Aa
Do I have symptopms of Cervical or MS?
Please bear with me for language, not belonged to English speaking nation.
-Hashimoto(75 mg) from past 3 years and on vegan diet from past 1.5 years.
So it started in last week of march. I had severe vertigo that lasted for 3 hours, and then for a couple of days (7-8 days) had sudden episodes of vertigo(1 sec to 1 min). Also I felt whole body weakness. My family medicine doctor asked me for brain MRI and EEG.(both done on 31 March)
Brain MRI- few punctate white matter hypersensitivities in subcortical region of bilateral frontal brain. Rest show no lesions.
EEG- Normal
My family doctor said it is normal MRI.
Then I went to see neurologist. He said everything is normal and told me it is BPPV.
Now around 20th May, I had severe vertigo in the morning lasted for 5 hours. (On 19th I had two bugs of beer). Then I vomit 2-3 times and then series of symptoms started.
Symptoms
: Extreme fatigue from 20th may till now
: When I move my head right upwards, a fixed object comes down to its position.(from 20th may till now)
: Weird kind of pain(not much) in right leg calf and right leg back thigh(from 25th may till now)
: Gets easily tired when I use stairs.(from 20th May till now)
: Anxiety(from many years)
: Numbness and tingling in feets/hands: I had this from 2-3 years. I checked my b12 levels last year in August 2017. It was low 162. I took b12 shots. Again checked on 31 Jan 2018, it was 420. Numbness tingling was 80 percent gone. Now I feel sometimes different kind of numbness in feet. Like my feet is 20 percent number all the time. Same for arms/hands. I recently checked my b12 levels- 444. and Vitamin D3: 37
: Vision is fine, but some times I feel my right eyelid is irritating my eye.
Routine Blood Test normal except ESR-28
Doctors visited:
Please see the symptoms accordingly the doctors, I visited
21 May 2018: Neurologist A: He said, looking at my symptoms, eye and MRI report. It is BPPV.
28 May 2018: Neurologist B: He said, looking at my symptoms and MRI report. It is BPPV.
29 May 2018: Neurologist C: He said, looking at my symptoms and MRI report. It is BPPV. He told me if symptoms persist even after 2-3 days, get your brain mrs done again.
2nd June 2018: Brain MRI done: few punctate white matter hypersensitivities in subcortical region of bilateral frontal brain. Rest show no lesions.
2nd June 2018: Neurologist C said everything is normal. It is BPPV. I asked him whether I need to do cervical MRI. He told me no need, but I still went for it.
4th June: Cervical MRI:
-Straightening of cervical spine with vertebral body degenerative changes in form of marginal osteophytosis.
-Disc desiccation noted at multiple locations.
-Diffuse disc bulge causing thecae sac indentation seen at c4-c5 and c5-c6.
5th June 2018: I went to medicine doctor(he is my doctor for 5 years and he knows me well so I thought to take advice from him.) He told me everything is fine.
Now what about my symptoms? I am really worried. Please help me!
-Hashimoto(75 mg) from past 3 years and on vegan diet from past 1.5 years.
So it started in last week of march. I had severe vertigo that lasted for 3 hours, and then for a couple of days (7-8 days) had sudden episodes of vertigo(1 sec to 1 min). Also I felt whole body weakness. My family medicine doctor asked me for brain MRI and EEG.(both done on 31 March)
Brain MRI- few punctate white matter hypersensitivities in subcortical region of bilateral frontal brain. Rest show no lesions.
EEG- Normal
My family doctor said it is normal MRI.
Then I went to see neurologist. He said everything is normal and told me it is BPPV.
Now around 20th May, I had severe vertigo in the morning lasted for 5 hours. (On 19th I had two bugs of beer). Then I vomit 2-3 times and then series of symptoms started.
Symptoms
: Extreme fatigue from 20th may till now
: When I move my head right upwards, a fixed object comes down to its position.(from 20th may till now)
: Weird kind of pain(not much) in right leg calf and right leg back thigh(from 25th may till now)
: Gets easily tired when I use stairs.(from 20th May till now)
: Anxiety(from many years)
: Numbness and tingling in feets/hands: I had this from 2-3 years. I checked my b12 levels last year in August 2017. It was low 162. I took b12 shots. Again checked on 31 Jan 2018, it was 420. Numbness tingling was 80 percent gone. Now I feel sometimes different kind of numbness in feet. Like my feet is 20 percent number all the time. Same for arms/hands. I recently checked my b12 levels- 444. and Vitamin D3: 37
: Vision is fine, but some times I feel my right eyelid is irritating my eye.
