One-sided hyperreflexia

[christobelle]

Hi all,

This is my first post here….

Bit of history - 13 years ago my right foot went cold and over the ensuing week I lost feeling moving up my right side.

MRI, CT and lumbar puncture were all clear. After a month in and out of hospital I was advised to go home and come back if anything else happened, because they couldn't pinpoint what it was. At that time the neuro had said he was very surprised lesions did not show up (as he believed it to be MS).

During that exacerbation I had severe numbness in my right side, severe nerve pain (even a light bed sheet caused the feeling of a thousand needles on my skin), numbness heightened with heat/hot water, longer leg feeling in right side, incoordination. I was pretty confused then too, as this was all really strange to me.

Since that time, several years apart I have had swallowing difficulties, was diagnosed with Raynaud's, developed a tremor, and more recently have developed quite marked spasms in my right hand and foot which distort the extremities, are quite painful and last anything from a few minutes to 15 minutes.

I finally got myself back to the neuro and he has found I have hyperreflexia on my right side (which is my "number" side - that never left me).

He states that he believes there is a problem in the left side of my brain which is causing this, and that it may be that I have actually had MS for the past 13 years but it simply didn't show up on the initial MRI.

Financial reasons mean that I have to wait on the public wait list for an MRI, and that is scheduled for the 9th of April, with neuro visit to follow up on the 17th of April.

I'm not quite sure what I'm actually asking. I think I am wondering if anyone else has one-sided hyperreflexia, and what that actually means in the context of MS.

So just as a 'here you go', my symptoms are:

- dulled sensation right side
- difficulty swallowing
- dizziness (not all the time, just random episodes where it is as though the world moves and I have to hold on to steady myself)
- right-sided hyperreflexia
- spasms in right hand and foot which distort the fingers and toes and are painful
- right leg feels longer than left
- tremor (noticeable)
- tremor in voice at times
- pain across the chest
- quite marked sweating (increased since I had kids so may be hormonal?)
- loss of fine motor skills

I also think I'm having trouble hearing, and seem to have difficulty sometimes finding the right word (i.e. went to get the kids out of the bath and said I was going to get them out of the washing machine. Meant to say sticker and said supermarket instead. Stupid stuff. Not sure if it is relevant or not).

I would really appreciate anything anyone has to offer to help insofar as offering maybe an alternative that it might be? Or whether they think it is actually MS.

I don't know. I think maybe I just am feeling a bit numbed by everything (pardon the pun).

It has been 13 years. Psychologically I really have dealt with a hell of a lot in that time (including doctors telling me it was a physical manifestation of psychological symptoms).

Any thoughts?

Appreciate it, thanks ever so much.

Oh, and I am a 40 year old female, symptoms first came on when I was 27. All blood tests (extensive) normal except low vitamin D.

[jimmylegs]

hi and welcome sounds like a lot of no fun there :S
what have they suggested in terms of action on the low d3? did they test any other nutrient levels? do you have your own copy of the test results?
a lot of your symptoms could be linked to low nutrients. nutrient issues are commonly seen in the average ms patient, so can't hurt to at least rule them out, and potentially see what you might be able to address from the list. the nutrition issues aren't typically dealt with very thoroughly in mainstream care (not they're fault, it's a system problem).

[christobelle]

Hi jimmylegs,

Thanks so much for responding.

Low Vitamin D I have been put on Vitamin D tablets with the aim to double my current level.

I was shown all the other results for calcium etc (there were concerns of hypocalcemia because of the spasms), and all were in the mid to upper level of the normal range. There were no results that were at the low end for any of the tests (save for the low vitamin D - it was 39). I can't remember off the top of my head what things they tested, but the results were about 4 or 5 pages long as he wanted to be thorough.

Whilst is nothing "medical", I took it upon myself at that time to replace my "chicken and chip" lunches with salads, and my rice or pasta for vegies. I figured at least I could try to give my body as much goodness as possible lol. No idea why I did, but I did. I am not sure if it is doing any good as everything is still the same, though I have lost a few kilos!

Which of my symptoms could be nutrient-related? What specifically can I do to "try it out" with regards to seeing if changes in behaviours/foods/nutrients will give me any relief/change?

Thanks so much.

