1. 50, male 2. 170/80, not much excess fat,

Question

1. 50, male 2. 170/80, not much excess fat,

just body type and muscles
3. Procrastination😊
4. Business in better times of my life, some stupid mental and physical work now, cannot stand too long (pronounced muscle discomfort, the veins are not painful)
5. No known hereditary diseases. Cancer: stomach, lung and liver in relatives; dad had diabetes, high blood pressure, heart failure and atherosclerosis (surprisingly, I do not have these), my granddad (father of mum) had leg problems in the 80s (the official diagnosis was obliterating endarteritis, maybe the diagnosis was wrong and I inherited the problems with my legs from him)
6. Only neurological problems. Also, I have my nose turbinates cut every 5-10 years
7. Baclofen 25+25 to reduce spasticity and unpleasant muscle pains in thighs and legs, l-dopa 200+200 to increase the range and speed of motion in legs, clonazepam 2 nightly to reduce hyperekplexia. No allergies.
8. The problems started in 2005 with right-side atypical parkinsonism features that were misdiagnosed as “functional”. Then numbness slowly developed in the right foot starting from 2012. In 2016 spasticity-like problems started to develop: e.g. I could not run fast as I was able before and I started having problems running down the stairs. In 2021 my gait problems became pronounced, the diagnosis was sensory ataxia (an alternative diagnosis was cerebellar ataxia, but I and other doctors do not see pure cerebellar signs and symptoms, in addition, Romberg test is definitely positive). Brain and spine MRI were normal, nerve conduction studies showed no demyelination, but some decrease in amplitude in certain leg nerves. Autumn 2021 added excessive startle response, responsive to clonazepam. Sometimes I also had breathing problems (Kussmaul-like), coupled with high lactate, in no way resembling panic attack or any other F disorder, responsive to several days of intramuscular B1.
9. Mentally sound, two shrinks that I happen to know, do not consider me as their patient and attribute everything to neurology.
10. Neuroborreliosis inconclusive, neurosyphilis excluded, liquor protein 78, vibration and proprioception sensation impaired/lost in both legs, brain and spinal MRI look normal (the cerebellum might seem a little shrunk, but again: no pure cerebellar signs and symptoms). Sadly, there are not many CSF tests in Russia.
11. Any ideas with possible diagnosis: I see issues with both pyramidal and extrapyramidal systems as as as well as with cuneatus gracilis and with brainstem: hyperekplexia. My opinion is that it is a forme fruste of either bacterial, autoimmune or neurodegenerative disorder. What can cause so many lesions in so many systems not visible on MRI? Neuroborreliosis (not sensitive enough to blood and CSF tests), some forme fruste of an autoimmune process or some kind or neurodegeneration that I cannot find examples of neither in Adams and Victor, Bradley, DeJong or scientific articles? Hopefully, I will be able to resume my investigations in June.
12. Near Moscow

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18.05.2023

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Anton Loboda · Accepted Answer

Anton Loboda

конверсионка вульгарис

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19.05.2023

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1. 50, male 2. 170/80, not much excess fat,

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