Lhermitte's sign

[mallori735]

*

[lyndacarol]

Hello! I posted on here a few years ago and have since developed other neurological symptoms which are concerning. I was wondering what the odds are of having MS if you have Lermittes sign? I experienced this in the fall about ten times (sometimes I was able to recreate it right then), but haven't had it again since. Also I've developed muscle jerks/twitches on primarily my left side hand, thigh and foot and slight tremors in my hands. This is all on top of the symptoms I have had for years, on and off: sudden waves of tingling on one side of my head and the same sensation on my shoulder and hip at different times, seeing pin-points of white light in my peripheral vision nearly everyday at random times. Those first symptoms were kindof set off by a couple different seizure type episodes a few years ago. Went to a neuro, brian MRI came back clear and so did EEGs. Wondering if I should go back now as the muscle movements in particular are concerning, even though I'm trying to write them off as anxiety or stress. It's harder to write off the Lhermittes sign, though. Thoughts? Thanks!

Welcome back to ThisIsMS, mallori735.

Since you asked for "Thoughts?", I assume you are open to any and all.

I urge you to read the book, Could It Be B12? An Epidemic of Misdiagnoses by Sally M. Pacholok, RN, BSN, and Jeffrey J. Stuart, D.O. (This may be available at your library.): http://b12awareness.org/could-it-be-b12 ... diagnoses/

and, for that matter, thoroughly explore the website – check out all the information there: tabs, videos, everything.

Then see your GP and discuss the possibility of testing for a B12 deficiency (MORE than just the "serum B12" test, which measures ALL B12 – you need to know the amount of B12 that can get into the cells) or even a therapeutic trial of methylcobalamin injections. (Methyl cobalamin is the better form of B12 than cyanocobalamin, which is the form given in doctors' offices in the US.) Do not take vitamin B supplements before any testing, as this will skew the results.

[jimmylegs]

welcome back mallori, sorry to hear you've been having more symptoms. you likely already know that lhermitte's is a sign of an active lesion in your cervical spine, for whatever reason.

for persective, i will say that when i had l'hermitte's i was definitely, absolutely, without a doubt severely b12 deficient, and no matter how i megadosed, absolutely nothing changed for the better. over time i would learn there was an awful lot more to nutrition for ms, and my biggest improvements were related to a major dietary shift and an intense therapeutic nutrient regimen involving much MUCH more than b12 if you're interested in the wider perspective feel free to ask for more info!

[mallori735]

Thank you both for the quick responses! I will definitely look into the B12 information. I take a multivitamin with it daily and eat lots of meat and eggs, but perhaps my cells aren't aborbing it. Interesting stuff!

[jimmylegs]

no problem i'll just restate that an attempt to correct my known b12 issues did nothing whatsoever for me when i was dealing with lhermitte's - it turned out to involve quite a lot more than that...
more info on possibilities where lhermitte's sign is concerned: http://teachneuro.blogspot.ca/2011/09/l ... -sign.html

[mallori735]

