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What Do My Lab Test Reports Indicate?
Question: XXXX XXXXXXX 34 years, male.
On 6th October 2015 i had back pain with fever, this continue, on 24 October suddenly my complete body except head and face stop working, i was admitted to icu. After few days i was discharged. Since then i am almost bedridden.
There are two conditions
1. Normal: i am at home only, low/nil energy to move out.
cannot walk, sit, bend and stand properly,
tingling especially at back.
pain at back.
from last few months strength in both leg below knee is very low.
2. Attack: with sudden bending, or long standing, or when somebody put pressure on my lower back by mistake, or when i sit for long,
(i mean with pressure on my lower back, pain increases)
THEN ONLY my all four limbs, sometimes my complete body including jaw eyes become senseless, that time i can hear everyone but i cannot respond.
Investigation: mri (head and complete spine), lumbar puncture, emg ncv, numbers of blood test.
Neurologist opinion on investigation:
previously they were saying its was due to stress anxiety, after having emg ncv they are saying it can be MULTIPLE SCLEROSIS or CIDP
i will attach
1. recent ncv emg
2. LP report done October 2015
3. mri report of lower back (i do not have report of brain mri i have the plates)
i request your opinion on this, i need to find out what going wrong.
Thank you
On 6th October 2015 i had back pain with fever, this continue, on 24 October suddenly my complete body except head and face stop working, i was admitted to icu. After few days i was discharged. Since then i am almost bedridden.
There are two conditions
1. Normal: i am at home only, low/nil energy to move out.
cannot walk, sit, bend and stand properly,
tingling especially at back.
pain at back.
from last few months strength in both leg below knee is very low.
2. Attack: with sudden bending, or long standing, or when somebody put pressure on my lower back by mistake, or when i sit for long,
(i mean with pressure on my lower back, pain increases)
THEN ONLY my all four limbs, sometimes my complete body including jaw eyes become senseless, that time i can hear everyone but i cannot respond.
Investigation: mri (head and complete spine), lumbar puncture, emg ncv, numbers of blood test.
Neurologist opinion on investigation:
previously they were saying its was due to stress anxiety, after having emg ncv they are saying it can be MULTIPLE SCLEROSIS or CIDP
i will attach
1. recent ncv emg
2. LP report done October 2015
3. mri report of lower back (i do not have report of brain mri i have the plates)
i request your opinion on this, i need to find out what going wrong.
Thank you
Brief Answer:
Upload all reports and prescription
Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
You need to upload all available reports and brain images.
Recurrent episodic weakness of all limbs with retained consciousness can be due to periodic paralysis.
If weakness persists for days then possibility of chronic idiopathic demyelinating polyneuropathy should be considered.
Multiple sclerosis can present with recurrent motor or sensory loss but requires investigation to prove the diagnosis.
Any history of headache, seizure, loss of consciousness, visual loss, urinary complains?
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist
Upload all reports and prescription
Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
You need to upload all available reports and brain images.
Recurrent episodic weakness of all limbs with retained consciousness can be due to periodic paralysis.
If weakness persists for days then possibility of chronic idiopathic demyelinating polyneuropathy should be considered.
Multiple sclerosis can present with recurrent motor or sensory loss but requires investigation to prove the diagnosis.
Any history of headache, seizure, loss of consciousness, visual loss, urinary complains?
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
LP report, EMG NCV, Lower spine MRI report
Brief Answer:
Provide more details
Detailed Answer:
Hello,
I have gone through all your reports.
The csf has not been evaluated for multiple sclerosis.
The nerve conduction study is near normal except for f wave abnormalities which suggests radiculopathy but csf normal.
Repeat nerve conduction may be required.
Upload Mri brain report or film.
Any blood test especially blood sugar, serum potassium and Thyroid profile.
Few questions need to be answered.
Is the weakness static, progressive or improving since October?
Any urinary complains?
Any period of complete normalcy?
Any stress?
Any visual loss, speech changes, swallowing difficulty?
Visit to a neurologist will be helpful as examination findings are required for making a diagnosis.
Regards
Dr N Kumar
Neurologist
Provide more details
Detailed Answer:
Hello,
I have gone through all your reports.
The csf has not been evaluated for multiple sclerosis.
The nerve conduction study is near normal except for f wave abnormalities which suggests radiculopathy but csf normal.
Repeat nerve conduction may be required.
Upload Mri brain report or film.
Any blood test especially blood sugar, serum potassium and Thyroid profile.
Few questions need to be answered.
Is the weakness static, progressive or improving since October?
Any urinary complains?
Any period of complete normalcy?
Any stress?
Any visual loss, speech changes, swallowing difficulty?
Visit to a neurologist will be helpful as examination findings are required for making a diagnosis.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
Sir i am uploading few blood test done recently.
I do not have brain mri report and film is not coming clear in camera.
I am also sending you dr XXXXXXX XXXXXXX prescription who asked for more blood test, as it cost 30k i did not done it yet.
Yes weakness is progressive, sometimes it becomes difficult to lift my legs also.
No urinary problem.
Since October i am not normal, pain weakness and tingling has increased only.
I have blurred vision sometime only.
Speech and swallowing problem is there at time of attack only.
Stress is there only because of my illness.
Doctors here are saying its MS but not sure.
I request your opinion, if its MS or CIDP or some other disease.
I do not have brain mri report and film is not coming clear in camera.
I am also sending you dr XXXXXXX XXXXXXX prescription who asked for more blood test, as it cost 30k i did not done it yet.
Yes weakness is progressive, sometimes it becomes difficult to lift my legs also.
No urinary problem.
Since October i am not normal, pain weakness and tingling has increased only.
I have blurred vision sometime only.
Speech and swallowing problem is there at time of attack only.
Stress is there only because of my illness.
Doctors here are saying its MS but not sure.
I request your opinion, if its MS or CIDP or some other disease.
Brief Answer:
Get investigated as advised
Detailed Answer:
Hello,
I have gone through your report and prescription.
Possibility of
1) Periodic paralysis
2) Myasthenia gravis
3) Anxiety disorder
4) Multiple sclerosis
5) CIDP
You need to visit doctor when you are having symptoms and weakness.
If Mri brain and spine is normal then multiple sclerosis is unlikely.
Cidp is less likely in presence of normal csf and near normal nerve conduction study.
Is there any fluctuations in weakness in a day with better power after sleep in morning and deterioration in evening, Intermittent diplopia or dropping of eyelids? Possibility of myasthenia gravis to be considered in such a case.
Periodic paralysis still a possibility and needs evaluation.
Last possibility should be anxiety disorder if all investigations are normal.
Regards
Dr N Kumar
Neurologist
Get investigated as advised
Detailed Answer:
Hello,
I have gone through your report and prescription.
Possibility of
1) Periodic paralysis
2) Myasthenia gravis
3) Anxiety disorder
4) Multiple sclerosis
5) CIDP
You need to visit doctor when you are having symptoms and weakness.
If Mri brain and spine is normal then multiple sclerosis is unlikely.
Cidp is less likely in presence of normal csf and near normal nerve conduction study.
Is there any fluctuations in weakness in a day with better power after sleep in morning and deterioration in evening, Intermittent diplopia or dropping of eyelids? Possibility of myasthenia gravis to be considered in such a case.
Periodic paralysis still a possibility and needs evaluation.
Last possibility should be anxiety disorder if all investigations are normal.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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