Routine Blood Test normal except ESR-28
Doctors visited:
Please see the symptoms accordingly the doctors, I visited
21 May 2018: Neurologist A: He said, looking at my symptoms, eye and MRI report. It is BPPV.
28 May 2018: Neurologist B: He said, looking at my symptoms and MRI report. It is BPPV.
29 May 2018: Neurologist C: He said, looking at my symptoms and MRI report. It is BPPV. He told me if symptoms persist even after 2-3 days, get your brain mrs done again.
2nd June 2018: Brain MRI done: few punctate white matter hypersensitivities in subcortical region of bilateral frontal brain. Rest show no lesions.
2nd June 2018: Neurologist C said everything is normal. It is BPPV. I asked him whether I need to do cervical MRI. He told me no need, but I still went for it.
4th June: Cervical MRI:
-Straightening of cervical spine with vertebral body degenerative changes in form of marginal osteophytosis.
-Disc desiccation noted at multiple locations.
-Diffuse disc bulge causing thecae sac indentation seen at c4-c5 and c5-c6.
5th June 2018: I went to medicine doctor(he is my doctor for 5 years and he knows me well so I thought to take advice from him.) He told me everything is fine.
Now what about my symptoms? I am really worried. Please help me!
COMMUNITY LEADER
Hi again,
You can only conclude your p100 latency of 154ms was inaccurate if within day's your VEP results were significantly different and in normal range for a male under 60 which 114ms is....
"The usual waveform is an initial negative peak (N1 or N75), followed by a large positive peak (P1 or P100), followed by another negative peak (N2 or N145). Maximum value for P100 is 115 msec in patients younger than 60 years; after this age, it rises to 120 msec in women and 125 msec in men. Even though published norms are available in the medical literature, each individual laboratory should have its own norms to control for laboratory-to-laboratory variations in technique."
https://emedicine.medscape.com/article/1137451-overview#a2
Your anxiety situation has been openly acknowledged by you in your posts, your Dr shopping behaviours should be like a neon sign bringing to your attention just how much your anxiety is driving you to continue to fear the worst and keep you desperately searching for proof of what you believe is wrong, despite your normal diagnostic evidence and extensive professional options and reassurances. For the record having a mental health issue does 'not' give anyone immunity from being dx'ed with any other medical condition, pwMS experience anxiety and depression too....please don't make a mistake and reject your health anxiety as being a significant factor in what your dealing with and seek professional help for this singular problem, MSer or not, anxiety and or depression will literally make everything feel worse than it truly is!
What compelled you to specifically get the VEP test anyway, you don't mention visual symptoms suggestive-consistent with Optic Neuritis, why that specific test?
Your focusing on MS but even IF you had been dx with Optic Neuritis (ON), not only are most cases of ON idiopathic but it's also associated with a lot of other conditions...
"What causes optic neuritis?
The cause of ON isn’t well understood. Most cases are idiopathic, which means they have no identifiable cause. The most common known cause is MS. In fact, ON is often the first symptom of MS. ON can also be due to infection or an inflammatory immune system response.
Nerve diseases that can cause ON include:
MS
neuromyelitis optica
Schilder’s disease (a chronic demyelinating condition that begins in childhood)
Infections that may cause ON include:
mumps
measles
tuberculosis
Lyme disease
viral encephalitis
sinusitis
meningitis
shingles
Other causes of ON include:
sarcoidosis, an illness that causes inflammation in various organs and tissues
Guillain-Barre syndrome, a disease in which your immune system attacks your nervous system
postvaccination reaction, an immune response following vaccinations
certain chemicals or drugs"
https://www.healthline.com/health/optic-neuritis#risk-factors
Cheers.....JJ
You can only conclude your p100 latency of 154ms was inaccurate if within day's your VEP results were significantly different and in normal range for a male under 60 which 114ms is....
