How to diagnose multiple sclerosis?

Question

Hi doctor,

I have some symptoms after having typhoid and gastroenteritis seven months ago. I got hospitalized with profound hypotension or hypovolemia with secondary acute kidney injury (AKI).

I have a mild elevation in liver function test levels. I was given Ceftriaxone intravenously with oral Ciproxin for five days with a resolution. I have problems with my vision. I have had a burning sensation in my feet with visible skin inflammation for several hours. I have lightheadedness with imbalance. I feel like a sponge. I feel shaky.

I have tingling in my fingers and toes with mood changes. I have hot flushes on my neck. Now, I have had a runny nose with sneezing and coughing for about three months. I have changes in my sleeping patterns. I have constipation along with imbalance and dizziness. I had a CT scan of my head, and it was normal.

I have a cholesterol of 6.5 mmol/L, triglycerides of 1.7 mmol/L, HDL of 1.27 mmol/L, LDL of 4.44 mmol/L, TP of 82 g/L, albumin of 5.1 g/dL, ALP of 57 IU/L, GGT of 63 IU/L, FT4 of 18.54 μg/dL, and TSH of 4.43 mIu/L. I have a hemoglobin level of 161 g/dL, WBC of 5.9 K/uL, platelet count of 262,000 platelets per microliter of blood, and ESR of 2 mm/hr. I am concerned about the possibility of MS.

Kindly help.

Answer 1

Hi,

Welcome to icliniq.com.

I have carefully gone through your symptoms and reports. Based on your description, your condition does not strongly suggest multiple sclerosis (MS). MS is relatively uncommon in males and typically presents with specific neurological symptoms such as painful vision loss, electric shock-like sensations, or clear episodes of neurological deficits.

Your normal CT scan and stable blood parameters, including a normal platelet count, WBC count, and low ESR, do not point toward an active inflammatory or autoimmune neurological disorder.

The combination of your symptoms, tingling, dizziness, head heaviness, mood changes, and sleep disturbances appears more consistent with anxiety-related issues or possibly post-traumatic stress following your previous severe illness. Post-infectious syndromes can also cause prolonged symptoms like fatigue, imbalance, and sensory disturbances.

However, to definitively rule out multiple sclerosis (MS), further evaluation is needed. An MRI (magnetic resonance imaging) of the brain with contrast and an MRI of the spine are recommended. Additionally, a VEP (visual evoked potential) test can help assess any subtle optic nerve involvement.

For symptom relief, you may consider taking Clonazepam 0.25 mg at night for a short duration, as prescribed by your doctor. It would also be beneficial to consult a psychiatrist to evaluate for anxiety or post-traumatic stress disorder (PTSD).

I hope this helps.

Thank you.