Thalamic Lacune??

[EC]

Dear Doctor?  After numerous test (blood, as well as MRI's of brain and spine) my doctor still has no idea what is wrong with me.  I had left sided numbness which included face, eye and arm.  It comes and goes.  I also get weakness in both arms and legs that comes and goes as well which includes dizziness.  I also get very tired when this occurs.  My neurologist now believes i had a Lacunar stroke and said the symptoms come and go?  Do you agree?  I am Female 34 in great health.  Sometimes my hands feel stiff like now when im typing.  My question is, do you think this is possible.  What about b-12 def.  he wont test for it since he does not believe it is perp. neuropathy due to the fact the numbess started only on one side!  Any suggestions for other testing?  Thank you.

[EC]

Thanks for all your info... Judy, yes, MS, lupus,Lyme,Thyroid, you name the test, ive had it have all been ruled out!  Had 2 mri's of the brain one spinal!  Yes, ive been seeing a Neurologist for all of this and he didnt seem to believe MS was even questionable with how my symptoms were.  This all started in my 8th month of pregancy (almost 1 year ago, still no diagnosis).  Since then, I really havent been the same.  I am seeking a second opinion from another Neurologist and maybe she can direct me in the right direction! Thanks!

[Judy - Follow-up question]

Hi EC,

RA is rheumatoid arthritis and AS is Ankylosing spondylitis. There are lots of itis's that could cause these symptoms. Including one I just saw mentioned on a Mass. General spinal disorders forum call faciitis. IRitis (eye) is associated with AS and some of the other forms of arthritis.

Facial numbness can be a first symptom of sjogren's.
Your comment about joint pain - makes me think you should look to one of the arthritis's. There are over 100 different kinds. A rheumy can help sort it out. In any case he can rule things out. Well worth the cost. Hopefully, you live somewhere you can get an appt. reasonably quickly. Some places there is a severe shortage of rheumy's. Try 1000 mcg of b12. Won't hurt and might help.

I hope you get some answers soon.

[EC]

Judy: what is RA & AS?  Is there anything they are giving you to help? what tests do they do for this?  thank you! anymore information you can give me on your condition would be great!  thank you!

[ellenc]

Is your Dr. a neurologist? If not, you should see one, even if you have topay apy for it yourself. Did they rule out MS? Thyroid problems, lupus and various other processes can casue the symptoms you mention . Keep pursuing a Dx and God Bless!

[Judy - Follow-up question]

Hi EC,

I have rheumatic diseases (RA and AS) and have neurological symptoms including the facial numbness, arm, hand and also lower extremity numbness. Joint pain / stiffness are associated with rheumatic diseases in addition to being from more benign causes.

You should consider getting an appointment with a rheumatologist.

Judy

[CCF Neuro[P] MD, RPS]

Dear EC:

Usually with a lacunar infarct, the effect is dramatic and doesn't come and go.  In addition, one should see changes on the MRI, especially with the diffusion weighted scans.  In addition, it would not give a bilateral arm and leg distribution of weakness.  I do agree that likely a vitamin B-12 deficiency is not likely as your paresthesia is unilateral.  Sometimes we see patients with migraines, especially basilar type, that have similar symtpoms as you describe.  But you do not indicate that you have ever had migraines or that anyone in your family has had a migraine.  I am not sure what to tell you otherwise.  Sometimes, we just don't have the answers and time will give us more information to uncover the cause.

Sincerely,

CCF Neuro MD