I RECENTLY SEEN MY FAMILY DR BECAUSE I HAVE BEEN SUFFERING FROM MUSCLE TWITCHESALL OVER MY BODY. I HAVE MINOR LEFT ARM WEAKNESS THAT COMES & GOES. I HAVE ALSO HAD ITCHING ALL OVER MY BODY, WITH NO VISIBLE HIVES ORREDNESS. MY DOCTOR ORDERED BLOOD WORK WHIC

I RECENTLY SEEN MY FAMILY DR BECAUSE I HAVE BEEN SUFFERING FROM MUSCLE TWITCHES ALL OVER MY BODY. I HAVE MINOR LEFT ARM WEAKNESS THAT COMES & GOES. I HAVE ALSO HAD ITCHING ALL OVER MY BODY, WITH NO VISIBLE HIVES OR REDNESS. MY DOCTOR ORDERED BLOOD WORK WHICH INCLUDED A CBC, LIVER FUNCTION TEST, PANCREAS TEST, & THYROID TEST. ALL OF MY BLOOD WORK WAS NORMAL, EXCEPT HIGH CHOLESTROL,& SED RATE WAS 1 POINT TO HIGH. HE ALSO ORDERED A CT SCAN OF BRAIN, W/ & WO CONTRAST, & A MRI WO CONTRAST OF MY C-SPINE. IM A 28YO MALE, AND SLIGHTLY OVERWEIGHT. CT SCAN W/CONTRAST FINDING: AREA OF NODULAR CONTRAST DENSITY IN THE INTERHEMISPHERIC REGION IMMERDIATELY ANTERIOR TO THE CORPUS CALLOSUM ADJACENT TO THE ANTERIOR CEREBRAL ARTERIES NOTED, COULD BE A SMALL ANEURYSM. NO OTHER ABNORMATLITY SEEN. NO PATHOLOGIC ENHANCEMENT. NO EXTRA-AXIAL FLUID COLLECTIONS. NO EVIDENCE FOR ISCHEMIA OR HEMORRHAGE. CT SCAN WO CONTRAST FINDINGS: THE GRAY AND WHITE MATTER ATTENUATION ARE NORMAL. THRE VENTRICLE SIZES, CONTOURS AND CALIBERS ARE NORMAL. NO REGIONS OF ABNORMAL INTRA-AXIAL OR EXTRA-AXIAL ENHANCEMENT. THE OPACIFIED INTRACRANIAL VESSELS ARE NORMAL IN CALIBER WITH NORMAL BRANCHING PATTERN. NO VASCULAR MALFORMATION OR ANEURYSMS SEEN W/ THIS EXAMINE. NO EDEMA (CYTOTOXIC OR VASOGENIC)HYDROCEPHALUS, INTERCRANIAL HEMORRHAGE, EXTRA-AXIAL FLUID COLLECTIONS, MASS EFFECT OR MIDLINE SHIFT. NO HERNIATION. NO SPACE OCCUPYING LESIONS EVIDENT. THE CALVARIUM APPEARS UNREMARKABLE. THE INCLUDED INTRORBITAL STRUCTURES ARE SYMMETRIC IN ATTENUATION, POSITION, SIZE AND CONTOUR. NO INTRAORBITAL ABNORMALITY SEEN. THE INCLUDED PARANASAL SINUSES AND MASTOIDS SO NO EVIDENCE FOR ACUTE OR SIGINICANT CHRONIC DISEASE. MRI C SPINE FINDINGS: NORMAL CERVICAL VERTEBRAL HEIGHTS, MARROW SIGNAL, ALIGNMENT. NORMAL ALIGMENT OF THE FACETS. NORMAL SIGNAL OF THE CERVICAL AND UPPER THORACIC CORD. NORMAL POSTION OF THE MEDULLOCERVICAL JUNCTION. NO SIGNIFICANT SPINAL CANAL, LATERAL RECESS OR FORAMINAL STENOSIS. NORMAL MARROW SIGNALS OF THE OSSEOUS STRUCTURES. NO MARROW EDEMA. NO FRACTURE. NO VERTEBRAL SUBLUXATION. NO ADVANCED DEGENERATIVE CHANGES OF THE FACETS. C5-C6 LEFT PARASAGITTAL BROAD-BASED DISC PROTRUSION MINIMALLY INDENTS THE LEFT ANTERIOR MARGIN OF THE CORD AND MAY RESULT IN MASS EFFECT ON THE LEFT C-6 VENTRAL NERVE ROOT BRANCH, THE MILD C6-C7 DISC PROTRUSION APPEARS INSIGNIFICANT. THE MILD C3-C4 VERTEBRAL SPURS ALSO APPEAR INSIGNIFICANT. NO CORD SIGNAL ABNORMALITY, NO SYRINX OR CORD EDEMA. NO CIRCUMFERENTIAL CORD COMPRESSION. UNREMARKABLE APPEARANCE OF THE INCLUDED UPPER THORACIC REGION. NO ACUTE CERVICAL ABNORMAILTY SEEN. IM HAVE BEEN WORRIED ABOUT DISEASES SUCH AS MS AND ALS, AND THE POSSIBLE ANEURYSM HAS ME CONCERNED. DO YOU THINK IF I HAD MS OR ALS, SOMETHING WOULD HAVE APPEARED IN THESE PROCEDURES? I HAVE WORRIED MYSELF SICK OVER IT, AND MY DR DIDNT REALLY TELL ME MUCH, HE JUST REFERED ME TO HAVE A MRA. SORRY THIS IS SO LONG, I JUST WANTED YOU TO HAVE THE BEST SNAPSHOT OF MY CURRENT HEALTH STATUS. THANKS SO MUCH, JOHN

