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 incontinence. Computed tomography (CT) of the brain done at first was reported as a left external capsular infarct. An magnetic resonance imaging (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 total count (TC), renal function test (RFT), uric acid, serum glutamic oxalate transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT). Cerebrospinal fluid (CSF) analysis showed raised protein and total count (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.
17 May 2024 - 1 min read
What do unenhanced intracranial appearances mean on CT?
Hello doctor,
I have headaches. I had a computed tomography (CT) scan of the brain, and the result was normal unenhanced intracranial appearances. What does this mean? I am currently on Omeprazole, Domperidone, Mebeverine, Fexofenadine, Avamys, Ventolin, Seretide, and Ranitidine. I have uploaded photos of my scan.
16 May 2024 - 1 min read
What causes the eyes to go around as if spun on a chair?
Hello doctor,
My son is four years old. He was diagnosed with vertigo. It started when he was playing on his gadget. When he plays an action game, we have found that he becomes extremely scared and points to his head. When it first started, I saw his eyes going around and around as if someone spun him in a chair. He can watch TV videos with no problem. Yesterday he was playing virtual games with his sister, the game with bowling, tennis, baseball, and boxing. He was boxing and had another episode. It is after the episode that varies. When it started, he either vomited or fell asleep. Now that it has been several months, yesterday's was not so bad, no vomiting, he did not sleep. However, later that night, when he was in his bed with no other distractions, he would kick his legs and move quickly. It felt like a residual episode. I am not sure how to explain it. We have treated him with Dramamine and an antihistamine through the doctor. He has had a brain scan and a complete blood panel. All the numbers were nominal. We know what triggers it. Is this something that will go away in time? Would seeing an ear, nose, throat specialist be beneficial?
16 May 2024 - 1 min read
What causes constant muscle twitching in feet and legs?
Hello doctor,
I have been having tiny random muscle twitching all over my body which seems like a constant thing at bottom of my feet, in both legs, both forearms, and even my stomach for almost two months now. I am scared of ALS diagnosis. I do not have any muscle weaknesses or balancing problems. I can lift 40 lbs dumbells with no problem and still do push-ups and other exercises with no problems and sprint and run without falling or tripping.
I have had some sort of issue for almost a year where it feels like I am not getting a satisfying breath from time to time so I bought a spo2 meter and my O2 level fluctuates between 95%-98% with an average of 97% most of the time.
I am just freaking out because everything I search for comes back to ALS. I even watched a similar story last night and I had a panic attack afterward. I guess I am just looking for a little reassurance to calm down.
15 May 2024 - 1 min read
Will spinal cord injury affect motor and sensory function?
Hi doctor,
I have some questions I would like answered on cervical spinal cord injuries, please.
If a person only had a partial transection of the cervical spinal cord would their final outcome still be a complete cervical spinal cord injury, where they no mobility or sensory function? Or is it possible their final outcome could be an incomplete cervical spinal cord injury where they have some mobility and sensory function?
Can a person with a neck fracture die from their cervical spinal cord being compressed because of bleeding and swelling from the fracture compressing against the cord?
Can a person with an incomplete cervical spinal cord injury, caused by a traumatic accident, die four days after the accident because of the cervical spinal cord failure to control blood pressure and heart rate, or respiratory failure because of damage done to the cord? Or would they have to have a complete cervical spinal cord injury to die four days after the accident because of the same reason stated above?
And lastly, would it be possible for a elderly male, aged 80, who has had a fall, and has either a partially severed his cervical spinal cord, or his cervical spinal cord been injured by being compressed from bleeding and swelling as result of a neck fracture, be physically able to walk roughly 50 meters with someone assisting him? If it is possible, what would their balance be like, for example, if the person assisting the injured man was holding him with one their arms holding him at the waist would be able to walk in a straight line, or would his walking be staggered, unbalanced and uncoordinated?
15 May 2024 - 1 min read
Neurology