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What Causes Memory Loss, Speech Disorder, Severe Fatigue, Exhaustion And Joints Pain?

Posted on Thu, 28 Jul 2016

Question: I was diagnosed with temporal lobe epilepsy 7 years ago. Nothing showed on my eeg and the only thing seen on my mri was white spots on the frontal lobe. I have never had a head injury and do not suffer from migranes. Over the last few years I have suffered from absence seizures but also get dystonia in my foot, have memory loss, keep tripping over my words and get words mixed up, have vitamin D deficiency, severe fatigue and exhaustion, pains in my joints and aches in my legs. I am concerned the diagnosis was wrong. I wonder whether it could be ms but can find no link that would explain the seizures. My neurologist fobs me off all the time. Could it be something other than epilepsy?

Answered by Dr. Sudhir Kumar (13 minutes later)

Brief Answer:
Is it possible to send the radiologist's report?

Detailed Answer:
Hi,

Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

I have noted your detailed symptoms. I agree with you that temporal lobe epilepsy and absence seizures are not typical symptoms of multiple sclerosis (MS). Seizures, if at all, are rare in MS.

The diagnosis of MS can be confidently made on the MRI. In case of doubt, additional tests such as lumbar puncture to look for oligoclonal bands should be done.

If possible, please send the radiologist's report of the MRI brain.

If more than six months have passed, MRI may be repeated to look for any new lesions (which are expected in MS).

What medications are you on now?

What is the vitamin B12 level? Any thyroid problem?

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Sudhir Kumar (2 hours later)

I have requested another mri which the epilepsy nurse is organising. She is also going to speak to the neurologist about getting a bone density scan due to the joint pain I have been suffering. I know I have something called a degenerative cyst in my wrist which they found when my gp sent me for an xray after having my daughter 3 years ago. I couldn't pick her up out of her crib it was that painful. I have noticed that the symptoms with my joints, excessive fatigue, memory problems and tripping over my speech has definitely gotten worse in the past 3 years. I do work but only during school term times. I honestly believe I wouldn't cope working full time now. I have had lots of blood tests due to the tiredness and vitamin D deficiency and the only things that have appeared abnormal were my vitamin d levels. If I don't take supplements it drops significantly. I think the worst it went down to was 22. I'm not sure if my b12 has been tested but I know they have tested my thyroid several times over the last few years and all appears normal.
I take lamotrigine and lacosamide at the moment for my absence seizures. I was diagnosed with cyclothymia many years ago so my epilepsy meds controls my mood swings as well. I find it difficult to believe that the other symptoms could be yet another medical issue. I have been on those meds for about 4/5 years and I haven't suffered side effects prior to having my daughter so I find it hard to believe I would suddenly develop loads of side effects now.
I figured if I got another mri and it shows the same white spots on my frontal lobe and there has been no changes in the past 7 years then at least I can stop worrying about it being ms.

Answered by Dr. Sudhir Kumar (6 hours later)

Brief Answer:
Yes, if MRI is same, you can stop worrying about MS.

Detailed Answer:
Thank you for getting back with more information.

I have noted the additional points mentioned by you.

Lamotrigine and lacosamide are excellent medicines, and you can safely continue them.

Vitamin D deficiency is common (affects about 70-80% of population in cities) and is easy to treat with weekly supplements.

Bone density study would help to detect osteoporosis, and treatment would help you get better.

Repeat MRI of brain would be very useful. On one hand, it can help in excluding MS, if there are no new lesions (white spots). On the other hand, any other problem in the brain (such as ischemia-lack of blood supply; or vasculitis- inflammation of blood vessels) can also be detected/excluded.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Yogesh D