Should I be asking for a MRI of the Brain?

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Macs Mum
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Date Joined Jun 2009
Total Posts : 46
   Posted 6/2/2009 5:54 PM (GMT -6)   
Hi All

This is my first time posting here, I found the forum thru Google. What a wealth of information in here!

A little about me: I suffered an unstable fracture to my T12 vertebra, without spinal cord damage back in 1995. This injury was corrected by inserting screws and rods into my spine and having a spinal fusion from my T11 - L1.

Over the years I have had bouts of neurological symptoms such as numbness, tinglings, brisk reflexes, loss of balance. I've had abnormal SSEP and nerve conduction tests, but the results were dismissed due to my back injury.

On March 27th this year, I had the screws and rods removed due to back pain from them becoming lose. Initially after the surgery I was fine. Four weeks post op my sensory disturbances/neuropathic symptoms have returned and have continued to get worse. My neurosurgeon ordered an MRI of the thoracic spine region, which I had last week, but it has come back clear. However, I'm still having sensory disturbances/neuropathic symptoms such as:

*Numbness & tingling that would happen occasionally in my feet. It has since returned and spread to my torso.
*When I tilt my head forward, I get an electric shock feeling in my feet and legs (New symptom in past four weeks)
*A tight band of pressure around my chest, just under my breasts. It feels like my bra is too tight, and it feels like I am still wearing one, even after I take it off.(New symptom in past four weeks)
* Sometimes there is a tinge of yellow to my vision (Off and on over past few years)

I'm beginning to wonder if my symptoms are not related to my spine, but are in fact symptoms of MS? Do you think I should ask my neurosurgeon (I am seeing him again tomorrow) to order a MRI of the brain to look for lesions? How soon would lesions appear if it were MS?

Thanks in advance for your input on this

Regards
MM tongue

Gretchen1
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Date Joined Jan 2007
Total Posts : 3518
   Posted 6/2/2009 6:32 PM (GMT -6)   
YES!  You need an MRI of your brain.  Your symptoms are very MSish.  The head forward electric shock is called L'hermittes sign.  It can be caused by spinal dammage.  You have enough symptoms to warrant a brain MRI.  The compression feeling you have around your chest is typically called the MS hug.  Below is a link to more info on L'Hermmites sign. 
 
 
Obviously I can't diagnose you but you have some concerning symptoms.  I know all diagnostics will be complicated by your spinal injury. 
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/2/2009 7:04 PM (GMT -6)   
Hi Gretchen

Thank you very much for your prompt response. I didn't think that the neck thing would be related to my T12 because that area is around the belly button, and I have never had any neck problems except for this new symptom. Thanks for explaining them to me.

I'll tell my neurosurgeon tomorrow.

Would a LP diagnose it any quicker or be any more accurate ?

Thanks
MM
If you're not leading the pack, the view never changes.


Gretchen1
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Date Joined Jan 2007
Total Posts : 3518
   Posted 6/2/2009 7:42 PM (GMT -6)   
A lumbar puncture should be used as a follow up if there is a lesion or more found.  Lumbar punctures are invasive and uncomfortable.  I would avoid that one until you have to wink
 
My L'Hermmites sign was caused by a couple of spinal lesions so it can be caused by spinal junk.  It could be that you have inlfammed something in your back?  Again, I am not a doctor so I can't say for sure.  You definitely have enough going on to cause concern in an MS direction.  By the way, the location of my largest lesion is T10, so not that far from your back problem.  Let's hope that all you have is some inflammation from your back problem. 
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/2/2009 9:04 PM (GMT -6)   
Hi Gretchen

I forgot to ask, do the 'MS Hug' and 'L'Hermmites sign' stay around for good or are they intermittent?

Thanks
MM
If you're not leading the pack, the view never changes.


Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3518
   Posted 6/3/2009 7:36 AM (GMT -6)   
They MS hug can be somewhat intermittent as it is a spastic muscle contraction.  I had L'Hermmittes for about 6 months.  Some have it for several months and for some it is permanent. 
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/3/2009 6:58 PM (GMT -6)   
Thanks again Gretchen.

I am seeing my neurosurgeon @ 4:30pm today - Australian time - and I have made list of my new symptoms in order of their appearance.

