December 24, 2002
Diagnosis and Symptoms
Question from Illinois, USA:
My 11 year old son is has been seeing floaters, flashing bright lights, and he says he sees lightness and darkness. He also has blurry vision. He has lost his vision twice, and he says it is like a black curtain comes over his eyes. He also feels dizzy and sometimes feels like he is going to pass out. He has problems with constipation. He said he has numbness and tingling in his legs and arms, and sometimes he has burning and pain with this as well. He has headaches and complains that when he eats it feels like the food doesn’t go down; it feels like it is stuck in his throat. He does have chest pain sometimes as well as heartburn. I almost forgot, he also has muscle twitching and restless leg syndrome really bad at bedtime. MRI, CAT scan, and an EEG — all of which were normal — and a blood test for lupus was normal as well. We have been told that these can be symptoms of MS or diabetes and that MS doesn’t always show up in MRI’s unless you have had one with contrast or sometimes it doesn’t show up unless you have a spinal tap. I wonder what problem my son has.
I have an aunt with MS. I also have a cousin who died at 26 with MS. I have diabetes, and we have a strong family history of it. My son’s hemoglobin A1c and two-hour blood glucose are normal. However, we have checked my son’s sugar levels with my monitor, and he has had readings anywhere from 47-197 mg/dl [2.6-10.9 mmol/L]. Can a person have diabetes with normal testing come back normal but not have normal readings at home?
We have seen our family doctor, two neurologists and an ophthalmologist, but nobody seems to be able to answer my questions. We can’t even see a pediatric endocrinologist because you have to have abnormal blood glucose test first. What do you think? Do you think my son has diabetes or MS. They say it is not only an adult disease but that that 20,000 children in the US have it. I would appreciate any input that you may have since it would be really nice to get some answers. I am very worried that it may be MS instead of diabetes.
Answer:
Wow! What a long list of problems and concerns. You asked if we think your son has diabetes. By definition, diabetes is present if the fasting glucose (drawn from a vein and run in the laboratory) is greater than 125 mg/dl [6.9 mmol/L] or, if the classic symptoms of diabetes are present, if the random glucose is greater the 200 mg/dl [mmol/L] on two separate occasions, or if a formal, properly done oral glucose tolerance test has a glucose level greater than 200 mg/dl [11.1 mmol/L] at the two-hour mark. If your child truly had a normal glucose, then I am confident that he does not have diabetes today. He certainly may be at risk given the strong family history.
Could the myriad of other problems be related to multiple sclerosis (MS)? I don’t know, but that diagnosis is indeed extraordinarily rare in a prepubertal boy! A neurologist should be able to guide you better on that point.
Perhaps these are all physical symptom manifestations of an underlying emotional issues such as anxiety disorder? Given your worries and the family issues, maybe your child is having reactionary symptoms [like the stories you’ve heard of husbands getting pains when their wives are in labor:-) ]. A visit with a child psychiatrist in conjunction with the neurologist may be appropriate.
DS
