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Multiple Sclerosis Message Board


Multiple Sclerosis Board Index


Thanks for all your help guys

Long post coming...

The biggest problem I have is that I am in a very cool job and I have a beautiful family. If MS is diagnosed then for the particular job that I have then MS is a serious no no and so I will be let go and my specialist career will be ruined :( How will I then provide for my family :(

what is making me scream is the particular Neuro I have seen says she "feels" its not MS as the tests I had would have shown it. Then I hear others say there is no test that can prove it. She was going to do a Lumbar Tap last week but because all of my Evoke Potentials and MRI of the brain came back negative she said if I had MS then it would have shown itself in those tests. The impression I am getting from here is "No it may might not have"

They initially thought Carpal Tunnel Syndrome as the EMG test said..

[B][I]FINDINGS & INTERPRETATION

Sensory study shows prolonged distal sensory latencies of bilateral median nerves.
Motor study shows prolonged distal motor latencies of left median and left ulnar nerves.
Mixed palm-to-wrist peak latencies shows prolonged latency of median nerve.

CONCLUSIONS

Prolonged distal motor latencies of left median and left ulnar nerves may suggest proximal root lesions. Mixed nerve study shows that the latency of median nerve is prolonged compared to that of ulnar nerve. This suggests slowing of conduction over the wrist.
Therefore, it provides electrophysiological evidence of left sided carpal tunnel syndrome.[/I][/B]

Because the Neuro said MS is not really an issue after the MRI and Tests and because I had an abnormality in my EMG and thus read that ALS in most cases mimics MS but shows clean MRI's but abnormal EMG's. I put this to my Neuro and the response was...

[I]ALS tends to give rise to motor symptom instead of sensory symptom. In other words, ALS makes you feel weak rather than making you numb. Remember your initial presenting symptom is numbness? It is not the typical symptom of ALS. ALS causes abnormality in motor system only. Your NCT mainly reports sensory problem.[/I]

I argued the point back via email and said that the EMG DID show Motor problems and again the response was...

[I]Yes, you are right, that's mild motor problem. However, that can be explained by your cervical degenerative problem. Anyway, ALS should not affect sensory system. Therefore, ALS is not on my mind.[/I]

My cervical problem has been described at worst as Mild and thus they cant give me anything definitive as the new Cervical Spine MRI report said

[B][I]Plain and contrast - enhanced MRI study of the cervical spine shows no abnormal signal intensity enhancement along the infra-nor extradural structures.
The cervical intramedullary cord is unenlarged throughout the visualized cranio-cervical junction and upper thoracic intramedullary segments. There are no cystic degenerations signs of calcifications nor mass effect.
Small ventral disc "bulges" are seen at C4-C5 and C6-C7 interspace levels. The annulus Fibrosus is not completely disrupted but suggestive small disc annular tear/fissure formations are noted: central at C4-C5. Left paracentral at C6-C7 interspaces.
Also, minimal if any postero-lateral vertebral end plate sclerosis is seen at the C6-C7, C7-T1, and C5-C6 interspaces with slight neural foraminal encroachments mainly left sided.
The intervertebral disc spaces are fairly homogeneous with no disc narrowing component. "Tendency" to anterolateral osteophytic bony spur " bridging" are seen at the mid-cervical spinal levels
The vertebral bodies perse. lateral masses.laminae.spinous and transverse processes are intact.
The C1- odontoid and accipito-atlas relationships are maintained normal.
The usual cervical spinal curvature is slightly straightened the pre and paraspinal soft tissue structures are unremarkable.

IMPRESSION:

Small sub-ligamentous disc annular tear/fissure formations central at C4-C5, Left Paracentral at C6-C7. Together with minimal degenerative spondylotic sclerosis slightly Encroaching the neural exit foramina at lower cervical interspaces.
NO compression deformity nor spondylolisthesis
NO intramedullary abnormality
Straightened cervical spinal curvature
[/I][/B]

This to me hardly shows signs of something that can cause weak legs, tingling feet/hands/ trembling muscles??? I mean wtf?

When I quizzed her again she said this...

[I]ALS is both a central and a peripheral nerve problem and its symptoms are ascending from feet up. Yours started in the arms. Seems like its more of a mechanical problem to me. At the most, we have cervical nerve impingement that is producing all these symptoms[/I]

I personally disagree as my Cervical issues are "mild"

This is why I am freaking out :(

Anyway sorry its a long post but wanted to fill you in - I hate to be so public with this but I am keen to get opinions. Also thanks for the kind words.

Just for reference my MRI report of the brain is below

[B][I]High resolution MRI study of the brain with axial and sagittal FLAIR, DWL.ADC maps and SWI sequences was performed together with Gd-DTPA contrast

No focal signal abnormality is noted intrinsic to the supra or intratentorial parenchyma even after contrast infusion
The cortical gyri formations are unremarkable.
The cortical-subcortical junction is preserved: centrum ovale is well-formed
The septo-callosal areas are clear
The basal ganglia internal capsule,brainstem,thalamus,midbrain,pons and cerebellum are characterized by normal signal intensities.
DWI reveals no focal areas of restricted diffusion and normal ADC maps. SWI showing no magnetic susceptibility abnormality intrinsic to the brain.
The ventricles are unenlarged with a midline septum pellucidum:Temporal horns are nor dilated appearing symmetrical while the peripheral sulci are within normal limits.
There is no interstitial edema.
The lepto-meningeal spaces reveal no focal abnormal Gd-enhancement
The C-P angles,visualized porous accousticus, internal auditory canal,sella and extrasellar soft tissues structures are clear.
The visualized retro-orbital structures particularly the retro-orbital nerve segments are completely unremarkable. The anterior and posterior compartment of the orbits are well preserved.

IMPRESSION:

No MRI abnormalities intrinsic to the supra or intratentorial brain Parenchyma with no localized mass lesion,sign of acute or chronic ischernic infarction nor hemorrhagic extravasation
No areas of demyelination in this study
Normal appearance of posterior fossa including the C-P angles and skull base
No lepto-meningeal abnormality.
[/I][/B]





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