Very concerned.. Could this be MS?

[jimmylegs]

hi and welcome to TiMS, @scaredmama. i missed your first post and discussion since! i do have some thoughts which might be worth exploring, if you're interested

[Scott1]

Hi,
Well, it's good news that your brain seems fine, however, knowing that won't change your symptoms. An MRI of your spine is a reasonable request. Solving your problem will be a process of elimination. A good testing regime should start with the obvious and eliminate possiblities to arrive at the right answer. You still don't have a right answer. Get an MRI of your spine and eliminate the obvious.
The question you may have have ask forcefully is "why am I like this?"
For what it's worth, I don't think much of the comment "a brain MRI rules out MS". Whether you have MS or not, that comment is very superficial.
Regards,

[Scaredmama]

Thank you both for the response. @jimmylegs I would appreciate any insight that I can come by.

@Scott1 I thought I would be reassured with a normal brain MRI that MS is ruled out, but it is still inconclusive. I’m concerned about the 5% possibility of having spinal lesions, which is being ignored by my doctor, who says “MS is NOT causing my symptoms”. I’ve heard of so many doctors who confidently tell patients after only a normal brain MRI, that they don’t have MS, without a spinal MRI to confirm.

Would a cervical MRI be sufficient to rule out MS? Or does the whole spine need to be imaged?

[Scott1]

Hi,
In an adult, the spinal cord is only about 40 cm long. What happens after that ends is a series of ropey tails, called the cauda equina, take over. That is outside the central nervous system. A scan that covers the cervical spine should be sufficient.

Regards,

[NHE]

Would a cervical MRI be sufficient to rule out MS? Or does the whole spine need to be imaged?

The spinal cord goes through the cervical and thoracic segments of the spine and terminates at the top of the lumbar segment at the L2 vertebrae. The typical MS MRI just includes the spinal cord within the cervical segment.

[Scaredmama]

Hello all,
I tried pushing my doctor for a cervical MRI, which was refused. I emphasized how it’s inconclusive with only brain MRI to rule out MS. I’m just not understanding why this isn’t typical protocol for a doctor to order thorough tests before assuming it’s not MS.

I’m being referred to a Neurologist on Aug 17, which might allow for further tests.

[Scaredmama]

My most concerning symptom now is intermittent sharp muscle spasms in my left intercostal ribs lasting a few seconds, with a constant tightness wrapping around my left torso. The tightness has lasted one week, but started to feel painful spasms just yesterday. I’ve had a similar feeling 9 months ago, which concerns me of a pattern of MS relapse symptoms.

Does this sound like the MS hug? And does this symptom usually last a short duration as with a pseudo-relapse? Or can last longer?

[Scott1]

Hi,

Possibly. I would raise that with a doctor but I doubt you will be offered a simple solution.
What I do when that happens is, firstly, I get massaged. You can tell the massuer it's called whatever you want but, in the end, it comes down to what they feel with their hands. I promise you that it is not a comfortable massage.
You may need to print this out and show it to the massuer. If the person does not know what I am saying then find a different massuer.
Start at the quadratus lumborum and back off any tightness. Check the erector spinae for tightness and relieve it. Check the rhomboids (especially rhomboid minor). Lie the patient on her side and check for tightness in the obliques.
Lie the patient on her back and use your fingers under the ribcage to release the diaphragm. If possible, get the patient to practice deep inhalation and full exhalation whilst doing this to create a PNF-style release. Massage the intercostals (this really hurts but I don't know how they do this bit with females.)
After this, sit the patient on the side of the massage table, with arms crossed so the right hand is on the left shoulder and vice versa. Use a gentle PNF stretch to rotate the torso.
Possibly you may also need the psoas massaged, which is intimidating to say the least.
I am not trying to say that your problem is MS in any way but that should relieve your tightness. There is no pill (except some very heavy duty stuff) that you can take.
Regards,

[Scaredmama]

I appreciate the advice, Scott. I’m getting mixed messages in regards to the MS hug, the symptoms and how long it lasts, which is leaving me with more anxiety and fear of the possibility of MS.

