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Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 6401
Experience:  Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
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I'm a teacher. Fairly new with epilepsy diagnosis and am

Customer Question

Hi. I'm a teacher. Fairly new with epilepsy diagnosis and am well controlled on meds. But, major concern is bilateral weakness in upper arms. Been months. Not long after seizures. Got a call that CK enzyme ?? levels were around 570. Significantly elevated. Possible muscle wasting (disease). Brand new neuro. Biopsy next. Kinda worried. Could this be indicative of MS? Or worse?
JA: What seems to make the symptoms worse or better? In general, how would you describe your health lately?
Customer: Reaching into dryer, shampooing hair, zipping a dress, walking dogs on their leashes...all things I never gave a second thought, seem to really hurt or at least cause an ache to BOTH arms, same way...same type of ache. I told my husband earlier this summer..."if I didn't know better, I'd swear I was losing strength in my arms......"
JA: Anything else in your medical history you think the doctor should know?
Customer: I'm 53
Submitted: 9 months ago.
Category: Neurology
Expert:  Dr. Muneeb Ali replied 9 months ago.


Im sorry to hear about your symptoms. Can i ask do you have any weakness in the lower limbs? Also do you have any vision issues? Difficulty in swallowing or change in voice? Also have you had an EMG done as of yet?

Customer: replied 9 months ago.
No to everything. No EMG. Well, my voice seems to be more "raw." I have noticed that. I noticed that this summer. Like I have been shouting at a football game. Slightly hoarse. But, nothing else.
Customer: replied 9 months ago.
Just FYI. When they did the initial MRI, on the seizures, it was noted I had "multiple areas of gliosis."Periventricular white matter. But, once I started meds (I had two grand mals.....three months apart), I've had no more....
Expert:  Dr. Muneeb Ali replied 9 months ago.

Well from what you are describing it does sound like that you have developed a neurological disorder which is causing muscle wasting as well as loss of power in the upper limbs. The seizures could be related to this problem however they can exist as another pathology. Now i think this is less likely to be MS as MS does not cause wasting in most cases. The raised CPK and loss of power can indicate that you have a condition like myopathy or even myositis. This would be diagnosed on the basis of a simple EMG which would be easily able to determine if the muscles are involved. This would also be diagnosed on the basis of a simple muscle biopsy.

Now it is possible that you could have an autoimmune disorder which isa ffecting the brain as well as muscles. This would need additional testing with the help of ANA, ESR and a complete ENA panel.

Now the gliosis can be due to small blood clots which cause the lesions on the MRI or it can also be due to autoimmune diseases as well like vasculitis. This can cause small infarcts in the brain which can appear in this manner.

So i would suggest that you have your doctor look into the above possibilities.

Do you have any more questions?

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Expert:  Dr. Muneeb Ali replied 9 months ago.

Would you like to know anything else? If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.