High B6, neurologic symptoms, and abnormal Brain MRI - connection?

[casio12]

Early last year, I began having neurological symptoms. They included tingling in my arms and legs, weakness and feeling tired, muscle cramps, small muscle twitches, and tremors that seem to be related to muscle weakness. All these symptoms came on gradually over several months. I eventually also started having trouble sensing acute pain, heat and cold but I can still feel normal touch. At times, I also feel as if a tourniquet is around my left arm and leg.

My brain MRIs appear to be the most significant evidence of disease other than my symptoms. MRIs show around 30 lesions/plaques in the white matter of my brain. Two small enhancements were seen in the first MRI but a second MRI, interpreted by a different radiologist, called it a "phased artifact".
I have seen 3 neurologists specializing in multiple sclerosis and several radiologists have reviewed these MRIs.

One doctor and three radiologists think I have multiple sclerosis. Another doctor suggested I had acute disseminated encephalomyelitis (ADEM) and a third doctor calls it nonspecific encephalopathy. My spinal tap and other tests were negative for MS. Lyme disease tests are negative as well. I have other tests done but most show nothing.

Another test I did recently shows I have high vitamin b6 levels: 86.3 ng/mL (range = 2.1– 21.7). Could there be a correlation between the MRI results, symptoms and out of sync B6 levels? Do folks on this thread general think they are experiencing metabolic issue with b6? I was only taking 12 mg a day (have stopped now.) If so, are there any known ways to address this? I can't even seem to find a toxic b6 blood level.

Because of this uncertainty in my diagnosis, I have not been able to receive any treatment.
I would appreciate any ideas you might have on a possible diagnosis or if I should pursue the b6 issue.

[casio12]

Thank you Dr. Kaul. I appreciate your input.

[S. Kaul, MD]

Hi there!

Well, it is difficult to comment specifically on the situation without having a look at the radiographs or a detailed clinical evaluation, though the symptoms and the radiographs could represent any of the three conditions described by the doctors. Also elevated B6 levels are known to cause neuropathy and could present similarly as well, while the MRI may not fit into the picture here. Elevated B6 levels could occur due to a few metabolic issues, hepatic/ renal causes. I would suggest consulting an internist for a detailed evaluation and suggestion of an appropriate management plan.
Hope this is helpful.

Take care!