Hello doctor,
I am a 29-year-old male. I have had left index fingertip numbness with partial sensation loss for two months, and it developed suddenly. After one week, I had numbness on the left side of my head (around the temple) and the face behind the eardrum. I also had the first episode of intermittent confusion or brain fog (feeling dissociated, difficulty in multi-tasking, and a feeling of slowing down) with discomfort visually focusing on objects and random muscle twitching (feeling of spasms) on the left side of the body (intermittent). After one month, I started having severe brain fog, and I could not do my job, drive, concentrate on simple tasks, or focus on personal things. I noticed that brain fog increases with lifestyle stress, but the baseline remains the same. The numbness in my hands and foot (mostly on the left side) had resolved slowly. I consulted a specialist doctor and had an MRI, and I am attaching the reports. The doctor suggested taking oral steroids (Prednisolone 40 mg). After taking the medications, the brain fog reduced, but it returned slightly before the steroid course finished, and it has been consistent till now. A CNS examination was performed and the results were normal. Other relevant medical histories are the following.
1. Childhood vitamin D deficiency.
2. High cholesterol levels.
3. Reduced testosterone levels.
4. Taking regular vitamin supplements.
5. Use of high-concentration nicotine electronic cigarettes, reduced for two weeks.
6. Uses tablet Cetirizine 10 mg for nasal sinusitis.
7. Using CBD oil for muscle twitching.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern.
I saw your MRI (magnetic resonance imaging) report (attachment removed to protect the patient's identity), and the findings suggest small repeated strokes. Therefore, I recommend starting the tablet Piracetam 1200 mg twice daily to reduce your symptoms and performing an inflammation test (complete blood count, C-reactive protein, and ESR) to exclude possible brain vasculitis. Consult your specialist doctor, talk with them, and take medications with their consent.
Thank you.
Hello doctor,
Thank you for your reply.
Is there any chance that the lesions and symptoms suggest MS?
Thank you.
Hello,
Welcome back to icliniq.com.
In your case, the localization of lesions is not typical of multiple sclerosis (MS). Anyway, I recommend performing a new brain and spine MRI (magnetic resonance imaging) after a year to investigate for possible progression of lesions. In the meantime, I recommend performing further tests to investigate for possible brain vasculitis. Do you have any family history of stroke at a young age?
Thank you.
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