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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Numbness, Tingling, Weakness, Stiffness In Lower Limbs. Lose Balance Frequently. Suspecting Multiple Sclerosis. Suggestions?

I have had numbness and tingling in my lower extremities off and on for years. This year it has worsened and I have weakness and stiffness in both legs, I lost my balance frequently, and my EMG showed positive Babinski and Hyper- Reflexes. The doctor who did the EMG stated he suspected a demyelinating disorder, but my neurologist is downplaying MS because I don t have vision problems and my MRI s of my back have only shown one small syrinx or possible lesion on the cervical spine . They ordered a brain MRI but they still are doubting I have MS. What else could it be?
Mon, 18 Feb 2013
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Neurologist,  's  Response
Hello,
Thanks for the query,

Let me tell you that multiple sclerosis is basically a diagnosis of exclusion. It is basically a clinical diagnosis, supported by other lab and MRI findings. So many conditions like Vitamin B 12 deficiency, vasculitis, other auto immune disorders, infections can mimic multiple sclerosis.

I have noted your clinical data. Based upon the data you have provided, you don't satisfy the criteria of diagnosis of multiple sclerosis. A possibility of spinal cord problem like demyelination (not multiple sclerosis), vasculitis, low grade lesions, infections etc is likely. MRI of the spine with contrast and that of brain will be helpful. Further Lumbar puncture and visual evoked potential will calcify the picture.

You can meet a local neurologist/multiple sclerosis specialist who will guide you through clinical and other investigations. They will discuss with you regarding other conditions that can mimic multiple sclerosis.

Hope this helps

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Numbness, Tingling, Weakness, Stiffness In Lower Limbs. Lose Balance Frequently. Suspecting Multiple Sclerosis. Suggestions?

Hello, Thanks for the query, Let me tell you that multiple sclerosis is basically a diagnosis of exclusion. It is basically a clinical diagnosis, supported by other lab and MRI findings. So many conditions like Vitamin B 12 deficiency, vasculitis, other auto immune disorders, infections can mimic multiple sclerosis. I have noted your clinical data. Based upon the data you have provided, you don t satisfy the criteria of diagnosis of multiple sclerosis. A possibility of spinal cord problem like demyelination (not multiple sclerosis), vasculitis, low grade lesions, infections etc is likely. MRI of the spine with contrast and that of brain will be helpful. Further Lumbar puncture and visual evoked potential will calcify the picture. You can meet a local neurologist/multiple sclerosis specialist who will guide you through clinical and other investigations. They will discuss with you regarding other conditions that can mimic multiple sclerosis. Hope this helps