Going down the road feeling bad
Posted: Mon Aug 17, 2015 10:36 am
For > 1 year, I've been dealing with some hand tremors. Generally I feel ok. Not sure what an MS episode is like so not sure if I've had one. The only think I can think of is getting fairly sick a few months back with what I thought was food poisoning initially but I was the only one that got sick. Really horrible headache and I could barely move. Felt nauseous but really didn't vomit. That said, I felt so bad that if I owned a gun, I might have considered putting myself out of my misery. Don't take me literally but yeah, it was that bad. About a year or so prior, I had a CAT scan for what felt like a sunburn under my skin. Most bizarre thing in the world but it went away. Shingles were ruled out. It was bilateral and pretty much throughout my torso and back.
With some encouragement, I finally went to the neurologist to see what was going on with my tremors as they progressed and I was starting to have a bit of weakness in part of my hand. Nothing major but it is there. Now after seeing 2 neurologists, I was just referred to a third who is a demyelination specialist. Second neuro was upfront in stating she was not diagnosing me yet but I could have MS based on what she was seeing and the results of my brain MRI.
Starting to get a bit worried but I realize it isn't the end of the world. Interested in thoughts?
Based on putting pieces together, I think I have 3 things going on which may or may not be related. 1) Compressed nerve in my elbow 2) Stenosis in my spine. Not horribly bothersome but annoying. I've had much worse spine issues so I would describe this as livable and 3) a bunch of lesions in my white matter that very well could be MS. I'm wondering if this is the cause of the tremors as my tremors are worse on the left side and these seem to be oriented perpendicular to the right lateral ventricle. THOUGHTS?
More background:
First neuro initially thought it was spine-related given my history of having 2 fusions but EMG showed otherwise. Ruled out Parkinsons and MND. He indicated that I likely need a decompression of elbow (makes some sense as I do have a little bit of tingling in my 4th and 5th digits) however he said it didn't explain the tremors. Decided for a second opinion for a number of reasons, not the least of which is that the first doc was clear that he didn't think the tremors were caused by nerve compression but didn't really offer any other course of action. Second neuro was more thorough and ordered a brain scan and reordered Cervical MRI and EMG (oh happy happy, joy joy). EMG was fairly consistent I believe but I don't have results in front of me.
Symptons include:
- Major hand tremors (intention) that occur primarily when closing my hand or attempting to touch a finger to thumb (slow or fast) or when I try to move my wrist up and down slowly. They are not resting tremors so likely not PD.
- Random twitching - sometimes in my hands, arms, legs, shoulders. Not constant but more than enough to know they are there everyday.
- blurred vision at times. I assumed this was just getting older and perhaps a bit far sighted. The issue occurs intermittently. Sometimes, staring at my phone for a while and then looking up will set it off. Generally will take several minutes for my eyes to adjust.
- Cramping. Hands (this is fairly new) and legs / feet (everyone has these). the hands cramps have occurred while driving and just by turning my arm.
EMGs (I've had 2) showed:
- L. slowing across the elbow (ADM: 61 m/s --> 43m/s, FDI: 59m/s -->42 m/s; CMAP amplitudes normal. R. Ulnar had similar findings at this location
- L. ulnar motor nerve conduction - 21% and 24% reduction in CMAP amplitudes btwn wrist and elbow stimulation sites suggestive of conduction blocks at ADM and FDI muscles respectively.
- L. Ulnar sensory nerve conduction study: reduced SNAP amplitude with normal conduction velocity and distal latency
MRI of C-spine (lots going on). I've had a fusion at C5-C7. Most notable issues were severe bilateral foraminal stenois C3-4 and on the left at C6-7.
Impressions were Bilateral ulnar neuroapthy aat elbow with possible conductive block on left side. No evidence of significant axonal injury .
Brain MRI:
- Impression: Fewer than 10 nonenhancing foci of white matter T2 prolongation, the largest of which is ovoid and oriented perpendicular to the right lateral ventricle, concerning for a primary demyelinating disease.
