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Neurology (Expert Forum)
Strange neurological symptoms
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Strange neurological symptoms
by abcsoup, Jan 28, 2006 12:00AM
I'm a 32 yr.old female, and about 3 weeks ago I began experiencing tingling in my feet, legs, back, left arm and face, along with muscle twitches. Then I had sensations of someone putting a freezing bag of ice on different parts of my body, mostly thighs and soles of my feet. I am also experiencing pain in my left upper arm, and sometimes forearm. I have a very difficult time sleeping due to this pain because my upper arms just ache when I lay on them. It is mostly my left arm, but now it's in my right arm as well, just not as much. My arms also experience "perceived weakness"...it's almost like someone is under my skin tickling my muscles, and it is very uncomfortable. However, my neurologist noted a normal clinical exam last week and started me on Neurontin. He said that since my brain MRI was negative in April 2005, there is no need to repeat it. He doesn't believe this is MS. I have had the tingling and twitches come and go ever since 1997, but the arm pain, neuropathy and weakness are all new. I see an orthopedic surgeon next week about my arms. I had routine bloodwork in October 2005, so they are not doing labs. I have Graves disease, but this is under control. Any ideas what this could be or where I should go from here? I know my body, and I know something is not right.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jan 31, 2006 12:00AM
I cannot give a clinical diagnosis over the internet unforutately, so my advice is purely educational
There does not seem to be a single area in the neuroligical system responsible for your symptoms. MS can affect multiple sites in teh nervous system over time, but rarely over a 3 week period, and rarely just sensory symptoms in isolation. As you have just had these symptoms for under a month, there is no indication for a diagnosis of MS (recurrent events affecting differing parts of the nervous system by MRI/examination over time)
A more systemic non-neurological disorder could be investigated such as hormone related disorders (thyroid, calcium, etc) or electrolytes. Your symptoms coud fit with hyperthyroidism so make sure your Graves disease is not a factor in this. After a viral (or some other infectious organisms like mycoplasma) illness one can see similar symptoms, that usually peak at 2-4 weeks and then subside. Some of these are called 'variants of Guillan barre syndrome' a term for a viral initiaited immune system affecting the peripheral nerves. Sometimes a spinal fluid analysis can be revealing.
I dont knwo why you had an MRI scan a year ago, so there is obviously more to your story, your neurologist should be the best person to piece your full history, exam, and tests together for a diagnosis. Up to 30% of sensory 'neuropathies' remain undiagnosed and they are just treated symptomatically as in your case. Time will tell if it is progressive or whether it will resolve like I mention above.
There are also some blood tests that can provide a 'screen; for various but rare sensory neuroapthies like sjogrens (an autoimmune disease increased in patients with GRaves), diabetes, Lyme, HIV, monoclonal antibodies among others - ask your neurologist if these are appropriate.
Good luck
There does not seem to be a single area in the neuroligical system responsible for your symptoms. MS can affect multiple sites in teh nervous system over time, but rarely over a 3 week period, and rarely just sensory symptoms in isolation. As you have just had these symptoms for under a month, there is no indication for a diagnosis of MS (recurrent events affecting differing parts of the nervous system by MRI/examination over time)
A more systemic non-neurological disorder could be investigated such as hormone related disorders (thyroid, calcium, etc) or electrolytes. Your symptoms coud fit with hyperthyroidism so make sure your Graves disease is not a factor in this. After a viral (or some other infectious organisms like mycoplasma) illness one can see similar symptoms, that usually peak at 2-4 weeks and then subside. Some of these are called 'variants of Guillan barre syndrome' a term for a viral initiaited immune system affecting the peripheral nerves. Sometimes a spinal fluid analysis can be revealing.
I dont knwo why you had an MRI scan a year ago, so there is obviously more to your story, your neurologist should be the best person to piece your full history, exam, and tests together for a diagnosis. Up to 30% of sensory 'neuropathies' remain undiagnosed and they are just treated symptomatically as in your case. Time will tell if it is progressive or whether it will resolve like I mention above.
There are also some blood tests that can provide a 'screen; for various but rare sensory neuroapthies like sjogrens (an autoimmune disease increased in patients with GRaves), diabetes, Lyme, HIV, monoclonal antibodies among others - ask your neurologist if these are appropriate.
Good luck
Have you had your heart checked out (even though it doesn't sound like your heart, but one has to wonder with left arm pain and tingling sensations...). I hope you get better.
No, I am not taking any vitamins or herbal supplements. I was tested for Lyme's a few years ago and the results were normal. I have not had an EMG done, as I have only had MRI's (last one in April 2005) and they have been normal.