Well, the past few days have been alarming. For the past couple of weeks, I've developed these weird new symptoms, my left leg feeling like its buzzing or vibrating, toes on my left leg twitching, or fasciculating a lot, hands and fingers jerking, having weird spots on my skin become very sensitive and painful even though I haven't hurt them, the tip of my left hand pinky feeling like its dipped in cold water/kindof numb on and off the past few days. My left side has been tingling for a couple days. And the three nights ago I started having muscle cramps in my legs, mainly left, even though I've never had muscle cramps before. The second night it happened it was my entire left leg, some of my right, then a while later, a muscle in my back and then a muscle in the left side of my neck. The muscles would just, one after the next, become hard as rocks and super painful. It gets really bad at night for some reason. Also, I'm incredibly weak and tired, I fell asleep yesterday in the strangest position with no sheets on my bed because I was too weak to make it back up for a nap. I just, passed the hell out. And, I had my dad test my plantar reflex, out of curiosity, and my left foot is positive for babinskis... Is it possible this could all be from B12? I've been taking a multi vitamin for months with 100% daily value of that in it. It's just all so strange. I had discitis (infection of a disc in my back) when I was two and I've always wondered if that would maybe put me at a higher risk for MS and I also have Endometriosis. I've kept some symptoms since I first developed them (right before my three seizures) five or so years ago. Seeing lights in my peripheral, tingling on head/arms/hip. Then I had a few weeks two years ago with L'hermittes sign, then it went away, now I'm having all these things happen, and I'll bet they'll go away or lessen in intensity. Idk. I'm so confused and worried about this. The brain MRI I had after my seizures came back fine, as did the EEGs, and the neurologist blamed the lights and tingles on silent migraines, which if that is true, I have every day almost all day. Ugh. Oh! And my head has been hurting on and off in the front, right above my eyes, for a week. Nothing will help it. I got my GP to give me a referral to my Neuro since its been over three years since I've seen him. And I'll bet it'll take a couple months to get in. Gah! So frustrating. It's like, I know something is wrong, but I'm also scared I'll go, get a damn expensive MRI and it'll come back normal and I'll be back to square one. What do you all think? All these new symptoms are freaking me out.

[jimmylegs]

re 'Is it possible this could all be from B12?' your body is more complex than that. as nice as it would be for there to be a one-shot answer, it's not likely to be true. esp if you take a multi that meets 100% of daily b12 requirements, plus eat lots of meat and eggs. a blood test could help you figure that out with more certainty.
in the meantime, on your own you can figure out if you're likely to be missing some of the nutrients that tend to be low for folks with chronic diseases of various kinds, incl ms. what multi do you normally take? what is your diet like? have you measured your daily intakes of essential nutrients against the daily recommended amounts? what is your normal level of physical activity, on the sedentary to athlete spectrum? all these things would be good bits of info to have, to help assess whether nutrition could be playing a role in your experience of symptoms.

[NHE]

Is it possible this could all be from B12? I've been taking a multi vitamin for months with 100% daily value of that in it.

My opinion is yes, a B12 deficiency could be a strong contributing factor. A B12 deficiency can cause demyelination of the spinal cord which is called subacute combined degeneration. It can cause symptoms that can mimic MS. It's best to get your B12 and related blood tests done to rule out B12 deficiency as it's part of the differential diagnosis workup for someone with MS-like symptoms. These tests include serum B12, serum or urinary methylmalonic acid, serum homocysteine and red blood cell (RBC) folate. Homocysteine and methylmalonic acid are both toxic and can build up if B12 is low. High levels of homocysteine are not specific to B12 as they can also be due to low folate and low B6, but it's thought that high levels of methylmalonic acid are specific. However, methylmalonic acid can be normal even if B12 is low if one happens to be taking antibiotics at the time of the B12 test. It's important to test folate and many doctors don't do this for B12. If folate is low, it can prevent the recycling of inactive B12 back to its active form which is methylcobalamin. It should be noted that when I refer to folate, I mean either dietary folate from uncooked greens or L5-methylfolate as a supplement, not folic acid (dietary folate is converted to methylfolate which is then used to remethylate cobalamin back to the active methylcobalamin form).

The RDA for B12 is only about 2.5 - 3.0 micrograms/day. There is little chance that this level of intake will correct a deficiency. If a person has absorption problems, which are not uncommon and increase as a person ages, then that chance drops quite close to zero. That's why people with confirmed B12 deficiency use either sublingual tablets or take B12 shots usually at a dosage of 1000 micrograms or more.

Lastly, don't accept being told that you're "normal." Instead, ask your doctor for a copy of your lab results. If they question this, say it's for your own medical records. B12 can still be low even if it falls into the "normal" range. Most US labs use a range for B12 around 200-800 pg/mL. However, it's best to have it around 500 or higher. Results at the low end of the range fall into a gray area where B12 could indeed be a problem and the other tests are needed to confirm it.