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Dr JS Anand

Sun 20, Dec 2009 12:33pm

Hello, Welcome to the AMD forum of doctors. Dr Anurag has very nicely explained the possibilities for your symptoms. From your CT head the possibility of minor aneurysm is there. In a cerebral aneurysm, there is a weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel. Since it is a small one, so there is no need to panic now but I completely agree with your doctor that you have to get MRA(magnetic resonance angiography) done which is the gold standard(although invasive) of detecting any vasospasm. It is true that multiple sclerosis usually presents with involuntary muscle spasms and altered changes in sensations, but any changes are detected on MRI head and spine. Your MRI spine and CT head are absolutely clear on this. But to clear your doubts, you can get CSF analysis and evoked potentials done. Regarding ALS, MRI scans are usually normal even in patients of ALS. Best would be to get an electromyography and nerve conduction velocity test done in addition. Your MRI spine is showing mild disc protrusion at c6-c7 levels. This may be responsible for arm symptoms that you are having. Regarding muscle twitching, it can be found in other medical causes like acid-base imbalance in the body, low sodium,calcium and vit D deficiency, muscle fasciculation syndrome(a disorder of the nervous system characterized by the uncontrolled twitching (fasciculation) of muscle groups in various parts of the body), chronic fatigue syndrome, hypoparathyroidism and spinal muscular atrophy. So my sincere advice would be to consult a neurologist and get evaluated for these possibilities. Since you do not have any rash on the body but itching is there, so I would suggest you to get neuropathic itch ruled out. I hope it helps. Take care and please do keep us posted in case you have any additional queries. Kind regards.

I RECENTLY SEEN MY FAMILY DR BECAUSE I HAVE BEEN SUFFERING FROM MUSCLE TWITCHESALL OVER MY BODY. I HAVE MINOR LEFT ARM WEAKNESS THAT COMES & GOES. I HAVE ALSO HAD ITCHING ALL OVER MY BODY, WITH NO VISIBLE HIVES ORREDNESS. MY DOCTOR ORDERED BLOOD WORK WHIC

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