I'll be sure to come back and let you know how I made out.
If you're not leading the pack, the view never changes.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/4/2009 3:11 PM (GMT -6)   
Hi Gretchen

Well my neurosurgeon looked at my MRI of the thoracic region and it was clear. My spinal cord is intact at the initial break site, and has healed well.

He said that L'Hermmittes is a classic sign of MS. It could also be caused my cervical stenosis, which he says I am too young for. He has ordered an MRI of the Brain and Cervical region of the neck. I booked my MRI last night, and I cant get in until July 15th! I am going to ring back today to see if I cant get in sooner.

In the meantime, he wants me to change to a different type of anti-convulsant medication for nerve pain. The medication I am currently on is not helping at all.

Thanks again for your advice on this, I will keep you posted.

MM
If you're not leading the pack, the view never changes.


Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3518
   Posted 6/4/2009 5:21 PM (GMT -6)   
MM,
Thanks for the update.  Keep us posted. 
 
I have not found anything that helps with nerve pain.  I hope you do.
 
If you have a flexible schedule, you might want to ask to be put on the MRI cancellation list.  That might get you in earlier. 
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/4/2009 6:05 PM (GMT -6)   
Hi Gretchen

I was taking Epilim for the neuropathic pain which isn't helping at all, and because he doesn't want to prescribe steroids without an MRI confirmation of MS (and rightly so) he wants me to try either Lyrica (Pregabalin) or Neurontin

I got my brain MRI brought forward to June 29th and the cervical spine to July 9th. I'm going to take your advice and see if they have a waiting list.
If you're not leading the pack, the view never changes.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/4/2009 6:11 PM (GMT -6)   
I just found this on Wikipedia regarding the Neurotin:

Gabapentin is frequently used to treat various types of Neuralgia. It has been found to be effective in prevention of frequent migraine headaches,[6] neuropathic pain[7] and nystagmus,[8] and is prescribed off-label (that is, without formal regulatory agreement) for these conditions. Gabapentin is widely believed to help patients with post-operative chronic pain (usually caused by nerves that have been severed accidentally in an operation and when grown back, have reconnected incorrectly) and nerve pain associated with spinal cord injury. It may be effective in reducing pain and spasticity in multiple sclerosis.[9], and has also had success in treating certain instances of Complex Regional Pain Syndrome.[10][11]
If you're not leading the pack, the view never changes.


nursekatb
Regular Member


Date Joined Apr 2008
Total Posts : 43
   Posted 6/5/2009 9:41 PM (GMT -6)   
Hi Macs Mum,

Just wanted to let you know that I take Neurontin for nerve pain and I have pretty good success with it. I take it only at night usually. I can take it twice a day if I have an attack with alot of pain. It's worth a try if your other medicine isn't working for you. I have also experienced what I think is the MS hug a couple of times. This last week in fact, after being sick and having an increase in my symptoms, I noticed a tightness in my upper chest. I also had tightness on one side of my neck and upper back. At first I was wondering if my infection had spread to my lungs, but it lasted for about 4 days and then just left, so I think it must have been the 'hug'. I am sorry you have to wait awhile for your MRI's...I know the waiting can be nerve-wracking. Hang in there!
Diagnosed with MS March 2008
Avonex         


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/6/2009 6:10 AM (GMT -6)   

Hi Nurse K!

Thanks for sharing your experience with Neurotin.  I was initally put on tegretol, but if left me feeling like a zombie, unable to look after my two year old, so my GP swapped me to Epilim.  My neurosurgeon has put it in writting to my GP that he wants my meds swapped ASAP, I just need to see if I have to have a 'dry out' period between meds.

My possible 'MS Hug' has lasted two weeks, which is making me think that maybe it's anxiety instead.  When I saw the neurosurgeon last Thursday, he said my T10 vertabra was clear, there was nothing to indicate to him what could be causing the sensation. I explained to him, that this symptom occured after the MRI, which was taken on May 27th.

Which leads me to a question: If this symptom happened after the MRI, would there be a lesion at the T10 level now?  If my MRI on June 29th shows a lesion(s) just on the cervical spine, but none on the brain is it still considered MS? And sorry, one more question, if there are lesions on my brain will the neurosurgeon be able to say 'ok, this lesion is affecting this part of your body, and this one this part'?

