Patient's Query
Hello doctor,
I am a 53-year-old male. My symptoms began about three months ago and include the following: Numbness and burning at the base of the neck. Shooting pains and stingers in the upper back and near shoulder blades. Soreness in shoulders. Muscle twitching that comes and goes particularly in hands, fingers eyelids and ankles almost all at rest. Body temperature regulation issues causing damp collar of my T-shirt after waking from sleep and now some anhidrosis on exertion because I did notice I do not seem to be sweating and I feel like I am overheating after some exertion. Foggy head feeling, especially in the morning. Dry throat upon waking up and sometimes during the day that will not go away. Frequent urination some days that sends me to the bathroom every hour to an hour and a half. Tests my internist has conducted in the last month to investigate my symptoms: Magnetic resonance imaging (MRI) of my cervical spine that showed some bulging discs but nothing significant. Computerized axial tomography (CAT) scan of my neck to look at lymph nodes and all was normal. Chest X-ray which was normal. Blood work which showed all normal except vitamin D which was low. I am now taking a supplement. I am obviously very scared that I am developing motor neuron disease (MND) such as Parkinson's or multiple system atrophy (MSA).
Hello,
Welcome to icliniq.com. I understand your concern and would explain that your symptoms could be related to low vitamin D levels. Anyway, I would also recommend performing further tests if you have not already performed yet: 1. Thyroid hormone levels for thyroid gland dysfunction. 2. Vitamin B12 levels for the possible deficiency. Nerve conduction studies would help investigate for neuropathy or motor neuron disease. Regarding Parkinson's, a direct antiglobulin test (DAT) scan would help investigate for this disorder. Anyway, your symptoms are not typical of this disorder.
Patient's Query
Hi doctor,
Thank you for your answer. In my lab work, attached my thyroid and B12 were checked and found to be within range. I do have an appointment with a neurologist next month and plan to ask for an electromyography (EMG) and direct antiglobulin test (DAT) scan. You stated that my symptoms were not consistent with Parkinson's and your opinion is that these are symptoms consistent with multiple system atrophy (MSA) or some other motor neuron disease (MND)? I do not know what MSA symptoms typically are. I am obviously scared out of my mind that I could be facing something dire. Thank you for your help and advice.
Hello,
Welcome back to icliniq.com. Multiple system atrophy (MSA) does not lead to muscle twitching, but it may cause anhidrosis, dry mouth constipation, and fatigue. Parkinson's can start with neck and shoulder pain, but the other symptoms that you are experiencing do not occur in the early stages. amyotrophic lateral sclerosis (ALS) may lead to muscle twitching but there is no pain or anhidrosis or any other symptoms that you are experiencing. So, as you can see your symptoms are not typical of any of these disorders. Nerve conduction studies are necessary to investigate for possible ALS. direct antiglobulin test (DAT) scan can help investigate for Parkinson's. There is a specific test for MSA.
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