Is this MS?

[HContrer]

My wife a 27 year old female, generaly healthy, used to work out everyday, but one day when we were on vacation in Brazil she started to feel weak on her legs, and something would shoot down her legs. We got back to the US. and I took her to the doctor, at first they thought it was a herniated disk which she does have but after a while she started to get weak all over her body; at that point they started to think it was something else because herniated disks do not cause weakness all over the body.

A couple of weeks passed by and they did not know what it was, and I took her to many different Docs. Finally she just would not hold her own weight so I called the Ambulance and they picked her up and took her to ER.

Initially she was treated for GBS (Guillian-Barre Syndrom) with Immune globulin Intraveneous. At first it appeared to work, but a week later after she started physical therapy, and right after her therapy she started to feel extremely tired, weak and also she would feel something running thru her body ( some type of tinggling sensation that would run back and forth thru her arms and legs, and also her head. She also, felt her head was extremely heavy.)

At this point she has been in the hospital for about a month and she goes from feeling much better(where she is able to hold her head, she can feed herself, sit up by herself and put herself on the wheelchair, to not been able to do all of the above plus feels tired when chewing her food she would chew two to three times and she needs to rest) and all this can happen in one day or even a couple hours. And lately she has been feeling burning feet, and legs, plus she has started to feel some pain of her legs.

Here are all the symptoms that she has been feeling for the past 3 weeks.  Weak arms, and legs all the time, also, she feels fatigue all the time.  She also gets more fatigue and weak if she walks a little bit, does not sleep, talk for a while, or does not eat for a long time.  Also, when she is extremely fatigue, and weak she gets paralyzefrom all of her lymbs and face for about 30 minutes or sometimes it could last 4 to 5 hours.

At this point the Doctors have done so many test and they do not know what she has. If someone know anything or can think of anything we would greately appreciate any feedback. Thank very much in advance.

[jensequitur]

Her symptoms do sound like a neurological disorder of some sort, but without MRIs or a lumbar puncture, it would be hard to nail down exactly what it was.  Best of luck!

[essdipity]

Could you tell us what tests she's had? We'll do our best for you.

ess

[santana8]

Did she have to have help breathing? I have read a lot on GBS and a lot of what you discribe sounds like it, but I believe that patients usually need help breathing because of paralysis of the diafram. I am not an expert in this but I have read about it. Quix would be the one to ask this question. I am sure she will come along and jump in here with what she knows. She is not a neurologist but is a retired physician and also has MS.

Santana8

[Quixotic1]

Hi, I'm so sorry to hear about what your wife is going through!  It does indeed, sound like Guillain-Barre.  GBS can occasionally have a relapsing -remitting course.  It usually is not helped by steroids. I couldn't tell how long all of this has been going on.

What did the spinal tap and the MRI's of the brain and spine show?  GBS is often precipitated by an infection, either viral, like Epstein-Bar & others, or by a bacterial intestinal infection called "Camphylobacter jejunei."   Did she have any "tourist diarrhea " while on your vacation? Has she been seen by an infectious disease specialist along with her neurologist?

What do the nerve conduction studies show?  Are there signs of "demyelination" in the peripheral nerves?  This would be consistent with GBS.

Also, the attack on the spinal cord in GBS does not always rise high enough to cause a problem with breathing.  In its full-fledged form it certainly can.  Do you know if your wife's tendon reflexes (when they tap on the knee, elbow, and back of the ankle) are absent or really hyperactive (BIG KICK when they tap her knee)?

Finally, if all of this has lasted long enough, and it doesn't sound like it has (like a few months or so) the doctors should be considering CIDP, Chronic Inflammatory Demyelinating Polyradiculoneuropathy.  CIDP is often treated successfully with steroids, Iv infusions of high dose antibodies called IVIG or gaamglobulin.  And it also often responds to a procedure  known as plasmaphoresis.

Another thought, but probably less likely with the sensory things like tingling and pain, is a disorder of muscle weakness called Myasthenia Gravis.  This can be diagnosed with blood tests (especially looking for an antibody called Anti-AChR) and a test using a med called Tensilon.  There are also many other tests that are done looking for associated diseases like thyroid disease, lupus and other autoimmune diseases.  Does she have difficulty moving her eyes around?  What makes me think of this is how incredibly easily she becomes fatigued.

Since it started in Brazil, have the doctors done a thorough search for tropical diseases that can cause a picture like this?  It is not my field of expertise so I don't have examples for you.

These are the first thoughts in my head.  I'm really interested in the results of the MRIs, the spinal tap, the nerve conduction studies, and what the doctors have suggested.  And how many weeks she has had this.

I'll do some reading about GBS to see if it can act the way you discribe, but I'm pretty sure it can.  Please remember that I was NOT a neurologist, this is not my field of expertise and I am no longer in practice.  Do NOT take what I say over what her doctors are saying.

I hope to hear from you soon.

Quix