Awaiting diagnosis - but symptoms don't fit

New here and looking for some clarity as I’m feeling a bit overwhelmed.

I’ve had a roller coaster of a journey for over a year now. It began early last year when it was discovered I had precancerous cells in my womb which I ended up having a total hysterectomy including removal of my ovaries in August, I’m 48 years old.

So I found myself in a wonderful world of surgical menopause and navigating all the symptoms of what that entails. The worst ones being constant migraine headaches day and night, spells of blurred / double vision, vertigo and dizziness which would come and go.

Then late September I began HRT under a private specialist which got rid of the migraines thankfully as it had been going on for nearly a month. Was still getting on and off vertigo and blurred vision and I also kept getting strange feelings of deja vu and experiencing false memories. Then one morning in October I had a scary spell of complete brain fog where I got so confused and couldn’t clearly remember what had happened up to two days prior which freaked me out and took a couple of hours before things came back and started to make sense again. I thought I was losing my mind!

Then a couple of weeks later at the end of October I had a suspected TIA. About 3am I woke up and my right arm and leg were so weak, I could barely move / lift them. I staggered to the toilet to pee and then struggled to lift myself up afterwards, but finally managed to get back into bed. Although I just flopped myself face down at the foot of the bed as couldn’t position myself. I noticed I was dribbling too. Then I managed to shuffle my way to the right end of the bed and went to sleep. When my partner woke me up in the morning about 8.30, I still had the same weakness, but also had slurred speech and the right side of my face felt paralysis, I kept laughing which freaked him out. I was with it mentally and knew what was going on, but just found it funny! It lasted about half an hour after waking before it got better. He took me to A&E and that was when they suspected a TIA as the symptoms had gone apart from a little weakness still in my right arm. I was given a CT scan which came back clear. They put me on a statin and aspirin and sent me home, with a follow up appointment at the TIA clinic a couple of days later.

I had an MRI brain scan (without contrast) and from that they found a lot of lesions which were “highly suspicious of MS” and was referred to a neurologist.
I saw her in December and she said my history of symptoms didn’t seem to be typical, as they haven’t lasted long enough. But I was sent for another MRI with contrast in January on my head and cervical spine and a lumbar puncture which I had done a couple of weeks ago in Feb, with a follow up appointment to see the neurologist in April.

My prior symptoms have not come back since my last episode in October. However I get a real sudden urgency to pee a few times a day and I get a persistent itch on my lower back that I’m always scratching but there’s nothing there. Very occasionally I get a sore feeling on my upper arm that feels like a graze but again there’s nothing there. In general I get incredibly tired easily both mentally and physically but the thing I’ve really noticed is how easily confused I get, lose my words / train of thought when speaking and have trouble staying focused.

I then had another severe brain fog spell earlier this week which freaked me out while I was working from home. I suddenly got confused with what I was doing and my head felt flooded with tons of random jumbled up thoughts and vague dream like memories that I couldn’t pinpoint. My memory got jumbled up too and couldn’t clearly remember what I was under investigation for at the hospital and what the timeline was, it just wasn’t making sense. It got me upset but disappeared after a couple of hours and left me with a headache, no other physical symptoms. I’m still getting easily confused and my thought process is like wading through treacle at times but not as bad as it was thankfully.

I sent an email to the consultant with an update on this and she brought my appointment forward to last Friday. She advised that my MRI didn’t show any new lesions, but my lumbar puncture shows some results that seem to relate to MS. She put my brain fog episode down to stress, even though I wasn’t feeling stressed at all, and says it sounds like i have an over active bladder so has given me Solifenacin to take but warned it could cause memory loss so I’m rather reluctant to try it!

She wants to take the approach of “watch and wait” but will arrange for an urgent MRI on my thoracic spine to see if any new lesions have appeared as she can’t fulfill the criteria for a diagnosis without them. She says everything is pointing to MS but my symptoms and their duration aren’t typical.

So what type of MS could it be if they’re not typical? I guess I’m overthinking everything and trying to work out if there’s a crossover especially with menopause adding to the mix.

My head is just spinning from everything. I’m getting paranoid at every slight twitch I feel and googling everything but it’s such a minefield. It’s like I’m a ticking time-bomb waiting for something bad to happen.

Has anyone been in a similar situation please? Thanks in advance and I’m so sorry for such a long-winded post, it’s taken me all day to write it.

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Hi @lucylastic104 i think that if I were you I would be asking what the Lumbar puncture revealed. Under the new, revised McDonald criteria for diagnosis of MS oligoclonal bands in the spinal fluid are sufficient to demonstrate dissemination in time

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Hi @lucylastic104

There is such a lot to process there! And some of your symptoms sound really scary, especially the confusion and memory issues.

I think that if your neurologist has / does diagnose you with MS, then it would be worth thinking about / asking about a disease modifying treatment. There are some really effective drugs around now which can very significantly reduce the risk of relapses and make them less severe if they do occur.

Personally, I think your neurologist’s ‘watch and wait’ plan is risky if you have MS. But I am not sure if you have actually received a diagnosis of MS? It sounds unclear from your post, but that may be me being a bit dopey - it’s late and I didn’t sleep well last night. So apologies if I’ve misunderstood.

Perhaps the next step is to ask the neurologist what the tests they have performed actually show, and what other tests would be needed to diagnose / rule out MS.

As @Hank_Dogs said, the diagnostic criteria changed in September and made it easier to diagnose.

I wish you well,

Alison

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Many thanks for your reply. She said in an email that the LP was supportive of MS but didn’t give me a copy of the results so I’m still left with confusion as to what her thought process is… will just have to wait it out I guess.

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Hi @lucylastic104 . I’m not sure how you might say this to the neurologist but ‘watch and wait’ is not good practice - lesions on your brain and clear signs of MS in your lumbar puncture fluid ( ask about oligoclonal bands) qualify for MS diagnosis under the new diagnostic criteria ( the McDonald criteria ) Similarly the sooner you are started on a Disease Modifying Drug the better.

I think that if I were you I would ask about oligoclonal bands and why you aren’t being given a diagnosis and why treatment is being delayed

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Hi Alison, thanks so much for your reply. No apologies needed bless you, it was a long and very rambling post lol, I’ve even confused myself!

I’ve already requested my LP results and my neurologist said in an emailed reply that one of the first things we discussed at my appointment was that they were supportive of MS, and that we discussed the probable diagnosis of MS. I’m now even more confused because she didn’t seem to say that as clearly in person, so can’t work out why she wants to watch and wait…

After doing some more research I’m starting to wonder whether she’s going to suggest it’s RIS even though I’m not completely symptom free. Will have to wait and see what comes from the next MRI in a couple of weeks I guess, just concerned if nothing shows up I’ll be left in limbo.

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Hi Lucy, I hope you get more clarity when you see your neurologist, it all sounds very confusing. Keep us posted (if you want to, of course).

Best wishes

Alison

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Hi @lucylastic104

I was just reading your post thinking, crikey, someone’s written my actual experience down, so many similarities.

From the hysterectomy to the brain fog, and all of the headaches in between I have had the same experience.

It’s a long process but I too am A -typical and have just received my diagnosis this week. The first lesions on MRI were seen last July.

I hope you get some clarity soon. It’s such a long process as they have to be careful not to mis diagnose or medicate incorrectly.

I’m not sure how much I can offer in terms of advice but feel free to message if you would like to compare our A-typical symptoms. :face_with_peeking_eye:

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