Chiari malformation and/or MS?

[ezziboo]

I'm a 38 year old female. I have a 10 year history of depression, fatigue, dizziness, unexplained leukocytosis (high neutrophils), enlarged lymph nodes, borderline high hct & hgb. Had complete hysterectomy in 2001 for endometriosis, tonsillectomy in 1999. I have regular checkups with GYN, hemotologist/oncologist, GP.

In July 2007, I began experiencing severe burning sensations in my scalp, severe headaches at the base of my skull, and neck/shoulder pain and burning...went on for 3 weeks before I saw an MD. An MRI (without contrast) of cervical spine indicated disc/osteophyte complex in left neural foramen (C4-5), disc/osteophyte complex in C5-6 and C6-7 minimally impressing upton ventral subarachnoid space without canal stenosis or foraminal compromise.... and right cerebellar low-lying tonsil 5mm below the foramen magnum with no mass-effect upon the brain.

For the past 4 months, I've been experiencing joint pain, GERD, swallowing difficulty, feeling like there's a golf ball in my throat and chest, sleep apnea (suspected by ENT), eye pain, dizziness, extreme fatigue, mental fogginess, mild balance problems & clumsiness. Swallowing & "golf balls" getting worse by the day (while not painful, the "golf balls" are the most unpleasant feeling I've ever experienced...had a couple of choking episodes...Prevacid isn't helping).

Gastro doc ordered blood tests: RF, ANA, ESR...ANA negative, ESR normal, but RF is high (normal range 0-20...my score is 69). Scheduled for upper GI scope next week, referred to rheumatologist (I"ll see him for the first time the day after the scope), and a sleep study. Could be lupus, rheumatoid arthritis, MS...

I've read that MS and symptoms related to Chiari Malformation overlap and can lead to misdiagnosis; I've also read that lumbar puncture is contraindicated for anyone with Chiari Malformation.

Questions:
Is 5mm low-lying tonsil considered "borderline" Chiari, or does it all depend on who's looking at the report?
Can MS and Chiari Malformation coexist?
If the rheumatologists suspects MS and wants to test CSF, would it be wise to ask for a neurology referral/consult first?

Thank you so much for your time; I think it's so wonderful that you guys generously donate your time!
Ezzi

[MG (Admin)]

Thanks for your question....have you had a full neurological examination?
If not then this should certainly be done.

I am not sure why the diagnosis of MS was mentioned here unless something was found on examination to indicate an abnormality in the nervous system...nothing you have mentioned so far would make me think of MS as a likely diagnosis.

Have you had an MRI of the brain?

looking forward to hearing from you.

[ezziboo]

No mention of MS from my doctors...1st visit with rheumatologist yesterday...I definitely have RA, possibly other autoimmune disorders...liver function test results forthcoming. I've read that certain autoimmune disorders are a bugger to diagnose, MS being one of them.

I am worried about MS because I've been experiencing some numbness (top of right arm & top of right foot) and weird leg stuff (cannot stand up from a squatting position without assistance...by the way, I'm tough-stuff...love to do yardwork, heavy-duty landscaping...haven't been able to lately) for the past few weeks..., and major problems with "fogginess" and fatigue...I'm having an awful lot of trouble finding words to express myself, which is out of the ordinary for me. However, I readily admit to being prone to paranoia and freaking-out Anything that could have a possible brain connection concerns me because my oldest brother, age 53, is very close to succumbing to Glioblastoma Multiforme (had a frontal lobe glioma 30 years ago....recurred 8 years ago...massive growth and neurological decompensation since 01/08...only a matter of time now).

But, I've read that RA and other autoimmune disorders (other than MS) can certainly lead to some funky symptoms...

I have never had a brain MRI...only cervical spine MRI.
Also had EGD procedure 2 days ago...doc took 9 biopsies...that certainly has me a bit worried.

Would I seem ridiculously hysterical to ask my doc for a neuro consult? Thank you again

[MG (Admin)]

First of all..I would mention that GBM is not usually hereditary, so there is no reason to think you are at higher risk than anyone else , although I can understand that psychologically it adds a bit of worry.

In terms of asking for a neuro consult, well that depends on how comfortable your GP feels with regards to neurology. If they can confidently perform a full and detailed neurological exam and find no abnormality then this should suffice. If they are not confident in neurology or the exam is not normal then a neurology consult is definitely warranted.

Please let us know how it goes with the GP.

all the best

[ezziboo]

Thank you very much, MG!

I should have the biopsy results from the EGD procedure by Tuesday...keeping fingers and toes crossed.

In the course of researching autoimmune disorders relative to gastric problems, I've learned that autoimmune gastritis can lead to demylination ( ) and neurological problems associated with it ( )...hmmmmm...

I'll definitely keep you posted...again, thank you!

[clinicalguru3]

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