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Neurology (Expert Forum)
Numbness associated with MS
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Numbness associated with MS
by cleorae, Jan 03, 2007 12:00AM
I began experiencing numbness in my entire arm or hand that was unlike anything I have ever felt before. The numbness is complete, and usually runs from the shoulder right down to the tips of my fingers, but only happens while I am sleeping. I was wondering if this is 'typical' of MS numbness? I know MS symptoms tend to appear, and then go back into remission, which is true with my numbness in my arms. For months I had no nightime wakings with my arms fully numb, but they just recently started again. Within a minute or two of waking they are no longer numb and I am able to fall asleep again. I am also getting all over body twitches, but these have been persistent, sometimes there are more of them and they are more obvious, but these happen day or night and any place on my body. I am just wondering if the numbness that is a sign of MS would be present for a period of time (such as days or weeks) before disappearing. I can't understand why the numbness only happens at night. I was given a lumbar, cervical and brain MRI with contrast when I first began experiencing the night numbness, and everything looked fine, but I also know that it MS is in it's early stages it doesn't always show up on a MRI. Any insight you might be able to offer would be appreciated. Thank you for your time.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jan 25, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms that you describe sound the most like carpal tunnel syndrome or a possible peripheral nerve entrapment at another site along the arm. Carpal tunnel syndrome is caused by compression of the median nerve at the wrist and classically causes night time wrist/ and even sometimes whole arm numbness/pain. This is thought to be related to repetative stress injury, but also has other factors ivolved such as the size of your canal etc. For this I would suggest that you have an EMG (Nerve-Muscle test) with nerve conduction studies(NCS) to evaluate for signs of carpal tunnel. The first line of treatment is to obtain wrist splints that are worn at night which help by maintaining the wrist in a striaght position. Multiple sclerosis(MS) does not present this way. MS presents with focal numbness, optic neuritis, and/or dizziness/imbalance, etc, that lasts for several weeks then improves. It is not correct that MS does 'not show up on MRI in the early stages'. Most patients with MS have multiple lesions on their first MRI, after presenting with their first symptom (the reason is, that much of the brain does not give rise to symptoms when a lesion is present and only "eloquent" areas give rise to symptoms, thus many lesions are silent clinically). When patients are very concerned about MS we suggest more testing, ie adding an MRI of the cervical spine, SSEPs and lumbar punctures to obtain more evidence. The twitches that you describe have the characteristics of benign fasiculations and should not give rise to concern in the absence of weakness and atrophy of the muscles. Your EMG will help with this diagnosis as well.
I hope this has been helpful.
The symptoms that you describe sound the most like carpal tunnel syndrome or a possible peripheral nerve entrapment at another site along the arm. Carpal tunnel syndrome is caused by compression of the median nerve at the wrist and classically causes night time wrist/ and even sometimes whole arm numbness/pain. This is thought to be related to repetative stress injury, but also has other factors ivolved such as the size of your canal etc. For this I would suggest that you have an EMG (Nerve-Muscle test) with nerve conduction studies(NCS) to evaluate for signs of carpal tunnel. The first line of treatment is to obtain wrist splints that are worn at night which help by maintaining the wrist in a striaght position. Multiple sclerosis(MS) does not present this way. MS presents with focal numbness, optic neuritis, and/or dizziness/imbalance, etc, that lasts for several weeks then improves. It is not correct that MS does 'not show up on MRI in the early stages'. Most patients with MS have multiple lesions on their first MRI, after presenting with their first symptom (the reason is, that much of the brain does not give rise to symptoms when a lesion is present and only "eloquent" areas give rise to symptoms, thus many lesions are silent clinically). When patients are very concerned about MS we suggest more testing, ie adding an MRI of the cervical spine, SSEPs and lumbar punctures to obtain more evidence. The twitches that you describe have the characteristics of benign fasiculations and should not give rise to concern in the absence of weakness and atrophy of the muscles. Your EMG will help with this diagnosis as well.
I hope this has been helpful.
My response is not professional advice or meant to be taken as medical advice.
With that said: With the variables presented MS seems unlikely. The problem with numbness, as aforementioned, is a constant problem involving sleeping positions, tension, and the b.plexus. Other factors could be considered and clinical correlation is mandatory for deeper insight.
The twitches too are variable and non-specific. I am seeing more and more that unexplained benign neurological interuptions are commonly a result of stress (Neuropsychology) and sleep issues.
MS symptoms do not appear for a few hours and then go away but rather an attack, lasting weeks to months, and then relpase. Or to the contrary, for some, steady progression. If it has been several months since your last set of MRI/s and new and/or symptoms have become impressed. See a neurologist.
I hope that I have been helpful.
Good Luck!
JCmcc.
I too have had the same night numbness at times on and off in the past. I am still in limboland with no diagnosis.
I had what you describe twice badly - once in my left leg that lasted a couple of hours when I was in bed and the last time was my left arm, which is as you describe. This particular incident it took about 3-4 hours for it to subside completely. My alarm clock went off that morning, laying on my stomach and my alarm clock went off, went to turn it off with my right arm and did not realize my left arm was completely dead numb at which point I fell out of bed luckily not breaking anything.
I know this is a forum where some people will say it is not this, not that and some say MS does not cause these things, BUT everybody with MS or any other disease affecting the neurological system will have different symptoms and NOT all are the same. For example, the words "relapsing and remitting" means exactly that and "waxing and weaning".
It upsets me that when you, I or anybody are looking for answers, we get comments negating symptoms in which they should not.
My physician said it is the brain that is not firing the neurons to tell your body what to do etc.
You and only you know your own body, and are looking for a medical doctor's help on this forum as have I been. I know for myself that my severe night numbness IS NOT sleeping positions of the neck or spine, and particularly not psychological. IT IS REAL...
Just keep your head up and fight for the true answers your looking for......
terri
Please be aware that I am not responding to you as a physician and that my statements are conversational, educational, and are not to be taken as diagnosis, advice, or as professional.
With that said, let us take a look. I am also 28 and I know that it is horrid to deal with this in your youthful years.
There are many variables that I do not know. Your sex, your geographical location, pathology, et al. Therefore I am looking simply at what you told me.
As you may know there are a plethora of smaller, less common, or even larger conditions that can cause this sort of lateral neuritis that you are experiencing. The 30 day cycle would have made me suspicious of the sad condition of Multiple Sclerosis. However, with clear MRI