You will need the best minds you can find to help you. I would also recommend that you take your case to large academic Neurology department in your area. This should only be considered after the testing is complete, but does happen and should be kept in mind. Stress can also cause some very strange symptoms that can mimic neurologic conditions.
Serum and Urine amino acids, urine organic acids, ammonia level(metabolic workup). Given the symptoms you describe, I would recommend a some screening lab work to look for more uncommon diseases that can cause similar symptoms including urine porphyria screen, anti-thyroid antibody panel (you could still have antibodies even if your thyroid is removed), paraneoplastic panel (looking for antibodies against occult tumors), ACE for sarcoid, EEG for seizures, Lactate and pyruvate from the CSF and blood (for mitochondrial disorders). I would also recommend a SPECT scan of the brain (lyme can cause vasoconstrictive disease that causes dysfunction without MRI abnormalities).
It may not turn out to be lyme, but a trial on antibiotics is low risk and potentially very helpful. Your symptoms are compatible with lyme disease and tests can often be negative until treatment is started (the agent that causes lyme (Borellia burgdorferi) is immunosuppresive). For the question of lyme disease, I would recommend a trial of antibiotics. The only test for MS that you did not describe was a visual evoked potential (evaluates for past optic neuritis) which may be helpful given your past history right eye blurring. However, the symptoms that you describe appear to involve the brain as well, making this explanation unlikely for you (face and vision involvement).
MS can be tricky to diagnose at times, and some "variants" will have a negative MRI brain, but have positive findings elsewhere (For example: Devic's affects the eyes and the C-spine, not the brain). It would be uncommon for multiple sclerosis (MS) to present in this way. The symptoms/story you describe is not classic for any particular disorder, and thus your evaluation needs to be taken to the next level to evaluate for less common diseases. First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
0 kommentar(er)
