I am an adult neurologist, and will attempt to answer your question. You are offline, so please review the following information and ask questions if you have them , or if you are asked to answer my questions, please do so and I will return to reply. If you feel you have recieved enough information and are satisfied, please hit the accept button as that is how I am compensated for my work. If you have additional questions, even after you have hit the accept, for example you now have lab results, please return and I will be glad to answer your questions. Please be aware that as a physician I cannot make a diagnosis without an examination, so this is for information purposes only and does not adhere to the role of a patient-physician relationship. Ok?
hi are you there?
please type something
I did not sure how this works
hi you can type in the lower window, this is a chat session
I was going to ask you questions first ok?
so you are a 35 year old, that has had repetitive right sided problems only, and because of this you had an MRI of the brain and C spine with contrast, both of which wasnormal, correct. you must have weakness, because they sent you to PT correct, so what is the diagnosis?
you might be having problems try to type the chat one line below the chat window top, and use the enter button instead of the yellow reply button,, ok?
The weakness is intermittent in my right foot. At times it seams like I am pushing my rt. foot into the ground for stability. In fact the bottom of my foot sometimes hurst from twisting it to suppost myself. On exam they have only found my lower leg weak at times. PT helped to correct some postural things but it seams wierd that it comes on suddenly and affects both my arm and leg. I have also had a lot of bloodwork with no answers.
The flip flop will fell heavy to me
there are unusual disease like myasthenia gravis or a variant called Lambert Eaton syndrome. these are neuromuscular disorders, havethey checked your ach-antibodies?
is this painless weakness?
That i am not sure about... I would prob say yes b/c they took 14 vails of blood. Checking genes mutations, lyme, clotting factors and more
well if you can get the studies, I might be able to tell you about it, did they do an EMG on your leg or arm?
no emg? do you have pain?
I also just did a visual provacation test, but not sure of those results yet.
I do not have pain.
this visual provocation test, this is a vestibular test correct?
No, it was a test to check the optic nerve. another test to r/o MS
that is called a visual evoked potential test or visual evoked response test (VEP or VER)
have you ever had a loss of vision or change in color vision?
No vision loss. I get a lot of floaters and the only vision prob. I have noticed is if I stare at a pattern or something like a blackboard for a while, when I look away I will continue to see teh image in a diff. color. Kind of like when you see sun spots after looking at the sun.
that is normal
never any imbalance (apart from the weakness) changes in language, transient numbness, problems with bowel or bladder?
would you consider an lumbar puncture?
No problems with bowel or bladder, language. I think I have had numbness on and off in different places throughout the years: face, leg,right great toe here or there. I do have vertigo and have had this for some time. They believe it is Cervico-genic. Not sure I want to go ahead with the lumbar puncture.
are you there?
Well you may need to if you want to have a diagnosis, maybe the VER's will be abnormal, but I will send you the McDonald criteria for MS, with normal imaging you have to have 2 or more documents episodes with improvement. here, I will send it to you, hang on
I have never gotten anything easy.. from the cervico-genic vertigo to dermatographism to this... no one can ever figure anything out!
please look at this, it outlines the criteria for MS, and i don't think you meet it at this time.
I would encourage you not to give up, but consider asking the neurologist to check for neuromuscular disorders like Myasthenia gravis, by checking your anti-ACH antibodies, and considering an EMG with repetitive stimulation to look at the neuromuscular junction
okay. Thanks... anything else? Some are now talking like its stress related although I can't imagine it only affects one side of my body? Seems wierd. I also don't consider my self to be stressed-infact I am now off work until August!
you can come back anytime with lab reports and I will discuss it with you. IF you feel I have answered your question, please hit the accept button as that is how I am compensated for my work.
I will switch this to the Q and A so you can print out a copy. ok?