"The usual waveform is an initial negative peak (N1 or N75), followed by a large positive peak (P1 or P100), followed by another negative peak (N2 or N145). Maximum value for P100 is 115 msec in patients younger than 60 years; after this age, it rises to 120 msec in women and 125 msec in men. Even though published norms are available in the medical literature, each individual laboratory should have its own norms to control for laboratory-to-laboratory variations in technique."
https://emedicine.medscape.com/article/1137451-overview#a2
Your anxiety situation has been openly acknowledged by you in your posts, your Dr shopping behaviours should be like a neon sign bringing to your attention just how much your anxiety is driving you to continue to fear the worst and keep you desperately searching for proof of what you believe is wrong, despite your normal diagnostic evidence and extensive professional options and reassurances. For the record having a mental health issue does 'not' give anyone immunity from being dx'ed with any other medical condition, pwMS experience anxiety and depression too....please don't make a mistake and reject your health anxiety as being a significant factor in what your dealing with and seek professional help for this singular problem, MSer or not, anxiety and or depression will literally make everything feel worse than it truly is!
What compelled you to specifically get the VEP test anyway, you don't mention visual symptoms suggestive-consistent with Optic Neuritis, why that specific test?
Your focusing on MS but even IF you had been dx with Optic Neuritis (ON), not only are most cases of ON idiopathic but it's also associated with a lot of other conditions...
"What causes optic neuritis?
The cause of ON isn’t well understood. Most cases are idiopathic, which means they have no identifiable cause. The most common known cause is MS. In fact, ON is often the first symptom of MS. ON can also be due to infection or an inflammatory immune system response.
Nerve diseases that can cause ON include:
MS
neuromyelitis optica
Schilder’s disease (a chronic demyelinating condition that begins in childhood)
Infections that may cause ON include:
mumps
measles
tuberculosis
Lyme disease
viral encephalitis
sinusitis
meningitis
shingles
Other causes of ON include:
sarcoidosis, an illness that causes inflammation in various organs and tissues
Guillain-Barre syndrome, a disease in which your immune system attacks your nervous system
postvaccination reaction, an immune response following vaccinations
certain chemicals or drugs"
https://www.healthline.com/health/optic-neuritis#risk-factors
Cheers.....JJ
2 Comments
The reason I went for VEP is: When I open(blink) my eyes, sometimes things in front of me takes time to see them, like there some kind of delay.
From past two days, sometimes, I also double double vision vertically upwards. :(
From past two days, sometimes, I also double double vision vertically upwards. :(
That still doesn't really make sense to me to the why of you specifically having to locate a place you could get the VEP done, your basically saying you did it off your own volition without first having your vision checked out by an optometrist or ophthalmologist to know if there was anything abnormal and you even need to get a VEP test.
From the beginning of this you've said your vision has been "fine" and after seeing all these drs who are all of the same opinion that you don't have any neurologically related abnormal test evidence suggestive or consistent with MS, you still assume difficulty focusing after opening your eyes (blink) was a serious sign of optic nerve damage and immediately arrange the VEP test....
The VEP test detects loss of vision from optic nerve damage, which is a common early symptom in MS and i have little doubt with your dr shopping behaviours that you will have also been doing a lot of reading about MS symptoms and all the tests involved and you will know that when your investigating MS visual symptoms the usual test is the VEP.
I genuinely can't think of any other reason why someone would choose to specifically get a VEP done for what you've described, with out it being recommended by an optometrist or ophthalmologist. IF i'm completely misunderstanding how this came about i'll graciously apologise for the misunderstanding but if i'm close or correct in my understanding, 'please' seriously consider researching health anxiety behaviours to see if any of it makes sense to what you're going through!
Food for thought.....JJ
From the beginning of this you've said your vision has been "fine" and after seeing all these drs who are all of the same opinion that you don't have any neurologically related abnormal test evidence suggestive or consistent with MS, you still assume difficulty focusing after opening your eyes (blink) was a serious sign of optic nerve damage and immediately arrange the VEP test....
The VEP test detects loss of vision from optic nerve damage, which is a common early symptom in MS and i have little doubt with your dr shopping behaviours that you will have also been doing a lot of reading about MS symptoms and all the tests involved and you will know that when your investigating MS visual symptoms the usual test is the VEP.
