Neuro problem?

[rm1996]

Hi there —

I apologize for the length in advance but I’ll try to keep this as short as possible. I’m at a loss for answers :(

22 y/o F

About 9 months ago, I started getting headaches — sharp, quick — and was eventually diagnosed with trigeminal neuralgia in March. Between those months I had an episode in October of 10% vision loss w/ new onset of floaters - cleared by ophtho and told normal.

In February 2018 I started with eyelid twitching for minutes at a time and it has been daily since. A few weeks later, this twitching started in my calves and feet. My calves cramp/twitch and tingle basically non stop but it’s worse at night. No associated pain. My right foot actually jumps and bounces when I’m laying down and at times when I’m sitting... not sure why...

A few weeks ago, I had an episode where my eye hurt like heck to move and I had blurry vision on the left. Again, I went to ophtho the next day and my exam was normal and was told it was nothing.

Symptom list: blurry vision episodes (ophtho has completely cleared me), feeling off balance (I stumble quite often and almost fall), episodes of face tingling (lasts 1-5 minutes), episodes of decreased smell (lasts weeks), and as stated — leg twitching/tingling, foot bouncing, and those ice pick / trigeminal neuralgia headaches

I’ve had a brain MRI in March which was normal. Since then, leg EMG, 24h and in office EEG, VEPs, and labs which were all normal (thyroid, CMP, CBC, paraneoplastic panel, MUSK antibodies, etc.).

My neurologist currently has me diagnosed with trigeminal neuralgia with focal seizures but I’m not quite sure since there’s no EEG changes.. I’m going to be trying Lamictal for a bit to see if that helps with my headaches and tingling/twitching/cramping. Should I be concerned or looking out for anything else? I asked about MS but there were no spots on my brain, so she said no need for a spine MRI.... just was hoping for any input from here. I’m not even sure if I posted this in the right “community” but any help is truly appreciated.

Thank you much!!

[supermum_ms]

Hi and welcome,

I don't see why you would be considering your dx is possibly incorrect or a potential sign of a neurological condition like MS because of your EEG being normal......A normal EEG doesn't rule out the possibility of epilepsy, an EEG records only a snapshot of the brain's activity so it's not uncommon for someone experiencing seizures to have normal EEGs.

MS literally means many scars so if you don't have any brain lesions at all on your brain MRI and your VEP was normal, it's very unlikely for you to have any spinal cord lesions. It's even more unlikely to be spinal related (central or peripheral) if your neurological clinical signs during your neuro exams were normal and your EMG peripheral nerve tests were normal...

Seizures, headaches and facial pain do go together, this slide show may help to explain and reassure you a little bit https://www.slideshare.net/yuyuricci/epilepsy-headache-and-facial-pain but if your really concerned please consider getting a second opinion!

I hope this helps......JJ  

[rm1996]

Thank you very much!! I appreciate it :)