Could It Be MS?
I am a 41-year-old woman grappling with a range of puzzling symptoms. Recently, I underwent a tilt table test, which I did not pass. I’ve been experiencing a crawling sensation in my arms and shins, along with tingling and numbness in my limbs, a strange punching feeling in my arms, a numb tongue, difficulties with coordination, frequent dizziness, and persistent fatigue, among many other issues. My electromyography (EMG) results were normal, and a small fiber neuropathy biopsy returned results that were on the lower end of the normal scale. My neurologist has advised that we repeat this test in two years to monitor any changes before we discuss potential treatment options. Additionally, an MRI conducted in 2023, prompted by my ENT due to my dizziness and coordination challenges, revealed a lesion that may be indicative of multiple sclerosis (MS). My neurologist clarified that this lesion does not appear to be related to a stroke. Following that, another brain MRI was performed, which yielded the following findings: There is a stable punctate hyperintensity located in the left frontal white matter compared to the MRI of 10/20/2023. Its clinical significance remains uncertain, and there are no signs of any acute abnormalities or unusual enhancements. Currently, my doctor is away on vacation. However, a colleague from her office reached out to inform me that they are unclear about the nature of the spot on my brain, but she mentioned that I do not have MS—although her lack of knowledge regarding my medical history raises questions about that conclusion. My neurologist expressed that my symptoms alone could suggest MS; hence, she wanted to carry out another MRI to monitor for new lesions or changes in the existing one, along with a cervical MRI, which did not reveal anything of concern. I am awaiting further guidance from my physician. Meanwhile, I am interested to know if anyone has been diagnosed with MS solely based on symptoms and the presence of a single lesion. Any insights or shared experiences would be greatly appreciated.
Answers (1)
3/29/2025, 12:20:38 AM
OpenHealth AI
Your situation sounds quite challenging, and it’s understandable to feel concerned with the variety of symptoms you're experiencing. Diagnosing conditions like multiple sclerosis (MS) can be complex, especially when symptoms and imaging results do not provide definitive answers.
Main Points:
- MS diagnosis typically involves a combination of symptoms, MRI findings, and sometimes additional tests.
- The presence of a single lesion and your symptoms could raise the possibility of MS, but many factors are considered in making a diagnosis.
- Monitoring with repeat MRI is an important next step.
Explanation:
Multiple sclerosis is a neurological condition where the immune system mistakenly attacks the protective covering of nerves. It's often diagnosed based on a combination of clinical symptoms, MRI findings, and sometimes lumbar puncture results. Symptoms like tingling, numbness, coordination difficulties, and fatigue, which you’ve mentioned, can be part of MS but are not exclusive to it.
Your MRI findings indicate a "punctate hyperintensity," which may suggest a potential lesion, but it’s important to note that not every lesion corresponds to MS. The stability of this lesion over time is a positive indication, suggesting it hasn’t changed, and this stability is often reassuring.
Prioritized Next Steps:
-
Symptom Monitoring: Continue to track your symptoms, including any new developments or changes in severity. Keeping a daily journal can help you articulate your experience clearly when discussing with your healthcare provider.
-
Patient Education: Familiarize yourself with MS and other potential diagnoses involving similar symptoms, like small fiber neuropathy, vitamin deficiencies, or anxiety-related conditions. Understanding these can help you have informed discussions with your doctor.
-
Follow-Up with Neurologist: Once your neurologist returns, schedule an appointment to review your MRI findings and the significance of the lesion in detail. Discuss any further action or tests that may be warranted based on your symptoms and MRI results.
-
Lifestyle Adjustments: Focus on managing fatigue through lifestyle changes, such as regular low-impact exercise, good nutrition, and sufficient sleep. Stress management techniques, such as mindfulness or yoga, may also be beneficial for your overall well-being.
-
Stay Informed: Engage with support groups or forums for individuals with MS or similar symptoms. Hearing from others who have gone through similar diagnostic processes can offer reassurance and insight.
It’s important to remain positive and proactive in seeking answers. Remember, you’re not alone in this journey, and there are resources available to help you navigate these uncertainties. If you have further questions or need clarification on any aspect, feel free to ask.