[jimmylegs]

hi no problem. for the vit d3 39 - I take it that was in nmol/L. you could probably stand to triple it, but you'll want to make sure you balance your magnesium status.
magnesium usually gets glossed over b/c everyone is 'normal'. but ms patients have low to mid normal levels and healthy controls have high normal levels. so it can look mid-range and still be trouble.
if you can get a serum magnesium test (or find one in your records) that could be useful info.
also, you could likely help your absorption of both magnesium and vit d3 if you ensure healthy (high normal) serum zinc status.

symptoms I would potentially associate with magnesium deficit:
- difficulty swallowing
- right-sided hyperreflexia
- spasms in right hand and foot which distort the fingers and toes and are painful
- tremor (noticeable)
- tremor in voice at times
- pain across the chest

if you do find a magnesium issue, it would be smart to look at potassium too. if you don't have a test handy, the other thing you can do is review your diet for magnesium intake to see if you're hitting 600mg of dietary magnesium daily. if not, it could be another indicator that mag is part of the problem. if you like I can link you up to some sites to help assess dietary mag.

[christobelle]

Thanks very much jimmylegs - will take any suggestions on board!

When the spasms first started becoming more regular a few months ago I increased magnesium intake as someone suggested that might be a cause of them. I even started taking magnesium tablets but they made me feel quite ill so I stopped and opted for the more natural dietary option (i.e. almonds, greens etc). Would be good to be able to see if my dietary intake is sufficient in that regard though.

I had heard about magnesium and calcium deficiencies being responsible for spasms/cramps but not potassium.

Yes, the Vitamin D level is in nmol/L.

So with regards to your comments about symptoms being related to magnesium deficiency, do you mean they are caused by it?? Or worsened by it? I am still at this stage undiagnosed too so really don't have a huge amount to go on, except that my neurologist says the hyperreflexia is a "significant finding". Whether that means it is significant standalone or in connection with my other symptoms is unclear to me.

All research I have done indicates that hyperreflexia's sole cause is an upper motor neuron lesion. I'm struggling to find other potential causes (not for want of searching). Not sure why I'm so hell bent on finding other causes - possibly because of my last statement, that I am still technically undiagnosed so still seeking possible alternatives to the diagnosis of MS. I suppose I should just do the logical thing and hang tight and not get ahead of myself until I have the MRI. But that would be logical lol.

I appreciate your time responding, and would be most grateful for those links you mentioned so I can find out a bit more.

Cheers

[jimmylegs]

no problem!

ok good info. always smart to hit dietary magnesium first. can you tell me more about the magnesium tablets you were using? ie what dose per pill, how much were you taking that caused a problem, and what form were they (eg, were they mag oxide, mag citrate, mag glycinate, or something else?)

also, how much vit D are you taking daily? is it vit d3? when it comes to supplements, it's definitely best to take vit d3 with magnesium.
for dietary - certain whole foods provide naturally occurring vit d3 (eg seafood, liver, kidney, and mushrooms).

detailed dietary D3 info: http://nutritiondata.self.com/foods-000 ... 00000.html
easy D3 info: http://www.whfoods.com/genpage.php?tnam ... #foodchart

easy dietary info for magnesium: http://www.whfoods.com/genpage.php?tnam ... #foodchart

as far as symptoms - I definitely have had symptoms directly caused by magnesium deficit. muscle spasms and difficulty swallowing in particular.

hyperreflexia has been found in those with copper and niacin deficiencies, as well as in patients with low magnesium levels.

study links:

niacin: http://neuromuscular.wustl.edu/nother/v ... htm#niacin

copper: "We describe three patients suffering from severe spasticity, ataxia and hyperreflexia and had laboratory evidence of copper deficiency." http://www.sciencedirect.com/science/ar ... 0X1000016X

"Diffuse hyperreflexia was found after the seizures. While serum magnesium levels were extremely low"
Downbeat Nystagmus With Magnesium Depletion http://archneur.jamanetwork.com/article ... eid=580158

