye so I am not really very diligent in proofreading my emails. I hope you can get the gist of what I am saying.
In 2011 I had a severe seizure and was in the hospitalized because when they would administer a seizure medication it didn't do much to stop them. When I started to become aware that I was somewhere that I did not have a clue as to where I was I started having a temperature which went up to right under 103 and I was projectile vomiting. I have had a left bundle branch block in my heart for hears and the mir or ct scan showed calcification of my carotid artery which was flag and responded to as an "unknown" symptom. I should have mentioned earlier that when I started running a fever and vomiting I was immediately put in isolation for possible meningitis. I had at least 5 spinal taps and one showed up asEpstein Barr virus but it was in the blood. There was a doctor there on my case that I liked who specialized in in contagious diseases. He was the one that ran the spinal for meningitis and put me on an antibiotic that is used to treat that before he even got the results bak. After two treatments of the antibiotic the Epstein Barr disappeared. He stayed on the case because he did not feel all that comfortable with the Epstein Barr showing up in my blood anger 7 days of labs then just disappearing. All my labs were flagged. Low potassium, red blood cell in the urine tests low white count with a SED rate of around 30 with 5 being the reference I had been admitted to another hospital here from seizures that I would not let treat my dog. One time the on-call doctor said to release me and when the neurologist was showing me the the paperwork I went into a 3 minute seizure while he was talking. When they got it stopped the other doctor said to go ahead and admit me. With the exception of the doctor that specialized in contagious diseases and the pain doctor who didn't have to ask if my beck hurt he just saw the scan and started me on paid meds iv then then switched to oral meds after I stopped throwing up. When I finally became conscious enough to care about brushing my teeth, etc. they ran some additional labs which were better but still had flags, they all huddled outside my room and argued what to diagnosis me with so they could discharge me. That was kind of funny. They mostly agreed on Lupus Encephalitis as the main diagnosis and put me on Keppra for seizures. It worked but in a previous hospital admittance I was on clonazepam for the seizures. It was much easier on my stomach so I was switched to that. I do see a Psychiatrist who mostly treats pain management. I mentioned the disability co and my son's death because the death of your child who you know is in pain and scared about his heart and alcoholism and wanted re-hab but I was 2 days late on getting to Los Angles for the heart doctor and I argued with this disability company to the point that they had no case but for some reason they wanted me to have to follow the ERISA guidelines they made me an employee of the Cal Soc. of CPA's in order to assert it was an ERISA claim. They basically followed a lon history of disability companies making up rules and XXXXXXX for you to break to the point of what the courts called "arbitrary and capricious." I basically did all the work on my sexual harassment case because it involved a lot of people and I had to write all the depositions and notes for discovery and other stuff. It was very new then and the lawyer I used reduced his rate by half. It was the largest settlement of any kind that firm had ever had. That along with doing was research for a large company made me more knowledgable than most clients. I guess I wanted some idea of what it might be because it was different and it was in addition to the regular symptoms. It was also a very sudden onset. I was in XXXXXXX and I had to hire someone to pack and ship my stuff to California. I probably have had 15 hospitalizations in 2010 and 2011 from seizures. It was just that last one that made me stop and try to do something. I am still on medication for low thyroid but not potassium. The other meds are the ms contin and clonazepam. I am going to schedule an appointment with a pain treatment doctor who is moe hands on so he can run some new labs and have my hips checked out. If something comes to mind please let me know. In the mean time I will get my labs and ex-rays to you. Thanks. XXXXXXX One other thing, I have ocular migraines in my right eye so I am not really very diligent in proofreading my emails. I hope you can get the gist of what I am saying.
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional info. Of course I would be happy to look at any lab or imaging report you might offer later on.
Based on what you say I can only reinforce the fact that I don’t think you have MS, I don’t see any reason to suspect that at all, no indication on that regard.
Looks likely that you have advanced osteoarthritis. It may be alone or it may be as part of lupus, joint involvement is one of the most common manifestations of lupus. It may also involve the central nervous system and cause seizures. So if there are also skin manifestations and laboratory tests confirm lupus I would say that it is a correct diagnosis.
