Question
Dr. Durnin,

This is somewhat of a follow up to a question I asked of you a year ago.  I was suspected of having viral neuritis (remember me?).  Things have gotten a bit complicated since then.

Briefly, I was diagnosed with idiopathic brachial plexopathy (believed to be auto-immune).  Although this diagnosis seems to be up in the air.  The original neurologist labeled it as possibly a 揻orme fruste? and I think it has since been questioned by another.   It was then theorized that this caused adhesive capsulitis.  I had capsular release in April, but unfortunately, it returned, despite my best efforts in PT, both formally and at home.  In fact, using my arm makes things worse.  I have also developed similar, yet much milder, symptoms in my other arm, but I wonder if it is just because of overuse.   My ortho surgeon feels I had a severe case, and has wondered about systemic disease.  I have been told by my PCP that I will probably not regain full use of my arm, and that I just 揾ave to learn to live with chronic disease?  My ortho feels the frozen shoulder should release on its own within 1-3 years.  I was put on Lyrica a few months ago, and have finally felt some relief from the pain, numbness and tingling, although my ROM has not really improved.  I also now take Soma periodically due to muscle spasms.

In July, I developed a mild case of optic neuritis.  The neuro-opthomologist  felt this, combined with the other symptoms I had been experiencing, pointed to MS.  MRIs returned clear (although upon viewing the MRI, there are several bright white spots, which I was told was due to 搉ormal aging?- I am now 37).  My neuro exam is reported as fairly normal, with just a few oddities, mostly sensory and reflexes, and 損ossible?mild muscle atrophy in the affected arm.

I currently feel 搒table?  with some lingering symptoms (aside from the arm pain and not being able to use it properly), but would like to have some difinitive answers.    I am most willing to detail my situation.  I am NOT looking for any type of diagnosis online.  I would like to find a doctor who can help me.  Do you have any suggestions?  Are YOU available?  I will travel if necessary.

Sincerely,
Michelle  

Answer
Depending on the location of the white spots on the MRI, this is pathnonomonic (means diagnostic for a particular disease.) of MS. Since this can only be controlled and not cured at this time, controlling and mitigating the symptoms is the best that can be done. Finding another doctor is probably not going to help much. If it is something else, I suggest you keep researching, with the multi-systemic presentation of the symptoms, I lean towards the MS. Keeping the range of motion and getting treatment for the eyes is paramount. I don't believe Chiropractic is your answer at this point. I would look at getting a comprehensive Food Allergy panel, preferably an IgG and IgA panel, not a RAST profile. This systemic issues that are difficult to diagnose are commonly a result of these allergies.

Good Luck,

Dr. Timothy Durnin