I can't get the full text of this study to get the context of this quote, but fwiw:
"Marked irritability of the muscles to percussion was noted, as well as generalized hyperreflexia with sustained knee and ankle clonus. ... Imme¬ diately after the seizure, prior to administration of the calcium or magnesium, the serum magnesium was 0.5 mEq/liter, confirming..."
Neurological aspects of magnesium metabolism http://archneur.jamanetwork.com/article ... eid=565793

magnesium has successfully been used to treat hyperreflexia:

"We discovered dramatically beneficial effects of magnesium sulfate on autonomic hyperreflexia during labor in a patient with spinal cord injury at a high level." http://www.ncbi.nlm.nih.gov/pubmed/10942492

"We report the successful use of i.v. magnesium sulphate to control life‐threatening autonomic hyper‐reflexia associated with chronic spinal cord injury in the intensive care environment" http://bja.oxfordjournals.org/content/88/3/434.short

"Hyperreflexia was the main indication to start magnesium sulphate treatment (75%)." http://europepmc.org/abstract/MED/15767 ... MYB3u8fj.2

[jimmylegs]

also - not a scientific source, but I generally find this site's info pretty interesting:

http://www.acu-cell.com/dis-mus.html#05
How does one prevent left-sided or right-sided Muscle Spasms?
If caused by a mineral deficiency, one-sided leg cramps or calf spasms can help with the decision of what tosupplement, whereby the left side is generally indicative of extra Calcium requirements, while the right side is usually an indication of extra Magnesium being needed. If right-sided muscle cramps respond to calcium(rather than magnesium or similar remedies), dehydration is suspect, and extra sodium or potassium may berequired instead.

[christobelle]

Thanks very much jimmy legs. I greatly appreciate the trouble you have gone to with sourcing those articles. The main concern I have is with the one-sided nature of the hyperreflexia. I found several causes for hyperreflexia as a generalised symptom, but not "one-sided" or "asymmetric". Many articles do deal with generalised or isolated/localised hyperreflexia, but not with an asymmetric or one-sided presentation.

With relation to the supplements I was taking, the magnesium tablets were called "Magnesium Chelate - 500mg" containing magnesium amino acid chelate "equivalent to elemental magnesium 100mg".

The vitamin d tablets contain cholecalciferal 25mcg which is equivalent to vitamin d3 1000 i.u. I'm taking one a day, which I think is probably insufficient judging by reading through a lot of your answers to other peoples' posts!!

I'll also have a read through those dietary articles today (I'm in Australia, not sure where you are, but it's first thing in the morning here lol).

Thanks again for all the info. Will work through it today

[jimmylegs]

hey no problem
re magnesium, see if you can track down magnesium glycinate. that might give you a better time.
1000 IU of d3 would build you up slowly, but it really would be best to ensure that your magnesium intake is good and high..
I'm on the other side of the world from you, but I lived in oz for 5 months a few yrs ago
have fun with the info I should get back to my own reading for now! if you have any questions about things you read, just say. I check in often.

[christobelle]

Thanks again jimmylegs.

I went to the chemist today and couldn't remember why I had gone there so came out empty handed. It was to find the magnesium glycinate lol.

Ah the joys.

[jimmylegs]

oh dear! better luck next time if you haven't already done so, it might be a good idea to call ahead. they probably won't have mag glycinate available at every chemist's.

[christobelle]

Thanks for that, I will do today Setting myself a reminder. Tis the easiest way to not forget. My poor phone is chockers with reminders!!

[jimmylegs]

aww! lol
ok good luck hope you find it easily

[christobelle]

Thanks very much for all your help. Enjoy your reading!

BTW, which part of Australia did you live in?

[jimmylegs]

thanks 'enjoy' is a strong word, but I'm making progress at least!

I stayed in perth. my cousin lived there so I stayed with her and went to school for a term at murdoch. visited coral bay one week, lancelin for surf camp another week, down to Margaret river area for one weekend, and over to Sydney for a week too, to catch up with some old friends who had moved there. did a couple days in royal national park, one to the north at the basin, one day out to the west in the blue mtns, checked out the 3 sisters, and one day downtown.
had read this book as a kid http://en.wikipedia.org/wiki/Playing_Beatie_Bow, so enjoyed visiting The Rocks.
tons of fun day trips while out west as well. loved bibbulmun track and the perth observatory.
if I get back there i will probably go straight to mettam's hole
http://www.lifeonperth.com/mettamspool.jpg