Now regarding suggestions, first if the lupus diagnosis is confirmed, since it is an autoimmune disease have immune suppressants been tried. They are the only means of (at least trying) to stop progression, other medication only alleviate symptoms without changing the course over the years.
Also regarding symptomatic treatment, for the pain, I would consider trying some chronic pain medication. A first line alternative for that are anticonvulsants gabapentin and pregabalin, medications which prevent seizures as well, sort of killing two birds with one stone. They could lower pain intensity and frequency reducing the need for morphine and norco. These are a couple of issues you should discuss with your pain treatment doctor.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Thank you for the additional info. Of course I would be happy to look at any lab or imaging report you might offer later on.
Based on what you say I can only reinforce the fact that I don’t think you have MS, I don’t see any reason to suspect that at all, no indication on that regard.
Looks likely that you have advanced osteoarthritis. It may be alone or it may be as part of lupus, joint involvement is one of the most common manifestations of lupus. It may also involve the central nervous system and cause seizures. So if there are also skin manifestations and laboratory tests confirm lupus I would say that it is a correct diagnosis.
Now regarding suggestions, first if the lupus diagnosis is confirmed, since it is an autoimmune disease have immune suppressants been tried. They are the only means of (at least trying) to stop progression, other medication only alleviate symptoms without changing the course over the years.
Also regarding symptomatic treatment, for the pain, I would consider trying some chronic pain medication. A first line alternative for that are anticonvulsants gabapentin and pregabalin, medications which prevent seizures as well, sort of killing two birds with one stone. They could lower pain intensity and frequency reducing the need for morphine and norco. These are a couple of issues you should discuss with your pain treatment doctor.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
That would be nice, if you have to pick a word for it. I have had Hep B and C and I was young and lived at at diabetic camp in XXXXXXX during the summer. I was looking at some pictures yesterday of a vacation I went to with my ex a lot of years ago. He always had to take pictures with someone in them because taking one of a peacock with his feathers fully out, beautiful, was boring. Anyway there were 2 pictures of me in the same swimsuit. This is a one week vacation. The first day he took a picture I was surprised at how light I was since I was always in the sun but kids and all. The second picture is 4 days later and I could easily have passed for a Mexican National. Anyway, your advise sounds reasonable but I am not going to tell the doctor I see. I want someone else to give me a second opinion without any previous knowledge. Anyway when I had Hep B it was summer and I was very dark. The doctor said I had the flu and to just take it easy and drink fluids. I ended up in the hospital after a week because the XXXXXXX was nice but the yellow eyes were a dead give away. Since then I have never been able to donate blood except for my self and my liver tests are relatively normal but doctors don't like using a lot of the drugs out there due to my lover. I guess I have no problem with morphine nice it is time released, the warnings on the commercials for all the other drugs are longer than the add for the drug it self. If I thought I was abusing narcotics I would try something else but when I compare the side effects of them with them side effects of some of the other drugs, no thank you. I get monthly refills and right now I have one coming up with over half of the previous prescription so I think I am taking it carefully and not just because I want to. In California, people matter more than pain. Since I have been using it so long and only decreased the dosages over time I don't feel it is a problem. Thanks for now. XXXXXXX
Brief Answer:
Read below.
Detailed Answer:
Thank you for your feedback.
I understand your reluctance about discussing my suggestions with the doctor for the moment, it is true among others that us doctors are not very enthusiastic to hear opinions obtained over the net, so perhaps in the first meeting can limit to listening his suggestions.
As for the liver that could be an issue. Gabapentin is not known for liver toxicity so if tests are all normal it could be tried carefully. I understand that you're okay with the narcotic medication, but it might still bee nice not needing them.
Wishing you good health.
Read below.
Detailed Answer:
Thank you for your feedback.
I understand your reluctance about discussing my suggestions with the doctor for the moment, it is true among others that us doctors are not very enthusiastic to hear opinions obtained over the net, so perhaps in the first meeting can limit to listening his suggestions.
As for the liver that could be an issue. Gabapentin is not known for liver toxicity so if tests are all normal it could be tried carefully. I understand that you're okay with the narcotic medication, but it might still bee nice not needing them.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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