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Remedy for urinary incontinence - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Women's Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1773 Questions
User :   Hi, I am 28 years old, female, with no children. I have been having a variety of symptoms for the past five months including bladder incontinence, muscle spasms/stiffness/pain/twitching, some left sided weakness, some patchy burning and tingling sensations in my legs, chewing and swallowing difficulties, nasal speech (sounds like I have a cold), and also several instances of the sensation that I have burned or scalded my tongue. I have been checked for Vitamin deficiencies and I don't have any. I am currently being checked for heavy metal poisoning. I have had two EMG's - the first one was done a month into symptoms and was normal. The second EMG was done 5 months into symptoms and showed "reinnervation (mild polyphasia only) in my left thigh and left deltoid. Paraspinal muscles were normal. What do you think, collectively these symptoms could indicate? BTW, I have not had an MRI yet due to the fact that I have a gastric pacemaker for gastroparesis, which will require surgery to explant the device to get the MRI.... Thank you for your time.
Doctor :   Hello
Doctor :   Give me a min please , let me read your query
User :   ok
Doctor :   So at present you are having all the above said symptoms ?
User :   Yes. It started in June with some mild twitching and mild left sided weakness. and incontinence.... I had a CT in June for the symptoms and it was normal. Symptoms have now progressed to not only twitching and weakness and incontinence, but now chewing/swallowing problems, nasally speech, and cramping and stiff muscle pain
Doctor :   And can you do tell me what all tests you have undergone besides the one you have mentioned ?
User :   I had a spinal tap which was normal. I also had cspine and brain CT with and without contrast, checked for lyme disease, checked for vit. deficiencies, EEG .... all these tests were done in Boston.
User :   CBC, CK
Doctor :   So the physicians have not been able to pinpoint the cause ?
User :   no. I am supposed to have an evoked potential test friday, but all the tests they've done, aside from the second emg, have been normal
User :   can EMG's miss certain disease processes if done too early in a disease process?
Doctor :   I see. well you do seem to have a very complex case which do require extensive testing. also i would like to recommend just one more test for you
Doctor :   I want if possible if you to get an antibody titer test
Doctor :   Antibody directed against the acetylcholine receptor
Doctor :   EMG is very accurate and the chances of missing are less. unless of course human error .
User :   I will mention that test to my doctor. ...... do you think these symptoms suggest possible MS?
User :   My doctor wants to do an MRI but wants to do all other tests first, because he doesn't want to put me through surgery to remove my pacer, understable.
Doctor :   It could be and a MRI will pick that up
Doctor :   I can understand this situation
User :   can an emg be mildly abnormal with MS even though MS is a central nervous system issue and not peripheral?
Doctor :   And its always better to rule out first all the causes before making you undergo surgery
Doctor :   No MRI is the only confirmatory diagnostic test for MS
Doctor :   EMG can show but its not seen as a confirmation
User :   do you know what could cause the nerve damage they saw on my second emg? i am assuming the "reinnervation" means that there has been damage
Doctor :   It means that restoration of nerve function after it has been lost.
Doctor :   The EMG (electromyogram) may show evidence of denervation with subsequent reinnervation
User :   if I had ALS, would EMG have picked it up? the test you mentioned, is that to test for MG?
Doctor :   Yes
Doctor :   and EMG will pick up ALS
Doctor :   but MRI is also must
User :   thank you for your time...... you have been helpful.
Doctor :   neurological diseases are complex and i am sorry but as a online consultant i can provide you with only limited knowledge
Doctor :   Your welcome
Doctor :   take cRE
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