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Dr. Andrew Rynne

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Had PMR. Feeling fatigue, shortness of breath and difficulty to talk. Could it be multiple sclerosis?

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Dr. Nsah Bernard

General & Family Physician

Practicing since :2012

Answered : 1704 Questions

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Posted on Thu, 7 Feb 2013 in Multiple Sclerosis
Question: I was diagnosed with PMR over 8 years ago. No longer on pred. Am having extreme fatigue and pain and some difficulty finding words when talking. Also, shortness of breath. Already been tested for COPD and not that. I am worried about MS.
Blood panels just done showed low hemoglobin and extremely low Vitamin D levels.
doctor
Answered by Dr. Nsah Bernard 3 hours later
Hi XXXXXXX,

Thank you for writing to us.
Simply speaking, your symptoms are not very specific for MS and can be caused by other diseases as well. The lab reports are also not consistent with MS although the low haemoglobin and vitamin D levels make me worry about your nutritional status. The only definitive way of knowing about MS is to do a MRI which can tell us if anything is wrong. Also, a spinal tap may be needed.
Your shortness of breath can be related to the underlying diseases condition or a sign of cardiac insufficiency.
As far as MS is concerned, I would like to share some more information. Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord (central nervous system). MS affects women more than men. The disorder is most commonly diagnosed between ages 20 and 40, but can be seen at any age. You are slightly more likely to get this condition if you have a family history of MS or live in an part of the world where MS is more common.
Symptoms vary, because the location and severity of each attack can be different. Episodes can last for days, weeks, or months. These episodes alternate with periods of reduced or no symptoms (remissions).

Fever, hot baths, sun exposure, and stress can trigger or worsen attacks.

Because nerves in any part of the brain or spinal cord may be damaged, patients with multiple sclerosis can have symptoms in many parts of the body.
- Muscle symptoms
- Bowel and bladder symptoms
- eye symptoms
- Numbness, tingling or pain
- other brain and nerve symptoms such as decreased attention, hearing loss, depression, dizziness, difficulty reasoning and solving problems etc
- sexual symptoms
- fatigue is most common and worsens as diseases progresses
So you will need to pay a visit to a neurologist for proper evaluation (neuro-physical, laboratory test, MRI etc).

Hope this helps and write back if you got any questions

Dr Nsah
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Nsah Bernard 21 hours later
Symptoms:
1. IBS diagnosed in late eighties or early nineties.
     a. chronic diarrhea 5 plus times a day.
     b. lots of undigested food pieces.
     c. occasional greasy sheen after eating something with a lot of fat content.
2. Shingles (left arm)
3. Polymyalgia Rheumatica diagnosed around 2003.
     a. chronic pain in neck, shoulders, hips, legs and upper arms. Back. Stiffness.
     b. Responded immediately to Prednisone.
4. Numbness and tingling in hands.
5. Sense of weakness and fatigue in arms and legs.
6. Shortness of breath.
7. Overheating and profuse sweating. (especially in hot weather even when inside)
8. Low Vitamin D.
9. Some slight gait problems at times. Vertigo at times. (feel like I’m walking on a boat dock)
10. Low hemoglobin
11. A problem with finding words when talking. (recent)
12. Glasses prescribed recently for eyes.
13. Blood sugar drops for years. Diagnosed with hypoglycemia years ago.
doctor
Answered by Dr. Nsah Bernard 1 hour later
Hi,

Thanks for updating.

After going through your list of symptoms and making a careful synthesis, I will like to know if the symptoms and tests are present/of the recent past (i.e if you are actually still suffering from those). If that is the case then, we would be looking at
- Multiple sclerosis
- Encephalomyelitis
- SLE
- Sacordoisis
- Lyme diseases
- Or other possible differentials of MS.

Your neurologist/internist will have to investigate each one of them until he/she can get a conclusion of your diseases before placing you on treatment. Do not forget that one or more of those symptoms could be unrelated to MS and may need to be treated as an associated diseases.

Therefore I would urge you to consult and discuss with a neurologist. He/she can prescribe battery of test that include MRI scans to narrow down the possibilities.

Hope this helps and wish you a better health...

Dr Nsah


Above answer was peer-reviewed by : Dr. Prasad
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