The symptoms of multiple sclerosis (MS) vary from person to person depending upon which parts of the brain or spinal cord (central nervous system) are damaged. The loss of myelin and scarring caused by MS can affect any part of the central nervous system.
Symptoms may come and go or become more or less severe from day to day or, rarely, from hour to hour. Symptoms may become more severe with increased (or, less commonly, decreased) body temperature or after a viral infection. Symptoms of MS, such as stiffness, tremors, pain, and difficulty thinking clearly, are similar to those of many other conditions and do not necessarily mean you have MS.
From the symptoms you describe of tremors, and fatigue, he might possibly have MS. However,
Multiple Sclerosis Tremors
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Multiple Sclerosis: MS-Related Fatigue
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I have to commend you on your resourcefulness and intelligence in your detailed and caring description of his symptoms. From the symptoms you describe of tremors, and fatigue, he might possibly have MS. However; you also stated that he doesn't have visual problems or incontinence problems. These two symptoms are among the more common early symptoms. Therefore I doubt that he has MS.
Common early symptoms:
Visual symptoms, such as blurred, foggy, or hazy vision, eyeball pain (especially when you move your eyes), blindness, or double vision. Optic neuritis—sudden loss of vision that is often painful—is a fairly common first symptom, occurring in up to 25% of those who develop MS.
Bladder symptoms, such as an inability to hold urine (urinary incontinence) or to completely empty the bladder, or a loss of bladder sensation—an inability to sense that the bladder becoming full until there is a sudden, urgent need to urinate
Multiple sclerosis affects the brain and spinal cord. Early symptoms of multiple sclerosis include weakness, tingling, numbness, and blurred vision. Other possible warning signs are muscle stiffness, thinking problems, and urinary problems. A multiple sclerosis diagnosis is made by the history of symptoms and a neurological exam, often with the help of tests such as an MRI or a spinal tap. No one’s sure what causes multiple sclerosis, but it may be hereditary. There’s no cure for multiple sclerosis, but treatment can relieve worsening of symptoms.
You should convince your aunt to take your nephew to a Dr to check and rule out MS. and diagnose other possible neurological disorders such as Guillain-Barre';(GBS) Myasthenia Gravis( MG) Parkinson or even a cerebellar tumor; Lyme disease; and Lou Gehrig disease( ALS) . They all exhibit muscle weakness, tremors, and fatigue.
GBS may be a rare side-effect of influenza vaccines.Guillain–Barré, unlike disorders such as multiple sclerosis (MS) and Lou Gehrig's disease (ALS), is a peripheral nerve disorder and does not generally cause nerve damage to the brain or spinal cord.
In MG, it might be due to a tumor in the thymus gland.
The poor dear!! Early detection and treatment is impt to avoid complications!!! My grandson had GBS; and he became paralyzed on the left side. He looked like he had a stroke and he is only 6 yrs old. He was hospitalized in a children's hospital for 1 month and had to go to Rehab to regain his motor function. Thank God! He's okay now but needs to be observed in the next 3 yrs for a relapse.
I'm a CCRN and worked in intensive care units for many, many yrs and am familiar with all these debilitating diseases.
You also posted this same question in the Gen Health Care Section. I hope the different sites will help. But again, I stress that you should convince his mother to take him to a neurologist specialist for proper diagnosis. They need to do a battery of diagnostic tests.
http://www.webmd.com/multiple-sclerosis/default.htm
http://en.wikipedia.org/wiki/Guillain-Barre
http://www.ninds.nih.gov/disorders/myasthenia_gravis/detail_myasthenia_gravis.htm
http://www.neurologychannel.com/als/index.shtml
http://www.medicinenet.com/parkinsons_disease/article.htm
http://www.mayoclinic.com/health/lyme-disease/DS00116
http://en.diagnosispro.com/differential_diagnosis-for/tremor/34747-154.html
It's true that his fatigue and muscle weakness might also be attributed to VitB12 deficiency. However, that's also accompanied by anemia and malabsorption condition. And again, other symptoms like burning of the tonque; color blindness aside from constipation, diarrhea and the like and numbness and tingling of the hands and feet. These symptoms you specifically pointed out are not among his ongoing and present symptoms.
It's also true that Drs don't have all the answers to every disease and illness and can make errors. After all they are also human! After all, medicine is not an exact science. However, they are more equipped to find out and seek the appropriate knowledge.
A physical assessment of your nephew; a keen observation of all his symptoms; history taking including his diet and activities; accompanied by intensive bloodwork and other diagnostic procedures and a complete follow up of progress or lack thereof. These are all extremely impt tools to get a clear picture of what's really wrong with him for a plan of care and treatment.
It's true the "pins and needles" sensation of the hands and feet are hallmark signs of MS. So again, I strongly stress the urgency to see the Dr and a neurologist for proper diagnosis and treatment. Peruse the site below for definitive symptoms of Vit B12 deficiency symptoms. You'll notice that truly, that deficiency is not a differential diagnosis to consider for his neurological problems. If he's deficient in this Vit and other minerals; ferritin level( Iron) and his blood count for anemia; I'm sure they will show up in his blood test.
http://www.evitamins.com/healthnotes.asp?ContentID=1287007