Related Questions
Understanding Possible Seizure Triggers and Recurrence Risks
Health Background: I am a 21-year-old female, standing at 169 cm and weighing 65 kg. Over the past three years, I have been using oral contraceptives. As of this morning, I started taking 25 mcg of levothyroxine along with a weekly vitamin D supplement of 0.266 mg. Recently, I was diagnosed with hypothyroidism and found to have a vitamin D deficiency that I suspect has existed for the last three years. I do not consume alcohol or smoke, and I can confirm I am not pregnant. Two years ago, I experienced a mild concussion. I currently reside in Spain. A couple of months back, in mid-December, I blacked out twice. The second occurrence took place while I was at the doctor’s office after seeking urgent medical care for the initial incident. Following the second episode, I underwent a CT scan and an EKG, both of which returned normal results. Further tests, as directed by my physician, revealed a critical vitamin D deficiency and hypothyroidism; however, he expressed doubt that either of these conditions led to my loss of consciousness. I was then referred to a neurologist, and I am presently awaiting an appointment. Although the waiting period is lengthy, my doctor indicated that I should receive priority for scheduling, although the exact timeframe remains uncertain. The referral document summarized my events, labeling the second episode (which the physician witnessed) as a potential seizure devoid of tonic-clonic movements—a revelation that took me by surprise. After regaining consciousness, I felt extremely disoriented and terrified, struggling to process what was happening. I have no prior history of seizures, epilepsy, or any related conditions, and there is no known family history of these issues. If this indeed was a seizure, what might have triggered it? Additionally, what is the likelihood of experiencing another one? Since that time, I have not had any further incidents, but I have experienced moments where I felt a sense of impending doom, which I managed to overcome. I intend to wait for the neurologist's evaluation, but the uncertainty surrounding a possible neurological condition is quite distressing. Thank you for any insight you can provide!
Persistent Pain in Right Shoulder and Arm After Lifting
Hello, everyone! I’m a 23-year-old male and have been engaged in weightlifting for several years now. Recently, I’ve been struggling with ongoing discomfort in my right shoulder and arm, which I haven’t been able to accurately identify. The pain manifests during particular movements, especially with lateral raises or when my arm is raised to shoulder level while rotating my wrist. Certain pressing and pulling activities can also provoke this discomfort. Rather than feeling sharp, it’s a deep, nagging sensation that sometimes seems localized in the front area of the shoulder or at the biceps tendon, and at other times it feels more like it’s situated between the shoulder and upper arm. Fortunately, there’s no numbness or tingling involved. This issue began while I was working out. I decided to take a break for around two months, but when I returned, the pain persisted. After consulting a physician, I was diagnosed with bicipital tendinitis. Since then, I’ve reduced my upper-body workouts, completely steering clear of shoulder exercises and heavy lifting, and have begun a gentle rehabilitation regimen focusing on external rotations, pendulum movements, and scapular exercises. Despite adhering to this routine for about a week, I haven’t experienced any noticeable improvement. Is it typical for this type of tendon injury to require an extended period for recovery? At what point should I consider diagnostic imaging, such as an ultrasound or MRI? Additionally, are there frequent rehabilitation errors that might impede the healing process? I appreciate your insights in advance!
Understanding EEG Results for My 22-Month-Old Son: Insights Needed
Could someone help clarify this for me? My son, who is just 22 months old, hasn’t started walking yet, becomes tired easily, and has been experiencing behavioral outbursts. He had a febrile seizure in February 2025, followed by another unexplained seizure in April 2025, which led us to consult a neurologist. Since he was 3 months old, he has been receiving therapy from a physical therapist for torticollis. At birth, he spent five days in the NICU due to issues with meconium aspiration. A recent MRI showed normal results, and he also had a follow-up EEG after one conducted in July 2025. The results from this recent EEG were abnormal for a pediatric patient in awake, drowsy, and sleeping states. Notably, there were brief episodes of left frontotemporal delta slowing, which occurred mainly when he was awake and drowsy. There were no signs of epileptiform activity detected. In contrast, the EEG performed back on July 3, 2025, was deemed normal for both awake and drowsy states, again with no evidence of epileptiform irregularities, although it did not capture any sleep data. This examination was prompted by the child's existing history of febrile seizures. Importantly, he is not currently on any anti-seizure medications. The EEG procedure used standard electrode placements per the 10-20 system, conducted a single-lead EKG, and included continuous video monitoring. During the analysis, the background activity was symmetric, indicating some anterior-posterior (AP) organization, with a dominant rhythm of 50-80 microvolts at 7 Hz. His drowsy state was marked by a reduced amount of eye blink activity, less breathing motion interference, and a generalized slowing in theta/delta frequencies. Stage II sleep exhibited spindles and vertex waves patterns. Additionally, there were intermittent bursts of 250-300 microvolts in the left frontotemporal region with semi-rhythmic activity of 2-4 Hz, mostly observed during wakefulness and drowsiness. No definitive epileptiform discharge was noted. Photic stimulation during the test did not elicit a strong response, and hyperventilation was not conducted during this session.