I genuinely can't think of any other reason why someone would choose to specifically get a VEP done for what you've described, with out it being recommended by an optometrist or ophthalmologist. IF i'm completely misunderstanding how this came about i'll graciously apologise for the misunderstanding but if i'm close or correct in my understanding, 'please' seriously consider researching health anxiety behaviours to see if any of it makes sense to what you're going through!
Food for thought.....JJ
Thanks superman_ms!
Quick update:
I went for VEP test on 10 June at a certified lab and results were bad.
It says: severe demyelination of optic nerves. p100 latency is 154ms
I went to Neurologist A yesterday with results and he was terrified and told me these results are wrong.
He again ordered VEP(hospital in which he works).
He also ordered Brain MRI with contrast on 3T machine.
This time VEP shows p100 latency 114ms. He told me this is fine. (Isn't it should be less than 100 or may be less than 105?).
Brain MRI with contrast shows: Few non enhancing non restricting foci of T2 and FLAIR hyperintensities are seen predominantly in anterior deep white matter. Corpus callosum is normal.
Doctor said it is non specific.
I am not as stressed as others percieved!
Please advice!
Quick update:
I went for VEP test on 10 June at a certified lab and results were bad.
It says: severe demyelination of optic nerves. p100 latency is 154ms
I went to Neurologist A yesterday with results and he was terrified and told me these results are wrong.
He again ordered VEP(hospital in which he works).
He also ordered Brain MRI with contrast on 3T machine.
This time VEP shows p100 latency 114ms. He told me this is fine. (Isn't it should be less than 100 or may be less than 105?).
Brain MRI with contrast shows: Few non enhancing non restricting foci of T2 and FLAIR hyperintensities are seen predominantly in anterior deep white matter. Corpus callosum is normal.
Doctor said it is non specific.
I am not as stressed as others percieved!
Please advice!
Thanks superman_ms.
This symptom: Severe muscle weakness in my legs and fatigue all over the body is from day 22nd May till now.
Forgot to mention yesterday(I don't know how to edit the post). Sorry for that :(
This symptom: Severe muscle weakness in my legs and fatigue all over the body is from day 22nd May till now.
Forgot to mention yesterday(I don't know how to edit the post). Sorry for that :(
1 Comments
It doesn't actually alter anything i'm trying to get you to recognise and pay attention too....the point your missing is that you've seem an extraordinary number of dr's and neurologists in only a matter of weeks, what you believe to be "severe" muscle weakness in your legs and fatigue all over your body can't be measurable clinical abnormalities or these medical opinions wouldn't all be telling you there's nothing wrong!
What you are experiencing is the perception of 'severe muscle weakness' which is not actually true muscle weakness but your anxiety talking....
"4. Weak Legs- feeling like your legs are jelly-like, or rubbery, weak and shaky and won’t hold you up when you walk. Or your legs and knees can feel too stiff too move. You can also feel this in your arms as well.
This is a common anxiety stress response. We’ve all heard the expression “going weak in the knees” referring to sudden shock or fear.
Often anxious people mistake this response for some serious disease, like Muscular Sclerosis, Muscular dystrophy, Amyotrophic lateral sclerosis (ALS) or a stroke. Weak legs from stress are not caused by a serious disease, and is not a cause for alarm."
https://reliawire.com/top-15-symptoms-anxiety-mistaken-conditions/
Focus on what you know to be true........JJ
What you are experiencing is the perception of 'severe muscle weakness' which is not actually true muscle weakness but your anxiety talking....
"4. Weak Legs- feeling like your legs are jelly-like, or rubbery, weak and shaky and won’t hold you up when you walk. Or your legs and knees can feel too stiff too move. You can also feel this in your arms as well.
This is a common anxiety stress response. We’ve all heard the expression “going weak in the knees” referring to sudden shock or fear.
Often anxious people mistake this response for some serious disease, like Muscular Sclerosis, Muscular dystrophy, Amyotrophic lateral sclerosis (ALS) or a stroke. Weak legs from stress are not caused by a serious disease, and is not a cause for alarm."
https://reliawire.com/top-15-symptoms-anxiety-mistaken-conditions/
Focus on what you know to be true........JJ
Thank you so much for quick response @superman_ms.
