Spasticity or something else?

[LisaH]

I used to walk so fast that I was often told to slow down, but I've been having a lot of trouble getting around lately. The muscles in my legs feel stiff and tight and every step seems labored. One of my knees will pop back suddenly or my hips/torso will jerk back and make it even more difficult to walk. I'm using walls, tables, counters or whatever is available to help me keep moving. I don't know if this is spasticity or something else. I'm walking slowly all the time but it's worse in the evening/night or when I get up in the morning. My appointment with the movement disorder specialist is still a ways off and I'm so anxious to hopefully get some answers. Does this sound like spasticity? Any feedback would be appreciated.

[jimmylegs]

hi what was your last serum magnesium result again?

[Scott1]

Hi,

In the absence of everything else then yes it does sound like you are struggling with a degree of spasticity. What that means needs a fair bit more investigation.

Where you feel tight is not always where the problem comes from. At a minimum, see an osteo or physio. More importantly see a doctor who will conduct not only an MRI but also a more exhaustive battery of tests.

You've posted under the undiagnosed section so you may be doing yourself a disservice if you don't seek a professional opinion.

Regards,

[LisaH]

jimmylegs... the blood work I had done didn't include magnesium. Is it unusual that they didn't include magnesium? What they did check and the results is under another topic: http://www.thisisms.com/forum/undiagnos ... 62-60.html (pages 4 and 5).

Scott1... I agree that more tests are needed to find out what's going on. I think an MRI of my spine should be done. There's a chance of a syrinx (due to my chiari malformation) and also possible lesions. My follow-up brain MRI only focused on one area because of the cyst/tumor that thankfully hasn't grown since it was discovered last November. I was very disappointed that the MRI wasn't of my entire brain. It's possible that lesions might have shown up because they don't always show up on an initial MRI but could have on the next one. How soon is it safe to do a full brain MRI? I'm hoping it isn't 6 months because that would mean waiting until January. I have managed to get several videos of the abdomen/torso spasms I've been having (http://www.thisisms.com/forum/undiagnos ... 29258.html) and I'll show those to the movement disorder specialist in October.

[jimmylegs]

ah yep, to reiterate what i said then with emphasis added: "would be great to see serum magnesium, zinc, copper, selenium, retinol, more of the B vits (esp b1), and uric acid. i'd consider the first three higher priority. magnesium is number 1 here bc you'll presumably be working on vit d3. as with other tests, if consistent with an ms patient you could expect the result to be lower in the normal range than levels seen in healthy controls."

it's not unusual that they've missed it. in many cases levels come back 'normal' so it never flags action - what's the point?

it's when you understand what's good and not so good *within* that normal range that the serum mag test becomes valuable. there's a mountain of literature showing higher normal mag in healthies and lower normal mag in patients, but those internal portions of the range aren't used at the lab and don't inform the doc's interpretation of the test result.

so normally you'd have to ask for it, and perhaps if you encounter resistance, make the case for having it done. as of this year, the literature has finally started to reflect the importance of knowing magnesium status when working to correct issues with vitamin d3, so there's an academic article you can put in front of the doc if you need.

if you're in the states you can just order a serum mag requisition online. if in canada, they're starting to get there re online requisition ordering, but it's going to be outlandishly expensive. if memory serves it's the same entity that offers private testing in the uk, which is also nonsensically highly priced when you compare to prices in the us.

don't believe the hype about rbc magnesium being the better test. it is, technically, but it is more expensive and has the same interpretation issues as serum mag. the 'normal' range is not good enough. i would only bother going to rbc if i had high normal serum mag and still had problems that suggested digging deeper would be worth the extra expense.