I’ve had these symptoms for 8 days, which seem to be relieving now. I did try the diaphragm release which seemed to help. Does an MS hug last this long? I’ve read it usually lasts hours and rarely for days unless it’s a relapse.

[Scott1]

Hi,

Not for a moment am I suggesting that you have MS. Only a properly qualified neurologist can do that. However, one of the things about MS is it does not have a monopoly on its symptoms. What you have described to me, so far, suggests something abnormal is going on that involves a spasm. I'd discount what you have read about an MS hug and focus on treating the discomfort you have now. Your problem could be caused by a range of things. It might be something as simple as a postural issue.
As I mentioned earlier, always eliminate the obvious first. Try getting someone who can follow the pattern of massage I suggested. Someone who does that sort of work all day can quickly decide where you are tight and release it.
Not every impingement shows up on a scan. If the scans show no sign of MS, you will need to try a different tack.
Nonetheless, I would still be after that MRI of the spine. It is an obvious thing to check.
Regards,

[NHE]

I appreciate the advice, Scott. I’m getting mixed messages in regards to the MS hug, the symptoms and how long it lasts, which is leaving me with more anxiety and fear of the possibility of MS.

I’ve had these symptoms for 8 days, which seem to be relieving now. I did try the diaphragm release which seemed to help. Does an MS hug last this long? I’ve read it usually lasts hours and rarely for days unless it’s a relapse.

You could try some magnesium glycinate to see if it helps with your muscle cramping.

I would try 200-400 mg per day.

Here's an example...

Doctor's Best Magnesium Glycinate

My own experience is that I became magnesium deficient while taking just 2000 IU of vitamin D3 per day. That occurred even though I was taking magnesium citrate concurrently. I would get painful muscle spasms at night in my feet and calf muscles. These were intense enough to wake me up. Switching over to magnesium glycinate resolved the cramps after 2-3 days.

[jimmylegs]

hi again @Scaredmama

this is an understandably very scary time and for what it's worth, you do have some great information in hand.

i have been away from tech for a few days, and have a few urgent things on my plate this week, but i will be back here with some insights (related to modifiable and unmodifiable risk factors, a couple more options to consider re modifiable aspects), and a few related questions as soon as i can

[Scaredmama]

Hello all,
I had a neurology consultation to further address my symptoms and a cervical/thoracic spinal MRI were ordered. Although, there is a possibility insurance will not cover such cost since they claim a spine MRI is not considered usual MS work up if brain MRI is normal.

Also, during my clinical exam, it was noted that one pupil appeared smaller than the other when performing the light test. I am now being referred to ophthalmology for further testing. This has now left me with more anxiety and fear of the possibility of MS.

Marcus Gunn Pupil points to MS, so if my brain MRI was normal, would there have been abnormality seen in the optic nerve in the brain MRI or can you have only spinal lesions and have this symptom? I’m very concerned about what is causing this and whether it relates to MS.

Any thoughts on this would be appreciated

[Scott1]

Hi,
Please don't be anxious or fearful about MS. It's not a death sentence, just a neurological condition. Millions of people have it and you probably walk past some of them and never know it. There are some symptoms that we would rather not have but please don't put the cart before the horse.
The test on your eyes might imply some damage to the optic nerve. That nerve carries all the information about luminance from one eye which then shares it with the other. So if a physician shines light into an affected eye, both will constrict. If he shines it into an unaffected eye, neither will constrict. The size of one compared to another doesn't necessarily mean something. It's how they behave together. There are conditions that are not MS that can mimic some MS symptoms. All you have, so far, is good information to help diagnose you.
I'm glad you are having the extra MRI. If nothing shows up on them then you still have another path to follow with the visit to the ophthalmologist.
What ever your condition turns out to be, it will be diagnosed by a process of elimination. That's the process you are on now.
Regards,

[NHE]

Don't forget to go for a walk. It'll help lower your stress level.

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