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Question about neuro disease, please (Read 4485 times)
Allochka
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Question about neuro disease, please
Oct 09th, 2011, 8:57am
 
Dear RLR,
I'm new to this forum. I understand that it is heart-issues forum and not the right place to ask about neuro things, but I'm desperate and would be grateful for any reassurance.
I'm 32 old female, who had a major stress in May (miscarriage after years of infertility). After that severe hypochondria started (it was new to me, never had it before).I was scared of various cancers, HIV, etc. Could't eat or sleep properly for weeks, running to different doctors, stressing non-stop. All tests were fine.
Then I've accidentally read an article about MS, where symptoms were listed. Next day I developed listed symptoms - got weak legs from time to time and felt that my vision had worsened. Went to ER, saw neuro and ophtalmologist. The neuro did all basic tests - all OK, eye doctor checked eyes and optic nerves - also OK. Both said my symptoms are due to severe anxiety.
But I couldn't relax and went to get a private brain MRI. 4 small hyperintensities were discovered, which didn't collect the contrast. Optic nerves were fine. So I went to the neuro again.
He did more detailed physical tests and said I'm clinically fine. He also mentioned that my abdominal reflexes are very good, but they are usually the first ones to disappear if any neuro problems. As for my MRI - he checked it and told my that these hyperintensities do not resemble MS at all. He said I obviously have severe anxiety and prescribed antidepressants. Told me to come for follow up in 2 weeks to check if meds are working.
So after his reassurance all my symptoms disappeared at once. I started meds and felt great.
But when I came for follow up in 2 weeks, my neurologist suddenly started to hesitate about my MRI. He again discounted all hyperintensities as definitely not MS except one - a small round spot approx 3 mm big. He said this is suspicious and I have to be referred to MS centre. He mentioned once again that I am clinically fine, my symptoms were due to anxiety, the spot is small and old. But still he is not sure anymore and I have to be checked further on.
I was desperate and asked if I can get a second opinion right now. He then invited a very experienced radiologist to have a look at my MRI. Radiologist said that it doesn't look like MS, and that he would give less than 15 % probability that this one spot could be caused by MS.
This statement made my neuro to relax, and change his mind. He said that visit to MS centre is not necessary anymore, and that I should just repeat MRI in 6 months.
I asked him why he clearly stated that it is not MS on my first visit, and he said that he probably didn't look at MRI attentively enough (which is not true, because he checked all photos on CD very carefully).
So I'm desperate and can't understand whether MS could be real in my case?
The only symptoms I had - worsened vision (but NOT optical neuritis) and slight percieved weakness in legs (but I was able to run, exercise as usual). It all was discounted to stress and disappeared now. Clinical exam was great.
So the only unclear issue is this one small round spot on MRI...
Dear RLR, I would be so grateful if you could give my your impression on my situation - could this be MS?
I have a feeling that my neuro is just covering his positions, because at the beginning he was absolutely sure that this is not MS. Also when one more specialist spoke against MS he relaxed, so looks like he would like to avoid a responsibility of giving a definite answer...
Please advise if MS scenario seems realistic to you, based on all the above?
Thank you so much for assistance! I'm sorry for the long post and possible mistakes (English is not my native language)
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Allochka
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Re: Question about neuro disease, please
Reply #1 - Oct 9th, 2011, 10:59am
 
Sorry, it is me again..
I would like to add that I have a great respect and trust to all doctors. All doctors in my life were really good. The only reason why I'm not sure in this particular neurologist is that he had changed his mind twice without any objective reasons.
When he changed decision from sending my to MS Centre to simply doing follow up Mri I asked why he did it. He said it is the fault of the first radiologist who described my results - he did it "poorly and nothing could be understood from his interpretation" ...
So my neuro seems to rely fully on radiologists' opinions and would not commit himself to any clear answer...
That is why RLR's opinion would be so important to me.Could this be MS?
Thank you so much in advance!
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RLR
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Re: Question about neuro disease, please
Reply #2 - Oct 9th, 2011, 1:51pm
 
Okay,  although I obviously don't have the clinical advantage of evaluating your MRI study I see nothing of your description to suggest MS, but what it does strongly suggest is conversion disorder.

Conversion disorder is very common in cases where medical illness or incident, ie miscarriage is in the patient's recent history and where psychological trauma is experienced. The symptoms typically arise suddenly, disappear just as quickly and can in some cases be quite dramatic in presentation. Some patients can even experience blindness or paralysis.

Based upon the information you've provided about the MRI and your physician's opinion, there would be no evidence to support a consideration of MS. Small hyperintensities are actually quite common and are very often not the basis for any clinical concern.

My suggestion would be to obtain a referral from your doctor to be evaluated by a professional licensed and well-experienced in dealing with anxiety and traumatic stress. While miscarriage itself has a significant impact upon any pregnant female, this sort of outcome can produce an even greater impact in persons who were previously infertile and had availed themselves of intervention to try and correct the problem. Wanting and bearing children is largely an instinctual drive and can produce a remarkable impact on women who experience difficulty in doing so. You should also be aware that initial miscarriage is not uncommon and should not deter you from subsequent attempts that are usually successful.  

Again, your symptoms would be inconsistent with MS and more inclined to be caused by conversion disorder as a result of the circumstances described.

Best regards and Good Health
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Best Regards and Good Health
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Allochka
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Re: Question about neuro disease, please
Reply #3 - Oct 9th, 2011, 11:24pm
 
Dear RLR,
thank you so much for your quick and detailed reply!
You've put my mind at ease finally and helped me enormously.
I also don't think that I have MS...
I didn't mention it, but I already started a therapy, exactly as you suggested. My therapist also doesn't believe in MS, and says my problem is trauma after the loss.
Finally I can put this MS fear to rest and concentrate on treating my real problem - this mental disorder I clearly have now.
Thank you VERY much once again. You are doing extremely important and noble thing on this forum!
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