### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi I have been seeing a neurologist for 15 months. It started with me having severe pain in my legs (spasticity). Had MRI and found a few lesions on my brain. Neurologist was 95 percent sure MS. Had spinal tap (Negative). B-12 was 344 when symptoms was occuring. Symptoms started improving b-12 dropped to 179. Had symptoms on and off for months. Balance is still messed up. Had more MRI s in May. Have cervical stenosis and cervical spondylosis. EMG was good. Had VEP and no results yet. During VEP lost visual a couple times in left eye in right eye screen went completely white a few times. Having major symptoms from neck: numbness in arms, back and neck. Shooting pain down arms, pain in legs and back. left arm feels heavy at times like I cant lift it. Legs are very heavy after work (I am a correctional officer) Just been told I have osteoarthrits in hands. Have necrosis in left knee)

### output:

Hi, Causes of your difficulties may be neuropathy or ischemic tissues. Neuropathic are seen in diabetics or injury of spine nerves. If this is not your case then these symptoms are indicating circulatory problems in legs which are common in this age and there may be present atherosclerosis that obstructs blood vessels and causes pain and blisters to form.  You should do Doppler ultrasound of the leg or CT angiography to rule out such obstructive changes, and then it can be treated properly by medications or by surgical and radiological procedures.  Also, you should have Aspirin and have elastic stockings applied and should avoid cold environment and long walks. In most cases, it can be managed with medications, but sometimes surgery may be required in severe cases. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.  Rammstein, General Surgeon