OpenHealth Q&A

Exploring Alternatives to MS: What Other Conditions Could Be at Play?

Profile: Female, 42 years old, 5'8", 150 lbs. Medical History: Diagnosed with epilepsy (well-managed), Tourette syndrome, ADHD, anxiety, significantly damaged lumbar discs, and platelet disaggregation possibly related to my medications (balancing benefits with risks). Current Medications: - Daily: Lamotrigine, Sertraline, multivitamin, vitamin B12. - As needed: Meclizine, Ondansetron, Dramamine (frequently), Tranexamic acid. Approximately a year and a half ago, I began to notice a range of unusual symptoms: - Double vision (which is corrected with prisms in my glasses). - Persistent vertigo (ENT evaluation ruled it out as a cause). - Gait abnormalities, specifically a limp on my right side. - Significant nausea and vomiting; I lost nearly 40 pounds last summer and still face challenges with eating. My appetite often disappears, and I transition quickly from feeling fine to experiencing intense nausea and vomiting. - Occasional tremors that vary in intensity, sometimes becoming so severe that I struggle to hold a drink. My menstrual cycle has become erratic; I suspect I might be experiencing perimenopause, although I’m frequently told I’m too young for it. Additionally, I experience sensations like bugs crawling or a wet feeling on my legs and occasionally my arms. A recent MRI indicated a bulging L4/5 disc, and levels L3/4 and L5/1 appear concerning as well. I've noticed changes in my speech; sometimes my sentences become jumbled, and I encounter significant memory lapses. Recently, I was unable to recall the job I had for a decade, despite leaving just last year. The words simply eluded me. I may have omitted some symptoms, and I'll add those if they come to mind. Consultations: - An ENT specialist has ruled out possible causes for my symptoms. - A visit to a neurologist raised the suspicion of MS, particularly since I have a family history of it. However, the MRIs showed no lesions, indicating no sign of MS, which is a relief but leaves me questioning: what else could it be? Neurodiagnostic Tests: - Comprehensive MRI scans, including one with contrast for both the brain and spine. I have a longstanding background with anxiety and mental health issues, so I’m aware that Functional Neurological Disorder (FND) might be a possibility. It's astonishing to think that it could result in such a wide array of symptoms within a relatively short period (though they did not all manifest simultaneously). I've enrolled in EMDR therapy, have an EEG scheduled in a few weeks, and my follow-up with the neurologist is set for September. I had been undergoing physical therapy to improve my gait, but it didn’t provide the relief I needed, particularly while I was also trying to recover from tennis elbow, which worsened during sessions (the therapist was not effective). I consistently take Dramamine due to lingering vertigo, although I’m grateful it hasn't incapacitated me in months. My intention is to consult with my gynecologist soon. Thank you for taking the time to read this. I could really use some insights to navigate this challenging situation—I’m not ready to slow down just yet!

Answers (1)

8/16/2025, 12:21:49 AM

OpenHealth AI

It sounds like you’re going through a complex and challenging set of symptoms that are affecting your daily life. While Multiple Sclerosis (MS) has been raised as a concern, it’s important to consider other possibilities given your extensive medical history and current symptoms. Here’s a clear approach to help you navigate your situation:

Main Points:

1. Complex Symptomatology: Your symptoms could relate to various conditions, including neurological issues, side effects from medications, or anxiety-related disorders.
2. Ongoing Monitoring: Continue monitoring your symptoms and their impact on your daily life, as more information can aid healthcare providers in finding effective solutions.
3. Collaborative Care: Engage with your healthcare team holistically, which includes your gynecologist, neurologist, and mental health professionals.

Explanation:

You have a history that includes neurological conditions, and your recent symptoms—like double vision, vertigo, gait abnormalities, memory lapses, and changes in your menstrual cycle—may be interconnected. While MS has been considered, the absence of lesions on your MRIs reduces the likelihood of this diagnosis.

However, other conditions like Functional Neurological Disorder (FND), anxiety syndromes, vestibular disorders, or even complications from existing conditions (like your lumbar disc issues) could contribute to these symptoms. Medications may also cause side effects that can complicate your symptom picture, particularly with the use of anti-anxiety medications or other drugs.

Next Steps:

1. Symptom Journal: Keep a detailed log of your symptoms, including their onset, duration, and intensity. Note any changes related to your menstrual cycle or medication adjustments. This will be invaluable for your follow-up appointments.
2. Continued Specialist Consultations: Follow through with your upcoming appointments, including with the neurologist and EEG. Ask specifically about FND, vestibular disorders, and the implications of your lumbar disc bulging on your symptoms.
3. Gynecological Evaluation: It’s wise to discuss the possibility of perimenopause with your gynecologist, especially if you're experiencing menstrual irregularities. Hormonal changes can affect mood, cognition, and physical symptoms.
4. Therapeutic Approaches: Continue with EMDR therapy, as it can be effective in managing anxiety-related symptoms. Consult with your therapist about how these techniques can be integrated with your physical rehabilitation efforts.
5. Lifestyle Adjustments: Since you’re dealing with significant nausea and appetite issues, consider small, frequent meals that are bland and easy to digest. Staying hydrated is crucial; ginger tea may also help with nausea.

Closing Thoughts:

Your journey is undoubtedly challenging, but maintaining a proactive approach with thorough monitoring and a collaborative care team will give you the best chance at finding relief and understanding your symptoms. You're navigating a complex landscape, and seeking clarity is an important step. Please keep me updated on your progress or if you have more symptoms to discuss.