Yesterday, I went to Neurologist A(My medicine doctor told me that he is good, anyways I went again).
He saw all of my reports and listened to my symptoms and was smiling and prescribed me anti-depressent and Benfomet Forte.
He even said that my spine MRI is fine. (How can it be fine)?
I am feeling severe muscle weakness in my legs and fatigue all over the body. :(
Regarding Hypothyroid, the latest reading last week for TSH: 1.4 and T3 and T4 are in limits(don't remember though).
Please help me!
Yesterday, I went to Neurologist A(My medicine doctor told me that he is good, anyways I went again).
He saw all of my reports and listened to my symptoms and was smiling and prescribed me anti-depressent and Benfomet Forte.
He even said that my spine MRI is fine. (How can it be fine)?
I am feeling severe muscle weakness in my legs and fatigue all over the body. :(
Regarding Hypothyroid, the latest reading last week for TSH: 1.4 and T3 and T4 are in limits(don't remember though).
Please help me!
1 Comments
I honestly think you are going to have to take a step back for a moment and seriously consider the potential of your anxiety being a bigger problem than you are 'maybe' acknowledging or willing to believe.......in a very short time frame (approx 9 weeks) you have already sought the medical opinions of 4 neurologist as well as 2-3 general physicians, you've had MRI's, neurological assessments, blood tests etc and all your medical evidence is perfectly normal or too close to normal to be of significance.
Do you realise you actually saw 3 neurologist in only 8 days, the 3rd neuro the day after you saw the second! All the medical opinions you've sought are telling you the same thing, and despite all the medical reassurances you've actively sought, you still believe there has to be something seriously wrong with your health.....days ago your dr told you you were fine and a few day's later you're already seen another neurologist, and since you've posted your symptoms here a day ago, they've rapidly become "severe muscle weakness in my legs and fatigue all over the body" which you obviously didn't have yesterday when you saw the last neurologist!
These are all the types of behaviours and symptom pattern that are more suggestive-consistent with someone who is dealing with health anxiety than a physiological medical condition and with that thought in mind, i'm going to highly recommend you focus your attention on seeking professional psychological help, treatment, education and support.
Hope this helps you......JJ
Do you realise you actually saw 3 neurologist in only 8 days, the 3rd neuro the day after you saw the second! All the medical opinions you've sought are telling you the same thing, and despite all the medical reassurances you've actively sought, you still believe there has to be something seriously wrong with your health.....days ago your dr told you you were fine and a few day's later you're already seen another neurologist, and since you've posted your symptoms here a day ago, they've rapidly become "severe muscle weakness in my legs and fatigue all over the body" which you obviously didn't have yesterday when you saw the last neurologist!
These are all the types of behaviours and symptom pattern that are more suggestive-consistent with someone who is dealing with health anxiety than a physiological medical condition and with that thought in mind, i'm going to highly recommend you focus your attention on seeking professional psychological help, treatment, education and support.
Hope this helps you......JJ
COMMUNITY LEADER
Hi and welcome,
What you have mentioned isn't suggestive or consistent with neurological conditions like MS but you do have two issues that can cause neurological symptoms that may explain the issues you've experienced......1 is the health of your spine, which you may benefit seeing a physio therapist about and if you've been diagnosed with BPPV whether or not the Epley maneuver will help you. Also within your post you say you have Hashimoto's, thyroid conditions can cause some neurological symptoms and are commonly associated with other medical conditions.
"Hashimoto thyroiditis is the most common type of thyroiditis and the most common cause of hypothyroidism. For unknown reasons, the body turns against itself (an autoimmune reaction). The thyroid is invaded by white blood cells, and antibodies are created that attack the thyroid gland (antithyroid antibodies).
In about 50% of people with Hashimoto thyroiditis, the thyroid is underactive initially. In most of the rest, the thyroid is normal at first (although in a small number of people, the gland initially becomes overactive), after which it usually becomes underactive.
