This Is MS Multiple Sclerosis Knowledge & Support Community

Hi,
I have struggled with various symptoms since my early 20's and have always been told that they are stress related. I'm now 39 and the symptoms gave increased, become more frequent and severe. Last year I missed a whole month of work.

I have convinced my Dr to rule out something neurological. She still believes it is just stress, but she agreed to make a referral to placate me.

I am scheduled for an EMG a week from Friday.Is this a test that can diagnose MS or point to another neurological disorder?

Jam2b36 wrote:Hi,
I have struggled with various symptoms since my early 20's and have always been told that they are stress related. I'm now 39 and the symptoms gave increased, become more frequent and severe. Last year I missed a whole month of work.

I have convinced my Dr to rule out something neurological. She still believes it is just stress, but she agreed to make a referral to placate me.

I am scheduled for an EMG a week from Friday.Is this a test that can diagnose MS or point to another neurological disorder?

Welcome to ThisIsMS, Jam2b36.

Neurological symptoms can be consistent with many conditions that are not in the realm of neurology. For instance, neurological symptoms are the first to appear in vitamin B12 deficiency; neurological symptoms also come with magnesium deficiency, celiac disease, thyroid, liver and kidney functions problems, Vasculitis, Lyme disease… Many possibilities!

Have you discussed initial screening for possible vitamin B12 deficiency with your doctor? The 4 tests that are necessary to rule out B12 deficiency (serum B12 or the newer HoloTc test; RBC folate test; serum homocysteine test; and methylmalonic acid test) are relatively easy (blood tests) and are relatively inexpensive compared to most neurologic tests. Do not take vitamin B supplements before testing as doing so will skew test results. Any person at any age can develop a vitamin B12 deficiency. (By the way, request your own copy of any test results – it is useful to have the actual numbers.)

There is no definitive test for MS – not an EMG, not an MRI, not even a lumbar puncture. MS is a diagnosis of exclusion, made after the other more likely possibilities have been ruled out.

Thanks for your response.

I have been screened for everything listed and it all comes back normal except my vitamin D is consistently low. I'm taking 5000 IU of D3 twice a day as instructed by my Dr.

I've even been sent to a cardiologist because of chest, shoulder and upper back pain. My cardiovascular system is healthy, and it appears the pain is caused by muscle spasms and stiffness.

My symptoms include:
Muscle pain in every part of my body, but not all at the same time
tingling/numbness/crawling/itching in my arms, hands, finger, legs, feet, face, lips, and tongue
Unsteady walking and balance
Stomach issues
Urination problems
Dizziness
Eyeball pain, floaters and cloudiness
Extreme exhaustion for no reason

Out of all of this the most distressing thing is how tired I get. I think I could cope with anything if I wasn't so fatigued.

Jam2b36 wrote:
I am scheduled for an EMG a week from Friday.Is this a test that can diagnose MS or point to another neurological disorder?

Hello Jam and welcome, although I'm sorry to hear you're dealing with all these symptoms!

To answer your question, no, an EMG does not diagnose MS, although it does point to peripheral nerve damage. MS is a disease of the Central Nervous System, however -- the brain & spinal cord & optic nerves. All our other nerves are part of the PNS (Peripheral Nervous System).

I'm surprised that your doctor isn't taking your symptoms seriously, since they do indicate that neurological follow up is needed. I got EMGs 16 years ago for a tremor in one finger, which DID indicate to my physiatrist (nerve/muscle/bone specialist) that I do have carpal tunnel, which made me likely to have HNPP, a hereditary peripheral neuropathy like my dad.

However, he didn't stop with that. A simple neuro check of my reflexes, etc., ALSO indicated to him that I had obvious CNS damage as well: Unequal reflexes on the right/left sides and a definite Babinski reflex on my left foot. So... he sent me straight in for an MRI of my brain and C-spine, which showed a brain full of MS-specific lesions and gave me an 'overnight' diagnosis of MS also.

Here's a link to a list of the simple, general neurologic exam that could lead to clues as obvious as mine were.

http://multiplesclerosis.net/diagnosis/ ... ical-exam/

Neurological issues could be due to dozens (if not hundreds) of other medical conditions besides MS, HNPP, vitamin deficiency. I have no idea which one, but a diagnosis of "stress" rather than further follow up with testing or MRIs is unacceptable. I seldom suggest abandoning one's doctor, but you may need to find a doctor who takes your complaints more seriously with testing before dismissing them.

A physiatrist or rehab specialist may be a good type of doctor to see next. They're looking at movement disorders in general (like mine was), not ONLY neurological issues. My doc followed the clues and was able to diagnose me almost immediately -- before I saw a neuro.

Physiatrist info:
https://www.aapmr.org/patients/aboutpmr ... trist.aspx

I'm not sure which type of specialist will be doing your EMGs, but I hope he/she is as observant as mine was! Good luck and keep us posted.

Jam2b36 wrote:I have been screened for everything listed and it all comes back normal except my vitamin D is consistently low.

I assume this means your doctor ordered a "serum B12" test for you. Many researchers consider the reference ranges for vitamin B12 established by US labs to be outdated and set too low.

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/

On page 11:

There is much controversy as to what constitutes a normal result for this test [serum vitamin B12 test]. Because of this controversy, this test is often used in conjunction with other markers of B12 deficiency (MMA, Hcy, and more recently the HoloTc).

… We believe that the "normal" serum B12 threshold needs to be raised from 200 pg/mL to at least 450 pg/mL because deficiencies begin to appear in the cerebral spinal fluid (CSF) below 550 pg/mL.

At this time, we believe normal serum B12 levels should be greater than 550 pg/mL.…

We commonly see patients with clinical signs of B12 deficiency who are not being tested. Others who are being tested are not being treated because their serum B12 falls in the gray zone [between 200 pg/mL and 450 pg/mL]. This error results in delayed diagnosis and an increased incidence of injury.

Compare your B12 test results numbers to those recommended by the authors.

Your symptoms are common to many conditions, but extreme fatigue is mentioned so very often with B12 deficiency (and a B12 problem is so common among the US population).

I don't know the name of the test but they have checked B12 twice in the last year. I've had the same labs done repeatedly for years. I always appear healthy, except for the vitamin D issue and occasional anemia.

The first time my thyroid was checked I was 23, and it has been done several times over the years with all three tests they have for it. I've been checked for diabetes multiple times since I was 20. Kidney function, gall bladder... All normal. I was tested for lupus and rheumatoid arthritis last year, and those results were good.

Through all of this my results make me look like I am mostly a healthy person. But I'm miserable and uncomfortable. My good days are so rare that they are a very big deal and really stand out.

Hi,

Have you been checked for mycoplasmas, chlamydias, borrelia, bartonella and Lyme? Particularly mycoplasma.

Those aching joints and the other symptoms sound like a infection.

Regards