Thanks in advance for your input on this.

Hope you are enjoying your weekend

MM


If you're not leading the pack, the view never changes.

Post Edited (Macs Mum) : 6/6/2009 6:31:10 AM (GMT-6)


Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3518
   Posted 6/6/2009 8:33 AM (GMT -6)   
You are asking good questions.  One lesion anywhere usually won't get you an MS diagnosis.  Most of the time the doctor wants to see two or more.  Multiple sclerosis indicates more than one "attack, episode or scar" seperated by both time and space (in the CNS).  You may get a diagnosis of CIS; clinically isolated syndrome.  This is considered a possible precursor to MS. 
 
MS is a very difficult disease to diagnose.  There are doctors that believe the damage and hence the symptoms of MS can show up before lesions are large enough to be seen on an MRI.  There are also different types of MRIs, some being slightly more sensitive than others.  The other problem is that lesions can be caused by other diseases, disorders and aging in general.  So sometimes a person can have multiple lesion and NOT have MS.  Are you confused yet? 
 
For the most part, lesion placement does coorespond to symptoms but not always.  There are general symptoms that seem to show up in most MSers like heat intolerance.  I have a couple of small lesions that are seemingly without symptoms.  It is also understood that there are tiny bits of demyelination going on through out the brain.  This causes not lesion but instead an overall atrophy of the brain.......god that scares me!!!!  Your brain literally shrinks in size.  This is why once you have a firm diagnosis of MS, you will have MRIs for the rest of your life.  Doctors want to measure and check for both atrophy and lesions in order to anticpipate possible disability.  This way they can evaluate the effectiveness of your teatment and recommend therapy and symptom management. 
 
I hope this wasn't too long.  I hope it helps.
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


nursejenn1012
Regular Member


Date Joined May 2009
Total Posts : 104
   Posted 6/6/2009 6:42 PM (GMT -6)   
as a nurse, what i see daily, you MUST be your own advacate!! If you think something is wrong, there is something wrong. I tell all my patients, if they are uncomfortable with the diagnosis they got, or lack of, get a second opinion. If you feel there is a clinical reason you should have a test, such as an mri--do some research--ie the symptoms you are having, tell the dr why you want the test, any good dr will respect your wishes and order your test. Dr's who dont, obviously are not listening to you, find a new one!! You know yourself better then anyone!
God will Give me nothing i cannot handle--i just wish he didn't trust me so much


nursekatb
Regular Member


Date Joined Apr 2008
Total Posts : 43
   Posted 6/6/2009 9:27 PM (GMT -6)   
Sorry, just saw your post. Looks like Gretchen answered all your questions though. For some, it can be a difficult process being diagnosed with MS. It took almost a couple of years from my first attack to be diagnosed. Hang in there...time will tell! One of the most helpful suggestions I got early on was to keep a journal of my symptoms. If you are like me, you always think you will remember that symptom and how bad it was or how long it lasted and so on, but with the passage of time and memory problems I forget the specifics. Good to have it on hand to refresh your memory when you see the dr. Hope this helps! Kathy
Diagnosed with MS March 2008
Avonex         


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/7/2009 4:36 PM (GMT -6)   
Good Morning Ladies

NURSE K: A journal is a great idea. I have jotted down my recent symptoms, but prior to this everything was dismissed due to my 'back injury'

I've gone over some reports that. and I had a few more questions, I hope you gals don't mind.

In 2006 I complained of numbness, tingling, & burning of the pinky and ring fingers on both hands. The outside of my wrist and arm felt numb, and was sometimes itchy. Sometimes, the pain went upto my arm pit. My GP sent me for a never conduction test, to check my for carpal tunnel syndrome - the test came back negative, I just assumed I was spending too much time at the computer studying & writing assignments. When I was having the test, I mentioned to the Dr performing it, that I was actually have the same feeling in my feet. He did a quick test on both toes and after reporting I was negative for carpel tunnel he noted that 'The patient seemed to have an extensor plantor respone on the right and neurosurgical or neurological investigation of the cervival cord/canal may be warranted' For the record,no action was taken on this observation. I mentioned it to my neurosurgeon on my last visit and he said it meant I had a positive babinski reflex. The hand symptoms are back now and my computer use is less that in it was in 2006, it what I am describing a symptom of MS?

