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Neurology (Expert Forum)
Burning and Partial Numbness
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Burning and Partial Numbness
by John, Apr 21, 2000 12:00AM
I'm a 45 year old male, and until 6 months ago in good health. At that time I began experiencing numbness and burning in a small area (about 2" in diameter) on my right thigh. Approximately one week after the burning in my thigh showed up I began having stamina and what seemed like equilibrium difficulties. I could get a good night's rest and an hour or so later I felt like the gravity had been turned up several percentage points. I generally felt like my body was collapsing in on itself. Going up stairs was a slow process and I didn't feel too stable. I did not have any headaches of fever during this time, did not have an accident, and wasn't knowingly exposed to any toxins or chemicals. The only other neurological problem that I've experienced was Bell's Palsy in the right side of my face nearly 20 years ago.
I saw my GP after the first month. He did some basic blood tests, including, CPK, thyroid and blood sugar. All results were normal. Two weeks later I was still feeling lousy, the burning in my thigh was expanding, and I was starting to get some burning in my right foot and the right corner of my mouth. My GP referred me to a neurologist and after a 3-week wait before I could schedule a visit my malaise subsided and I felt that the burning and slight numbness in my cheek might have been diminishing.
The neurologist conducted a basic exam and did an EMG on my right leg with normal results. He suggested a CT scan and more blood tests. All were normal. After a couple of weeks the burning and numbness expanded to other areas of my body. A MRI of my head was ordered as well as a B-12 and Lymes test. At that time, I was also placed on 900 mg/day of Neurontin. The blood tests were normal, as was the MRI.
The burning and numbness have continued to spread and are starting to effect my job where I need to do quite a bit of walking and driving. My dosage of Neurontin is now up to 2400 mg/day. I have a partial loss of sensation (I still can feel a pin or a cotton ball) in my checks, lips, forehead, and scalp, everything from my waist down, forearms and just last week my fingers started to lose some feeling. I have good days and bad days with my level and locations of pain. Occasionally my knees and hips ache so bad that it is difficult to walk, the burning in my feet reaches a level that it becomes hard to work the accelerator, brake and clutch. In some locations like my fingers, I never have had any burning, just loss of sensitivity. My motor nerves still seem to be working ok although, as the partial numbness moved into my hands, my ring and little fingers feel like they are swollen (as my lips frequently do) and it seems like they just don't want to work quite right. Although better, my stamina may be only 50 to 75% of what it was before this started.
Next week I am scheduled to have a lumbar puncture. While the analysis of the spinal fluid may reveal what is going on in my case, I seem to recall from a previous search of the archives someone with similar conditions. However, I don’t recall if a cause or remedy was mentioned and I haven’t been able to find the posting again.
Do you have any comments on my symptoms that may provide me some insight as well as discussion items for my Dr.?
Thanks for any information
John
I saw my GP after the first month. He did some basic blood tests, including, CPK, thyroid and blood sugar. All results were normal. Two weeks later I was still feeling lousy, the burning in my thigh was expanding, and I was starting to get some burning in my right foot and the right corner of my mouth. My GP referred me to a neurologist and after a 3-week wait before I could schedule a visit my malaise subsided and I felt that the burning and slight numbness in my cheek might have been diminishing.
The neurologist conducted a basic exam and did an EMG on my right leg with normal results. He suggested a CT scan and more blood tests. All were normal. After a couple of weeks the burning and numbness expanded to other areas of my body. A MRI of my head was ordered as well as a B-12 and Lymes test. At that time, I was also placed on 900 mg/day of Neurontin. The blood tests were normal, as was the MRI.
The burning and numbness have continued to spread and are starting to effect my job where I need to do quite a bit of walking and driving. My dosage of Neurontin is now up to 2400 mg/day. I have a partial loss of sensation (I still can feel a pin or a cotton ball) in my checks, lips, forehead, and scalp, everything from my waist down, forearms and just last week my fingers started to lose some feeling. I have good days and bad days with my level and locations of pain. Occasionally my knees and hips ache so bad that it is difficult to walk, the burning in my feet reaches a level that it becomes hard to work the accelerator, brake and clutch. In some locations like my fingers, I never have had any burning, just loss of sensitivity. My motor nerves still seem to be working ok although, as the partial numbness moved into my hands, my ring and little fingers feel like they are swollen (as my lips frequently do) and it seems like they just don't want to work quite right. Although better, my stamina may be only 50 to 75% of what it was before this started.
