Symptoms diagnosed psychological

[CaptainSparrow]

I’d be interested to hear from others who’ve had symptoms ruled psychological, and what you did about it. I’ve been having worsening vertigo, blurred/disappearing vision with sharp eye pains, fatigue, weakness in my left arm and leg, numbness in hands and feet, sharp shooting pains and muscle contortions in my face, neck, torso and limbs. I even get muscle spasms in my throat that make my ears pop over and over while I’m asleep. The noise wakes me up. These symptoms have been coming and going for 25 years and suddenly got worse 3 years ago. The first neurologist I saw (on a good day) diagnosed me with migraines and “functional overlay” which is a psychological disorder. I saw a second neurologist who agreed with the migraine diagnosis. She said MS was impossible because my MRI showed no lesions. When I asked her what was causing the muscle spasms and sharp pains, she said “I have no idea” but on the report sent to my doctor, she called it “somatization,” the new version of psychosomatic/hysteria disorder. I am skeptical. Why would I produce imaginary symptoms, many of which wake me up at night? This whole neurological business wasn’t even my idea. When I first started falling down and dragging my leg I went to my family doctor thinking I had a harmless inner ear disorder and an old whiplash injury acting up. She’s the one who urged me to rule out MS. I should add that the past 5 months have been the most stressful of my life, with moving to a new city, taking on a new job and the death of my father, yet the only significant change in my symptoms was the usual improvement I get when the cold weather sets in. Where do I go from here? Spend another two years trying to see a third neurologist?

[ElliotB]

"She said MS was impossible because my MRI showed no lesions"

About 10% of those diagnosed with MS do not have lesions. You obviously have something. Find another doctor.

[Scott1]

Hi,

We differ in as much as I have a diagnosis of MS and unequivocal symptoms.

At the time of my recent severe attack, I required rehabilitation and a psychological counseling was offered. I didn't feel I needed that but decided that others may see me as more odd than I thought I was myself.
Due to issues with spasticity, my neurologist put me on a very low dose of Baclofen. It did help my tightness considerably but the unexpected side effect was much greater mental clarity. Until I took it I wasn't so much "in the moment" as in all moments. i.e Anything that had happened plus anything that might happen as well as the present.
The psychologist was no help at all. She kept trying to herd me into a box that suited her. The Baclofen, however, really helped me just focus on the current moment and greatly assisted my sleeping. It might be worth trying half a tablet at night. More is not better so stay at the low dose if your doctor prescribes it.
A gentle alternative might be magnesium several times a day.
Regards,

[CaptainSparrow]

Thanks Scott and Elliot. I could sure use something to clear the brain fog and memory problems. The neurologist put me on a small dose of nortriptyline for migraines which does seem to be helping with the vertigo and fatigue. So I was satisfied with the migraine diagnosis until I saw that report. I told my chiropractor about the somatization diagnosis and he said no way. He's physically felt the problems I'm having with my muscles and he says they would not be caused by migraines. But I'm going through a good phase where my symptoms are not very obvious, so I guess I should wait until they get worse before seeking a 3rd opinion or I'll just confirm the mental illness diagnosis. My province is terrible for misdiagnosing women. My brother's girlfriend went to 2 doctors when she developed lumps under her arms and on her collarbone, both told her she was just stressed out. Within a year she died of cancer.

[lyndacarol]

Thanks Scott and Elliot. I could sure use something to clear the brain fog and memory problems. The neurologist put me on a small dose of nortriptyline for migraines which does seem to be helping with the vertigo and fatigue. So I was satisfied with the migraine diagnosis until I saw that report. I told my chiropractor about the somatization diagnosis and he said no way. He's physically felt the problems I'm having with my muscles and he says they would not be caused by migraines. But I'm going through a good phase where my symptoms are not very obvious, so I guess I should wait until they get worse before seeking a 3rd opinion or I'll just confirm the mental illness diagnosis. My province is terrible for misdiagnosing women. My brother's girlfriend went to 2 doctors when she developed lumps under her arms and on her collarbone, both told her she was just stressed out. Within a year she died of cancer.

Welcome to ThisIsMS, CaptainSparrow.

I assume you are in Canada and I know nothing about the Canadian healthcare system; but if your doctor has not ordered a vitamin D test (a.k.a. 25-hydroxy D test) – particularly important for Canadians, who are at higher latitudes – and vitamin B12 testing, I encourage you to request these tests. Any person at any age can develop nutrient deficiencies. Migraines are a symptom of a possible deficiency in either vitamin D or vitamin B12 (among other conditions). Likewise, cognitive and psychological symptoms can stem from either of these deficiencies. Likewise with fatigue, muscle weakness, etc.

ANY doctor in the US can order these tests – I assume it is the same in Canada. Please request your own copy of any test results – it is important to have the actual numbers. If these tests have been done, please share the results with us.