I'm not sure why the radiologist wasn't more specific as to the number of lesions but I assume fewer than 10 is greater than 1 but less than 10.
After receiving the results, second neuro referred me to a demyelination specialist and ordered a T-Spine MRI.
So group, what are your thoughts? Is this consistent with MS? I know, I know, let the docs diagnosis and don't get myself crazy but I'm definitely a bit apprehensive.
Thanks in advance!
Meyro
With some encouragement, I finally went to the neurologist to see what was going on with my tremors as they progressed and I was starting to have a bit of weakness in part of my hand. Nothing major but it is there. Now after seeing 2 neurologists, I was just referred to a third who is a demyelination specialist. Second neuro was upfront in stating she was not diagnosing me yet but I could have MS based on what she was seeing and the results of my brain MRI.
Starting to get a bit worried but I realize it isn't the end of the world. Interested in thoughts?
Based on putting pieces together, I think I have 3 things going on which may or may not be related. 1) Compressed nerve in my elbow 2) Stenosis in my spine. Not horribly bothersome but annoying. I've had much worse spine issues so I would describe this as livable and 3) a bunch of lesions in my white matter that very well could be MS. I'm wondering if this is the cause of the tremors as my tremors are worse on the left side and these seem to be oriented perpendicular to the right lateral ventricle. THOUGHTS?
More background:
First neuro initially thought it was spine-related given my history of having 2 fusions but EMG showed otherwise. Ruled out Parkinsons and MND. He indicated that I likely need a decompression of elbow (makes some sense as I do have a little bit of tingling in my 4th and 5th digits) however he said it didn't explain the tremors. Decided for a second opinion for a number of reasons, not the least of which is that the first doc was clear that he didn't think the tremors were caused by nerve compression but didn't really offer any other course of action. Second neuro was more thorough and ordered a brain scan and reordered Cervical MRI and EMG (oh happy happy, joy joy). EMG was fairly consistent I believe but I don't have results in front of me.
Symptons include:
- Major hand tremors (intention) that occur primarily when closing my hand or attempting to touch a finger to thumb (slow or fast) or when I try to move my wrist up and down slowly. They are not resting tremors so likely not PD.
- Random twitching - sometimes in my hands, arms, legs, shoulders. Not constant but more than enough to know they are there everyday.
- blurred vision at times. I assumed this was just getting older and perhaps a bit far sighted. The issue occurs intermittently. Sometimes, staring at my phone for a while and then looking up will set it off. Generally will take several minutes for my eyes to adjust.
- Cramping. Hands (this is fairly new) and legs / feet (everyone has these). the hands cramps have occurred while driving and just by turning my arm.
EMGs (I've had 2) showed:
- L. slowing across the elbow (ADM: 61 m/s --> 43m/s, FDI: 59m/s -->42 m/s; CMAP amplitudes normal. R. Ulnar had similar findings at this location
- L. ulnar motor nerve conduction - 21% and 24% reduction in CMAP amplitudes btwn wrist and elbow stimulation sites suggestive of conduction blocks at ADM and FDI muscles respectively.
- L. Ulnar sensory nerve conduction study: reduced SNAP amplitude with normal conduction velocity and distal latency
MRI of C-spine (lots going on). I've had a fusion at C5-C7. Most notable issues were severe bilateral foraminal stenois C3-4 and on the left at C6-7.
Impressions were Bilateral ulnar neuroapthy aat elbow with possible conductive block on left side. No evidence of significant axonal injury .
Brain MRI:
- Impression: Fewer than 10 nonenhancing foci of white matter T2 prolongation, the largest of which is ovoid and oriented perpendicular to the right lateral ventricle, concerning for a primary demyelinating disease.
I'm not sure why the radiologist wasn't more specific as to the number of lesions but I assume fewer than 10 is greater than 1 but less than 10.
After receiving the results, second neuro referred me to a demyelination specialist and ordered a T-Spine MRI.
So group, what are your thoughts? Is this consistent with MS? I know, I know, let the docs diagnosis and don't get myself crazy but I'm definitely a bit apprehensive.
Thanks in advance!
Meyro