Q. Is multiple sclerosis the right diagnosis for him?
Hello doctor,
My 66-year-old father who is a retired school teacher was having a cold and cough for 10 days. One month back, he developed slurred speech and blurred vision, double vision, giddiness, imbalance, nasal intonation of voice, hypertension. Blood pressure was fluctuating. As per him, symptoms were more in the morning and improved gradually as the day passed by. There was no headache, vomiting, seizure, loss of control, bowel or bladder incontinences. CT of the brain done at first was reported as a left external capsular infarct.
An MRI done revealed prominent right cavernous sinus to correlate for significance there is age-related cerebral atrophy with white matter changes. Doctors first doubted MG then MS. Neostigmine test came negative. He was started on an antibiotic, a course of IV methylprednisolone, lipid-lowering agent, PPI and supportive. Blood parameters showed raised TC, RFT, uric acid, SGOT, SGPT. CSF analysis showed raised protein and TC. With treatment, a bit of improvement was seen but not substantial.
Ten years ago, he was diagnosed with retrobulbar neuritis. Doctors are more or less supposing it to be MS and gave a further course of prednisolone of 20 mg and Atorvastatin 20 mg tablets along with those for hypertension, cough and acidity and advised to take care about the blood pressure. There are no definitive answers or assurances. What should we do? Please help.
Hello,
Welcome to icliniq.com.
Your father's symptoms are not typical of MG (myasthenia gravis). I would exclude MS (multiple sclerosis) due to his age and MRI (magnetic resonance imaging) findings although his past history of optic neuritis.
A stroke cannot be excluded although I would directly review his MRI for a more professional opinion. Are white matter changes enhanced by gadolinium?
Lambert-Eaton syndrome could mimic this clinical situation too.
I would recommend also checking any malignancies.
For this reason, it is necessary performing a chest X-ray study and an abdominal ultrasound coupled with tumoral antigens like CEA (carcinoembryonic antigen), CA (cancer antigen) 19.9 and PSA (prostate-specific antigen) levels.
For more information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist
Was this answer helpful?
|Same symptoms doesn’t mean you have the same problem. Consult a doctor now!
Related Questions:
Can seizures be related to chronic sinusitis?
If yes, does that mean he might have a brain complication ... It will allow the brain to remodulate itself with a hope of outgrowing of... Read full
What is the reason for double vision following an accident?.. be due to subconjunctival hemorrhage. It usually resolves without treatment. Diplopia could be due to nerve palsy. In this case we usually observe the patient for six months for spontaneous recovery. Another less common cause could be muscle entra... Read full
I have multiple sclerosis. Can I get artificial valve for urinary incontinence?.. is a progressive disease. So with time, incontinence may change in either direction, positively or negatively. The best option is what you have been doing. It is called CIC (clean intermittent catheterization). It is adaptable to all stages of di... Read full
Also Read Answers From:
Comprehensive Medical Second Opinion.Submit your Case
Also Read
Coronavirus Variant Arcturus: | Omicron XBB.1.16 Variant
Arcturus is an emerging variant of the Omicron virus that causes various symptoms and spreads rapidly across the world. ... Read more»
Adrenaline Rush - Symptoms, Causes, Effects, and How to Control
Adrenaline is a hormone responsible for fight or flight response. It is also a neurotransmitter and medicine. It is also... Read more»
Fatty Liver - Types, Symptoms, Stages, and Treatment
The liver is the largest gland in the body. Its primary function is to process the food and drinks we consume. and filte... Read more»