INTENSE Spine Discomfort, Breathing Difficulties, Muscle Twitches, and Sweating
To elaborate on the situation mentioned in the title, I’ve been experiencing unusual muscle twitches and spasms for the past few days, along with some discomfort in my back. However, today, I felt an unexpected sharp pain shoot through my spine, which has left my legs feeling numb and made it impossible for me to sit up straight. Additionally, I’ve been dealing with cold sweats for the last hour and struggling to breathe properly. Perhaps I’m just overanalyzing things and it’s a common occurrence, but the intensity of the pain is overwhelming—it's truly unbearable. I’m shaking quite a bit, and unfortunately, my parents aren’t responding to my attempts to reach them for help. I have a history of a chronic heart condition and arthritis, yet I’ve never experienced pain this severe, especially in my spine. For context, I am nearly 15 years old and female. My current medications include pain relievers, anxiety medication, beta blockers, and some vitamins, though those specifics may not be particularly relevant. I don’t smoke; however, I have tried vaping a few times, which might not matter much, but I thought it was worth mentioning as it was requested.
Understanding Atrial Fibrillation and Thyroid Issues: Variability in Cardioversion Decisions
Hello everyone, I’m reaching out for guidance regarding my mother’s current health situation, and I’d greatly appreciate any shared experiences or thoughts. **My mother's background:** - **Age**: 55 years - **Weight**: Recently dropped to 116 kg from 118 kg in just two days, likely due to diuretics. - **Health history**: Previously an underactive thyroid, undiagnosed and untreated, now presenting as overactive. - **Medications**: Currently taking thyroid medication and a beta-blocker (Rapiblock). **Current health status:** My mother has been hospitalized since Tuesday, experiencing **atrial fibrillation with heart rates exceeding 200** beats per minute due to her thyroid's hyperactivity. - The plan for cardioversion was initially settled on Tuesday. However, the following day, the medical team advised postponing it until her thyroid levels could be stabilized, believing that her heart rate would return to normal once her thyroid condition was managed. - Her **obesity** precludes her from undergoing a transthoracic echocardiogram, and due to her thyroid concerns, she cannot handle contrast dye (this has been a consistent issue for over four years). Therefore, the only feasible option was a **transesophageal echocardiogram (TEE)**, which has yet to be performed. - She has been prescribed various medications including beta-blockers and thyroid treatments in the past. - On Friday, a doctor proposed proceeding with cardioversion; however, the attending senior physician objected. - Today (Saturday), another clinician has expressed a desire to move forward with cardioversion, having initiated a new medication, as the senior physician is unavailable. - **Communication has been unclear**, as we were notified of developments by a nurse rather than the physician in charge, causing confusion and anxiety. - Currently, only a **chest X-ray** is scheduled, and the TEE remains unaddressed. **My inquiries are as follows:** 1. Is it common for medical professionals to have varying opinions and frequently revise medication or treatment plans like cardioversion? 2. Is it safe to conduct cardioversion in the absence of a TEE? I presumed that this was a standard procedure to exclude the presence of blood clots. 3. Is it usual practice to have only a chest X-ray prior to moving ahead with cardioversion? 4. How typical is it for patients or their families to not be directly informed about treatment changes and learn about them through nursing staff instead? I recognize that this cannot substitute for professional medical advice. I’m simply trying to discern whether these circumstances are typical or if we should express our concerns more assertively with the healthcare facility. Thank you for your insights!