In May 2008 my neurosurgeon sent me to a neurologist for 'Motor & Sensory Nerve Conduction Tests', these came back negative, showing now sign of peripheral neuropathy. The neurologist said 'The clinical finding suggest sensory disturbance. This could be evaluated further with a sensory evoked potential study if that would be helpful' Again, no action was taken. As mentioned in my first post, still having problems with the sensations in my feet and legs.

Anyone care to comment on this LOL
MM
If you're not leading the pack, the view never changes.


Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3518
   Posted 6/7/2009 6:41 PM (GMT -6)   
A postive babinski response can be a sign of brain disease or damage to the spinal cord.  It could very well be from your spinal cord injury and yet it is commonly seen in MS as well as some other diseases and injuries.  It can be both permanent and temporary.  It is something that should probably be looked at again. 
 
Have you ever had evoked potentials?  That is a good test to have.  It can tell you quite a lot, especially vision and hearing as that would NOT be related to your spinal cord injury. 
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/7/2009 7:23 PM (GMT -6)   

Hi Gretchen

Sorry about the typos in my last post, I was typing with Mackenzie on my lap, she's facinsated with the computer. Glad you could understand what I was saying tongue

I remember about 10 years ago, I had really bad gait.  I would stumble into the corners of walls, the floor felt uneven, I couldnt walk with one foot in front of the other (like being on a balance beam) and I was getting bad dizzy spells.  I remember going for a test where I was on my stomach and they put needles on the backs of my legs and up my spine, and I wore something around my head to measure the responses.  I remember another test where I had to look at a flashing screen.  I know after these tests I was given an MRI of the brain but it was clear.  I tried last week to track down the tests results, but being so long ago, I was unsuccessful.  I've had a positive babinski for a while now, I even remember a psyhio commenting on it last year.  Remember, I have no spinal cord injury, well at least not from the T1-l5 vertabra, as MRI taken on May 27th was clear.

When I see my GP on Wednesday I am going to ask him for a referal to the MS Clinic at the local hospital. There, I can get all the tests done for free, rather than having to go to a private neurologist and pay for them.

Could what I described about my hands be a symptom, or perhaps I've just over used them.

Thanks

MM

 

 

 



If you're not leading the pack, the view never changes.

Post Edited (Macs Mum) : 6/7/2009 7:27:25 PM (GMT-6)


Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3518
   Posted 6/7/2009 9:07 PM (GMT -6)   
Well I am not a doctor of course.  I am sure it could be a symptom of MS, but the fact that you have it in both hands and exactly the same two fingers.  MS tends to be asymetrical but not always.  Both of my feet are numb but one is from the mid thigh down and the other is from the mid shin down.  I am also numb on the thumb of my left hand.  My numbness is sensory and not functional.  I have a tiny bit of functional numbness in my left knee. 
 
Asking for the referral to an MS Clinic or a specialist is a great idea.  That is great that you have an MS Clinic right there. 
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/8/2009 6:46 PM (GMT -6)   
Hi Gretchen

Thanks for the asymmetrical explanation. I have a numb 'band' so to speak, it feels as though it goes right around my right leg, just below the knee, whereas my left foot just feels tingly and burning. Nothing to do now but wait. I don't want to be one of those people who sifts through the threads reading stuff, and makes myself worry more, if you know what I mean? If I get a positive diagnosis, then I'd like to read the threads so I can be better informed. I'll be sure to check in once I start getting some results in, and if any strange symptoms appear.

Just want to thank you ladies again for your input.

Speak Soon
MM
If you're not leading the pack, the view never changes.


Macs Mum
Regular Member


Date Joined Jun 2009
Total Posts : 46
   Posted 6/9/2009 9:22 PM (GMT -6)   
Hi Again

Just a note to let you know that I saw my GP today and he's faxed a referral off to the MS clinic at the hospital. He's also ordered a truck load of blood tests. Not too sure if anyone will understand this (I don't) but he's ordered:

EUCR LFTS CK; FBC; esr tsh ana fbgl rh factor S e B12 All the tests are being done after a fast, so no snack for me tonight.

I only understand RH Factor and I know that I am RH -ative... I was tested during my pregnancy.

Hope everyone is well.
MM
If you're not leading the pack, the view never changes.

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