[jimmylegs]

i posted this study elsewhere on the site the other day: http://www.thisisms.com/forum/natural-a ... 25993.html

Kroushavi, M., Behrooz, M., Rashidkhani, B., Bahadori, N., & Hekmatdoost, A. (2015). Association between index of nutritional quality and multiple sclerosis. Journal of School of Public Health and Institute of Public Health Research, 12(3), 0-0. Chicago
http://sjsph.tums.ac.ir/browse.php?a_id ... lc_lang=en

Background and Aim: The role of nutritional quality of the diet in the development and progression of multiple sclerosis (MS) is not yet well understood. The aim of the present study was to determine the association between index of nutritional quality (INQ) and MS.
Materials and Methods: In this case-control study, 70 patients with a definitive diagnosis of MS in the preceding year and 140 frequency-matched hospital controls were selected from among 20-50 year-old patients referred to Sina and Lolagar hospitals in Tehran. The subjects’ dietary intakes were assessed using a valid and reliable semi-quantitative food frequency questionnaire. INQs for all the nutrients were then calculated for every participant, and logistic regression analysis was used to calculate the odds ratios for having MS in relation to every nutrient’s INQ.
Results: After adjusting for potential confounders, it was seen that subjects who had higher [indices of nutritional quality] for alpha-linolenic acid, vitamins A, D, K, B1, B2, B5, B6, folate, B12, and C, and minerals calcium, phosphorus, zinc, and potassium were less likely (p<0.05) to have MS as compared to subjects with lower INQs for these nutrients.
Conclusion: The findings of the present study show inverse associations between the INQ of many nutrients and risk of having MS. Therefore, it seems that overall improvement of the nutritional quality of the diet might be an appropriate approach for prevention of this disease.

this study doesn't make the cut to be in my library listings, so i can't get in to the full text to check whether any other nutrients of concern were tested but were not significantly different, or if there were things missing from the assessment entirely. i am curious about their evaluation of magnesium and vitamin e for example either way, it's a nice long list of things to go through. each one deserves thorough attention.

in my case, i zeroed in on b12 at first and i already knew i really was seriously deficient. it didn't matter how much b12 i took though, no improvement. there was a lot more going on and the best result i got in the early days involved making some big dietary changes and taking a wide array of supplements according to an old protocol - more protein, lecithin, a lot of b vits, a lot of E, and a multi (i ignored some parts of the protocol because it was so much info - i got so much better so fast that in hindsight i wish i had done everything recommended and more - research has shown that still more nutrients should be considered than in that 1970s regimen). it was kind of frustrating not to know which one helped the most. but in the end, it's not important. your body's systems are like detailed recipes. you can't just throw eggs at a kitchen and end up with a cake

[lyndacarol]

Well, the past few days have been alarming. For the past couple of weeks, I've developed these weird new symptoms, my left leg feeling like its buzzing or vibrating, toes on my left leg twitching, or fasciculating a lot, hands and fingers jerking, having weird spots on my skin become very sensitive and painful even though I haven't hurt them, the tip of my left hand pinky feeling like its dipped in cold water/kindof numb on and off the past few days. My left side has been tingling for a couple days. And the three nights ago I started having muscle cramps in my legs, mainly left, even though I've never had muscle cramps before. The second night it happened it was my entire left leg, some of my right, then a while later, a muscle in my back and then a muscle in the left side of my neck. The muscles would just, one after the next, become hard as rocks and super painful. It gets really bad at night for some reason. Also, I'm incredibly weak and tired, I fell asleep yesterday in the strangest position with no sheets on my bed because I was too weak to make it back up for a nap. I just, passed the hell out. And, I had my dad test my plantar reflex, out of curiosity, and my left foot is positive for babinskis... Is it possible this could all be from B12? I've been taking a multi vitamin for months with 100% daily value of that in it. It's just all so strange. I had discitis (infection of a disc in my back) when I was two and I've always wondered if that would maybe put me at a higher risk for MS and I also have Endometriosis. I've kept some symptoms since I first developed them (right before my three seizures) five or so years ago. Seeing lights in my peripheral, tingling on head/arms/hip. Then I had a few weeks two years ago with L'hermittes sign, then it went away, now I'm having all these things happen, and I'll bet they'll go away or lessen in intensity. Idk. I'm so confused and worried about this. The brain MRI I had after my seizures came back fine, as did the EEGs, and the neurologist blamed the lights and tingles on silent migraines, which if that is true, I have every day almost all day. Ugh. Oh! And my head has been hurting on and off in the front, right above my eyes, for a week. Nothing will help it. I got my GP to give me a referral to my Neuro since its been over three years since I've seen him. And I'll bet it'll take a couple months to get in. Gah! So frustrating. It's like, I know something is wrong, but I'm also scared I'll go, get a damn expensive MRI and it'll come back normal and I'll be back to square one. What do you all think? All these new symptoms are freaking me out.