[ElliotB]

CaptainSparrow, what kind of diet are you following and are you gluten free?

[Scott1]

Hi,
I reread your original post and do think you have to try again for another medical opinion.

Nortriptyline is an antidepressant. “It works by inhibiting norepinephrine and serotonin reuptake and blocking histamine and acetylcholine, restoring levels of norepinephrine and serotonin in the brain”. (see - http://whatmeds.stanford.edu/medications/pamelor.html )

Acetylcholine is a neurotransmitter than operates at nerve junctions to send messages from one cell to another. It is necessary to activate muscles to tell them to tighten. Baclofen just might be a better way to modulate the acetylcholine impact as you need a very big dose to impact mood. It mainly works by slowing how fast potassium leaves a cell which impacts how fast your muscles can tighten.

Magnesium spread across the day should help as well.

On the brain fog issue, the thing that worked for me 20 years ago and still does is the antiviral, Valacyclovir. Taken as 500mg morning and night I find it very useful.

For the fatigue very large doses of a coenzyme Q10 (say 600mg) plus acetyl-l-carnitine should help.

Here’s my now very long and jumbled ideas. You might something useful

http://www.thisisms.com/forum/regimens- ... 24019.html

Regards,

[CaptainSparrow]

Before I saw the neurologists my doctor sent me to an internist who ran a bunch of tests to rule out lupus, lyme disease, vitamin deficiencies etc. Everything was normal except a vitamin D deficiency. She also did some reflex and coordination tests that indicated damage to my central nervous system. She sent me on to the neurologists with "possible early MS" on her referral letter.

What I'd like to know is what do you do or say to get a specialist to take you seriously when you're sitting in their office??

[Scott1]

Hi,

That's one the worlds hardest question. A lot of what medical examiners do is make an educated guess. Sometimes they get it right and sometimes they can't tell.
If the internist did reflex tests then a good neurologist will want to repeat them. They are actually quite good at sensing spasticity even when we can't tell. If a neurologist does the basic examination they will double check with another MRI but they will know there is a chance they won't see much.
You need to talk about your symptoms; where you are tight, what spasms you have, how fatigued you are, what your vision is like etc. You don't have to be medicated. Most of us who have hung around these pages for years really limit medication in preference to supplements and diet. Some seem to know the Vitamin D levels in baby elephants and some just talk about what works for them. If the neurologist cant find something then don't be downhearted. You might be fine with a few changes to lifestyle for a considerable time.
Don't forget a specialist starts from a basic position where the cause of MS remains undetermined so the treatment must be as well. None of them want to upset their peers and be branded a loose canon. I would suggest that you tell them you don't think you are mentally impaired so something other than antidepressants would be your preference. They won't give you an MS blockbuster drug without a definite diagnosis.
I would look for ideas here on supplements and diet, try massage and Pilates and look for ways to stay healthy. If they can't find something then come back and tell us again what you have been doing. There's always a few ways to approach stuff.

Regards,

[CaptainSparrow]

I had never looked at it that way, that neurologists might get into trouble with the professional community if they make a controversial diagnosis. I did wonder if the two of them had been in contact with each other, because both incorrectly listed a medication on my reports that I wasn't taking. One thing that annoyed me was that they didn't do the same reflex tests the internist did. When he read on my list of symptoms that I can't do the flipping hands test with my left hand, the first neurologist got irate with me, for some reason he was ticked off that I knew the proper name for the test. But he didn't ask me to show him.

I'm having good luck with the diet recommended for Crohn's disease and kidney disease, which I also have. Yoga helps, and massage. I also noticed a big difference when I changed jobs and didn't have to do so much heavy lifting.

I'm very happy to hear that medication is not necessary even if I do have MS. That takes the pressure off trying to get a diagnosis. It's also good news that my family doctor can prescribe at least some of them if I do need them. That would make my situation totally manageable, if it doesn't get worse. Thank you, everyone!

[CaptainSparrow]

This morning I woke up with the throat spasm-ear popping thing again, so I looked it up. It's called palatal myoclonus and the most common cause is lesions in the brainstem. Interesting, but nothing I can prove unless someone is prepared to put a stethoscope over my ear as I sleep. I'll just throw it on the pile of weird symptoms that convince specialists I'm nuts.

[Scott1]

Hi,

You probably saw this webpage - http://www.nejm.org/doi/full/10.1056/NEJMicm0806049 In that case, they used a form of botox with some success. It might, as a first step, be worth collecting a few different examples of web based articles and taking them to your doctor. Say that is exactly what you are experiencing and ask to see an ENT specialist or a neurologist.
Unfortunately, this sounds like a case where you will have to argue your own case but always ask to see a specialist.
Regards