Next week I am scheduled to have a lumbar puncture. While the analysis of the spinal fluid may reveal what is going on in my case, I seem to recall from a previous search of the archives someone with similar conditions. However, I don’t recall if a cause or remedy was mentioned and I haven’t been able to find the posting again.
Do you have any comments on my symptoms that may provide me some insight as well as discussion items for my Dr.?
Thanks for any information
John
Doctor's Answer
by CCF Neuro[P] MD, RPS, Apr 21, 2000 12:00AM
Dear John:
I am alittle stumped at your symptoms. Everything seems normal and with the normal EMG study it seems that there is not an usual etiology to your problem. I would have suspected vitamin B12 with your symptoms. Even with a normal B12 level we have seen this be the problem, but usually the demyelination of the large sensory fibers will be detected on the EMG study. At least with the normal studies one can rule out the real major worrisome problems like ALS, tumor, paraneoplastic, diabetes, alcoholism, porphoria, hereditary sensory neuropathies, mitochondria cytopathies, toxins etc. See what the CSF turns up, but I will bet that it too will be normal. I am not sure what is causing your sensory neuropathy, with a normal EMG study. It will have to be something small fiber but as what the etiology is I am unsure.
Sorry, that I am not much of a help. Let us know what your physician thinks.
CCF Neuro MD
I am alittle stumped at your symptoms. Everything seems normal and with the normal EMG study it seems that there is not an usual etiology to your problem. I would have suspected vitamin B12 with your symptoms. Even with a normal B12 level we have seen this be the problem, but usually the demyelination of the large sensory fibers will be detected on the EMG study. At least with the normal studies one can rule out the real major worrisome problems like ALS, tumor, paraneoplastic, diabetes, alcoholism, porphoria, hereditary sensory neuropathies, mitochondria cytopathies, toxins etc. See what the CSF turns up, but I will bet that it too will be normal. I am not sure what is causing your sensory neuropathy, with a normal EMG study. It will have to be something small fiber but as what the etiology is I am unsure.
Sorry, that I am not much of a help. Let us know what your physician thinks.
CCF Neuro MD
Thanks for your comments. I'm sorry to hear about your wife. The pain does tend to wear on a person. If the 2400 mg/day of Neurontin is doing me any good, I shudder to think what it would be like without it.
I definitely would like to read your posting and any replies. What was your title and the date so I can find it in the archives?
Best of luck to you. Perhaps we'll correspond again. If I find out anything from my puncture, I'll let you know.
I have a schwanoma (benign tumor) on the nerve that is between fourth and fifth lumbar. It was found about 5 years ago and has not grown (MRI each year). The doctors say it would not cause the pain but I'm not sure. I was interested if anyone reading this has or had this same tumor in the same place and if it has caused pain and what type of pain. If you have had surgery, what was the result. Specifically, was there nerve damage?
Sorry to tag along on your posting, John, but I too cannot post a new question.
This is a great site.
With my wife the Dr seemed to think it was not MS because of the continued progression, sudden onset, continuious symptoms..with no past history of any complaints or problems. Who knows though, she had the VEP test and somatosensory on Friday, are those the ones you said above were abmornal? We get her results soon and then if its abnormal a CSF. The testing person was very tight lipped, and when I asked her well is anything abnormal she just said well... I really cannot say these tests are very sensetive. And she then showed me the chart, like a brain wave thing.. I am just wonderinf what someone with MS in the spine's chart would look like? I know they measure the time it takes for the charge to reach certain points in the spine.. heck Im no good at speculating, but it will be 3 days of sheer hell untill we get the resutls.. I do recall her saying you were more tense when we did this side.. whatever that means. Also with the VEP I saw a dip on one of the waves, but she said when you see the dip towards the end of the exam something is seriously wrong.. my wifes dip was in the beginning.. I'll let ya all know. Thanks everyone!