Multiple Sclerosis (MS) or CIDP?
TOUGH CASE; TOUGH QUESTIONS
Particularly because, apparently, an MS attack might cause, as you put it, neuropathy in your arms and legs. I suggest your EMG/NCV tests need to be done and reviewed by an expert.
Let’s compare MS “[I]At this time, there are no symptoms, physical findings or laboratory tests that can, by themselves, determine if a person has MS. The doctor uses several strategies to determine if a person meets the long-established criteria for a diagnosis of MS and to rule out other possible causes of whatever symptoms the person is experiencing. These strategies include a careful medical history, a neurologic exam and various tests, including magnetic resonance imaging (MRI), evoked potentials (EP) and spinal fluid analysis.”[/I] Source? the MS website.
Compare to CIDP “.[I]..The diagnosis of CIDP is suspected with a history of progressive sensory motor neuropathy. Physical examination consistent with distal sensory loss in the upper and lower extremities, in conjunction with motor weakness that can be more proximal than distal supports the clinical diagnosis…[/I]” source? The MDA (Muscular Dystrophy Association) website.
More on CIDP “[I]…How is CIDP Diagnosed? The CIDP patient typically presents with difficulty walking which progressively worsens over a few months. Tingling or other abnormal sensations may also be experienced if the patient’s sensory nerve myelin is damaged. Physical examination will usually show loss of reflexes, such as the knee and ankle jerk. Evaluation by a neurologist will often include an electrical test, a nerve conduction velocity-electromyography study. It shows slowing of conduction of electrical signals or even blocked conduction. A spinal tap, to analyze cerebrospinal fluid, will typically show elevated protein with normal cells to help confirm the diagnosis. Patients with variants of CIDP, such as multifocal motor neuropathy, may only show slowing of conduction in some motor nerves to muscles. Your doctor may obtain blood and urine tests, including analysis of proteins, to look for causes of CIDP….” [/I] Source? GBS-CIDP Foundation website.
For a diagnosis of MS the MS website says-
[I]”… Analysis of the cerebrospinal fluid, which is sampled by a spinal tap, detects the levels of certain immune system proteins and the presence of oligoclonal bands. These bands, which indicate an immune response within the CNS, are found in the spinal fluid of about 90-95% of people with MS. But because they are present in other diseases as well, oligoclonal bands cannot be relied on as positive proof of MS….”[/I]
Importantly, it seems to me, MS is a Central Nervous System (CNS) disorder. CIDP is a Peripheral Neuropathy System (PNS), or anything outside the CNS, disorder. (usually).
Treatment- Some treatments use the same medications. For example, again from the main MS website-
“[I]…Initial treatment of MS usually starts during the acute relapse. Several studies have found that treatment with corticosteroids can shorten the length of relapse and might even improve long-term outcome
Cyclophosphamide, methotrexate, azathioprine and cyclosporine all have been studied in small- to medium-sized trials. An evaluation by the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and MS Council for Clinical Practice Guidelines has made recommendations regarding these therapies. Methotrexate, azathioprine, and cyclosporine were each found to be possibly effective (Type C recommendation) in altering the course of disease, but cyclosporine was found to have an unacceptable risk-to-benefit ratio. In their review, pulse cyclophosphamide treatment was found to not alter the course of MS (Type B recommendation), although a more recent clinical trial observed reduced relapses and MRI lesions in patients treated with cyclophosphamide…[/I]”
I couldn’t say which medicines you’ve taken might be counter productive to CIDP. You are right about having a boatload of meds. I would hope to downsize to a kayak.
Welcome and Good Luck