mallori735 – I, also, had endometriosis.

From Could It Be B12? An Epidemic of Misdiagnoses by Sally M. Pacholok, RN, BSN, and Jeffrey J. Stuart, D.O.:

(Page 177)

There are dozens of common causes of male and female infertility, ranging from endometriosis, pelvic inflammatory disease, and polycystic ovary disease in women to structural or hormonal problems in males, and to anti-sperm antibodies in either partner. But there is another risk factor for both male and female infertility that is often overlooked, even by infertility specialists. That problem is vitamin B12 deficiency.

You have asked, "What do you all think?"… I think that since your GP was willing to give you a referral to a neurologist, ask for a referral to a hematologist (specialist in blood abnormalities), as well. In my opinion, all your symptoms are consistent with B12 deficiency, but I have no medical training; discuss a written list of your symptoms with a hematologist and consider asking for testing to rule out B12 deficiency.

I have sent you a personal message; you can retrieve it by clicking on "new messages" in the upper left-hand corner of this page.

[jimmylegs]

some potentially interesting scientific perspective on nutrition and endometriosis

top results on search terms "endometriosis" nutrient status:
https://scholar.google.ca/scholar?q=%22 ... _sdt=0%2C5

Diet and risk of endometriosis in a population-based case–control study (2011)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374872/
"...the present study suggests a possible inverse risk of disease with dietary fat and dairy consumption and an increased risk of endometriosis with β-carotene and higher servings of fruit/d, but these findings have not been confirmed elsewhere and require further evaluation in a prospective investigation."

Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study (2013)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626048/
"In this study, we investigated whether intake of dairy foods, nutrients concentrated in dairy foods (calcium, vitamin D, magnesium, and phosphorus), and predicted plasma 25(OH)D levels were associated with incident laparoscopically confirmed endometriosis ... Our findings suggest that greater predicted plasma 25(OH)D levels and higher intake of dairy foods are associated with a decreased risk of endometriosis."

Women with endometriosis improved their peripheral antioxidant markers after the application of a high antioxidant diet (2009)
http://www.biomedcentral.com/content/pd ... 7-7-54.pdf
"Comparison of antioxidant intake between WWE and WEN showed a lower intake of vitamins A, C, E, zinc, and copper by WEN [women with endometriosis] (p < 0.05, Mann Whitney Rank test)"

A prospective cohort study of Vitamins B, C, E, and multivitamin intake and endometriosis
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916184/
"Intakes of thiamine (B1), folate (B9), vitamin C, and vitamin E solely from food sources were inversely related to endometriosis diagnosis. However, intakes of these nutrients from supplements alone were unrelated to endometriosis. ... Our results suggest that the protective mechanism may not be related to the nutrients themselves but rather other components of foods rich in these micronutrients or factors correlated with diets high in these vitamin-rich foods."

i particularly like that last bit re the food-source emphasis.

overall, looks like quite a list of food factors to be aware of where endometriosis is concerned - dietary fat, vitamins A, B1, B9, C, D, E as well as calcium, magnesium, zinc, and copper. pretty much item for item things you want to watch in ms as well.