extremely painful tingling and burning of the upper legs

My wife came home tonight in extreme pain, and she is a woman who can normally tolerate pain (while pregnant, she had a molar pulled without the aid of any painkillers), but not this time! The pain started out first as a tingling or "falling asleep" of the upper back thighs, while she was sitting. It progressed to an extremely painful burning sensation that traveled all the way down to her toes. This lasted about one hour, then it subsided. This has never happened before! During this period, she took an Ibuprofin and I massaged the backs of her legs. Now all that remains, three hours later, is a tingling sensation in her legs. She sufferes from frequent bouts with extremely low blood sugar. She has passed out on a couple of occasions when she is unable to catch the drop in time and drink something sweet. At nights, she often has problems with her hands and arms "falling asleep" and becoming painful. Could this be a related to what she is going through now? She has been tested for diabetes and the results were negative. She is thirty eight years old, in good health, petite, slim, and active. She does not smoke or drink. At the age of eighteen she fell about 20 feet breaking her pelvis and wrist. Her mother died from cancer at an early age, and her father, at the age of seventy was diagnosed with and is suffering from Diabetes. We have been to different Doctors many times for this, but they have been unable to diagnose the problem. We are desperate! Do you have any suggestions?

[Kevin Pho, MD]

Hello - thanks for asking your question.

Without examining your wife, it is impossible to say exactly what is going on.  Especially if you have seen many doctors in the past, please understand my limitations over the internet.  Here are some possibilities.

There are many, many causes for nerve pain.  A short list includes electrolyte abnormalities, infection, a variety of neurologic diseases (i.e. myesthenia, Guillen-Barre, ALS etc.), and nerve compression.  

To start with the diagnosis, I would pursue a referral to a neurologist.  A comprehensive neurological exam can narrow down the causes.

Laboratory tests would include electrodiagnostic testing such as electromyography and nerve conduction studies.  Blood tests for electrolytes, thyroid function, ANA level, erythrocyte sedimentation rate (ANA and ESR levels looking for any rheumatological causes), serum protein electrophoresis (SPEP), and B12 may also be considered.  

Based on what is found, your personal physician may also consider either muscle or nerve biopsy if the tests above are non-revealing.  

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[der]

Hi

I am gradmother is getting heat treatment which is called the PUVA for her poriasis. She has been getting this treatment now for a good few weeks. However she has now stopped the treatmnent cause she has a tingling sensation similar to a electric shock in her thighs.