Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Sarcoidosis, Extreme Fatigue, Memory Loss And Pain
Question: Hello
I am in need of a extremely experienced Neurologist.
If you are NOT conversant in the following please refer me to another neurologist.
Again if you are NOT a very experienced Neurologist please refer this out.
I am a 50 year old white male with Sarcoidosis (biopsy lymph gland in chest -medianoscopy- in 1997. While I tested positive I have NEVER presented as a standard sarcoidosis case. NO cough no real lung issues - However had extreme fatigue memory loss pain etc.....
Ok so for the past 15 years I have been stable with a very regimented diet etc.
Weak but stable - could basically do basic stuff - drive etc. and get through my day
walking short distance etc.. The one thing is that have been slowly loosing my voice and speaking duration each year. But nothing like what has happened recently.
About a year ago I started experiencing slight numbness on left side and also numbness in upper teeth and dizziness and random extreme light sensitivity,and extreme exhaustion. Extreme.
I recently moved to a new city where the temp has been 95-100 degrees and all the symptoms have multiplied to the point where I could barely walk or see clear after a few hours after waking up.
I had a MRI of the head before I moved about 30 days ago due to the symptoms described above and it was perfect as were all my labs - ALL including vitamin B D etc and also my ACE level was normal as well as thyroid and blood sugar etc etc etc Basically every major test was run. I also have low testosterone and do a small daily dose of Androgel.
I went in to see a general doc 3 days ago and he was really sharp and honest and said he had never seen a single case of Sarcoid but from his knowledge he thought this could all be related.
I will get to the point.
My concern is that while my MRI was good I am presenting like a text book case of MS
I say this as MS is coming up every time I research my current symptoms and add hot weather to my search terms
I am now on 20mg of Prednisone which is why I am able to even type this.
After the first dose I was almost back to normal.
This is quite amazing. My only symptom now is that I only have a slight numbness to my upper teeth. Today I was able to walk and get dinner and not feel like I was going to faint or fall down from dizziness.
Finally before I went to the doctor 3 days ago the weather actually went back to normal from 95 F to down to 75 F and immediately I felt significantly better but not like I do now from the Prednisone. I dare say I feel good.
As of this writing it is now raining outside and that combined with the Prednisone has made me almost back to where I was about a year ago before all the symptoms started
To summarize:
Extreme exhaustion
extreme light sensitivity - when I go into a store from the outside it is unbearable.
blurred vision
Non fuctional in the high humidity and heat
numbness in upper teeth
slurring words
left hand weak
Ok this is it for now.
I hope this is enough info for you do render you initial thoughts.
My last spinal tap was 15 years ago and was negative.
Looking forward to your thoughts
Thank you
I am in need of a extremely experienced Neurologist.
If you are NOT conversant in the following please refer me to another neurologist.
Again if you are NOT a very experienced Neurologist please refer this out.
I am a 50 year old white male with Sarcoidosis (biopsy lymph gland in chest -medianoscopy- in 1997. While I tested positive I have NEVER presented as a standard sarcoidosis case. NO cough no real lung issues - However had extreme fatigue memory loss pain etc.....
Ok so for the past 15 years I have been stable with a very regimented diet etc.
Weak but stable - could basically do basic stuff - drive etc. and get through my day
walking short distance etc.. The one thing is that have been slowly loosing my voice and speaking duration each year. But nothing like what has happened recently.
About a year ago I started experiencing slight numbness on left side and also numbness in upper teeth and dizziness and random extreme light sensitivity,and extreme exhaustion. Extreme.
I recently moved to a new city where the temp has been 95-100 degrees and all the symptoms have multiplied to the point where I could barely walk or see clear after a few hours after waking up.
I had a MRI of the head before I moved about 30 days ago due to the symptoms described above and it was perfect as were all my labs - ALL including vitamin B D etc and also my ACE level was normal as well as thyroid and blood sugar etc etc etc Basically every major test was run. I also have low testosterone and do a small daily dose of Androgel.
I went in to see a general doc 3 days ago and he was really sharp and honest and said he had never seen a single case of Sarcoid but from his knowledge he thought this could all be related.
I will get to the point.
My concern is that while my MRI was good I am presenting like a text book case of MS
I say this as MS is coming up every time I research my current symptoms and add hot weather to my search terms
I am now on 20mg of Prednisone which is why I am able to even type this.
After the first dose I was almost back to normal.
This is quite amazing. My only symptom now is that I only have a slight numbness to my upper teeth. Today I was able to walk and get dinner and not feel like I was going to faint or fall down from dizziness.
Finally before I went to the doctor 3 days ago the weather actually went back to normal from 95 F to down to 75 F and immediately I felt significantly better but not like I do now from the Prednisone. I dare say I feel good.
As of this writing it is now raining outside and that combined with the Prednisone has made me almost back to where I was about a year ago before all the symptoms started
To summarize:
Extreme exhaustion
extreme light sensitivity - when I go into a store from the outside it is unbearable.
blurred vision
Non fuctional in the high humidity and heat
numbness in upper teeth
slurring words
left hand weak
Ok this is it for now.
I hope this is enough info for you do render you initial thoughts.
My last spinal tap was 15 years ago and was negative.
Looking forward to your thoughts
Thank you
Brief Answer:
New spinal tap and spinal cord MRI needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
Since recent MRI was normal and since the symptoms you are experiencing are mostly neurological, it is not neurologic involvement by sarcoidosis (neurosarcoidosis) that is causing your symptoms.
In addition, when it comes to cranial nerves, sarcoidosis affects facial nerve resulting in facial palsy, not the trigeminal nerve.
Sarcoidosis usually goes away on its own, in cases it spreads, results in easily notable ( by tests too ) damages of lungs, liver and nervous systems.
MS could be a possibility ( supported by your symptoms and by sudden improvement to prednisone), but absence of white matter changes in your MRI questions this possibility too. Regarding to our recent conversation, ALS should be considered as a possibility.
So, here is my opinion: another spinal tap and cerebrospinal fluid examination about antibodies associated with MS, viral infections is needed.
MRI of the cervical and thoracic spinal cord is needed as well, because MS affects white matter of spinal cord too.
Hope this helps. Take care.
New spinal tap and spinal cord MRI needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
Since recent MRI was normal and since the symptoms you are experiencing are mostly neurological, it is not neurologic involvement by sarcoidosis (neurosarcoidosis) that is causing your symptoms.
In addition, when it comes to cranial nerves, sarcoidosis affects facial nerve resulting in facial palsy, not the trigeminal nerve.
Sarcoidosis usually goes away on its own, in cases it spreads, results in easily notable ( by tests too ) damages of lungs, liver and nervous systems.
MS could be a possibility ( supported by your symptoms and by sudden improvement to prednisone), but absence of white matter changes in your MRI questions this possibility too. Regarding to our recent conversation, ALS should be considered as a possibility.
So, here is my opinion: another spinal tap and cerebrospinal fluid examination about antibodies associated with MS, viral infections is needed.
MRI of the cervical and thoracic spinal cord is needed as well, because MS affects white matter of spinal cord too.
Hope this helps. Take care.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