Some people with Hashimoto thyroiditis have other endocrine disorders, such as diabetes, an underactive adrenal gland, or underactive parathyroid glands, and other autoimmune disorders, such as pernicious anemia, rheumatoid arthritis, Sjögren syndrome, or systemic lupus erythematosus (lupus)."
https://www.msdmanuals.com/en-au/home/hormonal-and-metabolic-disorders/thyroid-gland-disorders/hashimoto-thyroiditis#v12757155
You also mention your blood test picked up your ESR is 28 which would likely to be on the high side for your age and gender (normal is 0 to 15 mm/h in men younger than 50) so whilst it doesn't point to any particular disease, infection, or type of inflammatory condition on it's own, it still might be worth asking your family physician if it could have a connection to what you're experiencing or your other medical issues ie spinal MRI, dx Hashimoto, dx BPPV
I hope that helps.......JJ
What you have mentioned isn't suggestive or consistent with neurological conditions like MS but you do have two issues that can cause neurological symptoms that may explain the issues you've experienced......1 is the health of your spine, which you may benefit seeing a physio therapist about and if you've been diagnosed with BPPV whether or not the Epley maneuver will help you. Also within your post you say you have Hashimoto's, thyroid conditions can cause some neurological symptoms and are commonly associated with other medical conditions.
"Hashimoto thyroiditis is the most common type of thyroiditis and the most common cause of hypothyroidism. For unknown reasons, the body turns against itself (an autoimmune reaction). The thyroid is invaded by white blood cells, and antibodies are created that attack the thyroid gland (antithyroid antibodies).
In about 50% of people with Hashimoto thyroiditis, the thyroid is underactive initially. In most of the rest, the thyroid is normal at first (although in a small number of people, the gland initially becomes overactive), after which it usually becomes underactive.
Some people with Hashimoto thyroiditis have other endocrine disorders, such as diabetes, an underactive adrenal gland, or underactive parathyroid glands, and other autoimmune disorders, such as pernicious anemia, rheumatoid arthritis, Sjögren syndrome, or systemic lupus erythematosus (lupus)."
https://www.msdmanuals.com/en-au/home/hormonal-and-metabolic-disorders/thyroid-gland-disorders/hashimoto-thyroiditis#v12757155
You also mention your blood test picked up your ESR is 28 which would likely to be on the high side for your age and gender (normal is 0 to 15 mm/h in men younger than 50) so whilst it doesn't point to any particular disease, infection, or type of inflammatory condition on it's own, it still might be worth asking your family physician if it could have a connection to what you're experiencing or your other medical issues ie spinal MRI, dx Hashimoto, dx BPPV
I hope that helps.......JJ
1 Comments
Thank you so much for quick response @superman_ms.
Yesterday, I went to Neurologist A(My medicine doctor told me that he is good, anyways I went again).
He saw all of my reports and listened to my symptoms and was smiling and prescribed me anti-depressent and Benfomet Forte.
He even said that my spine MRI is fine. (How can it be fine)?
I am feeling severe muscle weakness in my legs and fatigue all over the body. :(
Regarding Hypothyroid, the latest reading last week for TSH: 1.4 and T3 and T4 are in limits(don't remember though).
Please help me!
Yesterday, I went to Neurologist A(My medicine doctor told me that he is good, anyways I went again).
He saw all of my reports and listened to my symptoms and was smiling and prescribed me anti-depressent and Benfomet Forte.
He even said that my spine MRI is fine. (How can it be fine)?
I am feeling severe muscle weakness in my legs and fatigue all over the body. :(
Regarding Hypothyroid, the latest reading last week for TSH: 1.4 and T3 and T4 are in limits(don't remember though).
Please help me!
Have an Answer?
You are reading content posted in the Multiple Sclerosis Community
Top Neurology Answerers
Australia
ON
Queensland, Australia
Queen Creek, AZ
Find out how beta-blocker eye drops show promising results for acute migraine relief.
In this special Missouri Medicine report, doctors examine advances in diagnosis and treatment of this devastating and costly neurodegenerative disease.
Here are 12 simple – and fun! – ways to boost your brainpower.
Discover some of the causes of dizziness and how to treat it.
Discover the common causes of headaches and how to treat headache pain.
Two of the largest studies on Alzheimer’s have yielded new clues about the disease
