Is it time to rule out MS or should I pursue more tests?

You have kindly answered one other post , so I am hoping you can help me one more time. I am a 39 year old woman who has been experiencing tingling, numbness and color/temp changes in my hands and feet for the last 9 months.  I have had almost all the tests for MS - brain MRI, evoked potentials, several clinical exams  - all normal. I just got the results for a cervical MRI yesterday - normal. I am so relieved, but also am perplexed. I have had every blood test- ANA, lupus, diabetes, mixed connective tissue disease, Sjorgrens's, RA, etc. - all totally normal,. The only thing I know that I do have is two small thyroid nodules .I am on synthroid to suppress them, and my THS is normal.
The rheumatologist DX'ed me with primary Raynauds, and seemed to be very dismissive of me. She did prescribe a calcium channel blocker to help with the vasodilation. However, she says that the Raynauds would not explain the tingling/buzzing/pin ***** sensations.

On the other hand, my neuro now feels that without clinical evidence, and with normal EP's, brain and cervical MRI's, MS is completely ruled out.  I do not, and have not had ON, gait disturbance, or any other MS-like problem.

My question to you is....should I still press for a spinal tap or a lumbar MRI ? I know the neuro is becoming exasperated at my request for tests. In your opinion, can I completely rule out MS in my mind, and what other causes should I pursue? I feel relieved yet in limbo.
One last question- are these symptoms suggestive of a mitochondrial disease or could anxiety over the THOUGHT of MS produce these sensations?

Thank you agan for your inout. I apprecite this forum and your work tremendously.

[CCF Neuro[P] MD, RPS]

Dear Ellen:

I would not do a lumbar MRI as your symptoms are in the upper extremities which should make the lesion in the cervical region.  It is good that all your testing has been negative as most of the really worrisome things can be eliminated at this point in time.  With what you describe I would feel that MS would be unlikely.  In mitochondrial disease, we have seen numbness in the extremities but in most cases we see something else, such as muscle fatigue, cramping, autonomic dysfunction, GI problems, mental changes, etc.  I would not think that you have a mitochondrial disease.  Raynauds is a good possibility but I would agree that you do not have the usual case, there is usually no paresthesias such as tingling etc.  Thyroid problems can give neuropathies, but you say that you are in good control, so I would not think this is the problem.  Anxiety could add symptoms to the Raynauds and be a cause of numbness and tingling.  

I guess I would just kind of follow your symptoms.  See if they worsen or change in character to suggest a specific disease.  I hope it is just anxiety.

Sincerely,

CCF Neuro MD

[ellenc]

Thank you for your reply. If I ever win the lottery I will make a donation to this forum! Regards, Ellen C.

[goodgal31]

Hi Ellen,

Wow I to have the blue feet episodes, but not the hands.  I get buzzing, numbness and tingling, also in my face the numbness.. strange things.  I saw the most fantastic Dr here at the Clev clinic who ruled out MS basically and attributed it to anxiety.  Well I do feel much better but I have muscle twitchess all the time and was put on Paxil but unfortunatly I had bruising on it and had to stop.  To make a long story short the paxil took all my symptoms away excluding the blueness, so I guess anxiety was a big player, I have had a lupus ANA test also which was normal.  I think that some things just go unanswered so we wait to see if it progresses.  If you ever want to email me @ ***@**** we can discuss our blue feet ;)  Also share some of our similair problems.  Take care.

[ellenc]

Gina, thanks...I will do so !

[Kathy]

Hi Ellen,

I have tingling in my face and right arm and leg.  After some of the same fears and tests that you have been through, I too have no answers.  I have recently found that women with low estrogen levels experience the same condition!  How simple.  I did have an early start with menopause.  I am going to get my estrogen levels checked.  Have you?

Kathy

[ellenc]

No, it never even entered my mind. My Mom went through menopause early...how do you have your estrogen level checked? I take birth control pills - would that affect the level, or give a false level? I REALLY appreciate your input...Ellen
PS Gina,I have not forgotton to e-mail to you , only just got back from vacation! :)

[goodgal31]

Ineressting on the estrogen levels... seems after I had my baby this all began.  And now my period is all messed up, they tell me not from the anti-depressant given.. who knows, this is very very odd!  But now that I have heard about the estrogen, i am going to keep my eye out on it.  I think I had a hormone panel that was normal, is it called an fsh?   Anyhow also heard soy milk has high estrogen, maybe help?  ELLEN EMAIL ME!!!! :)  WE can discuss the blue feet episodes, im glad im not alone!

Gina

[Barbara]

I have been having similar problems too!  Don't accept a diagnosis of anxiety too quickly... There are too many problems that exist and Doctors often use "ANXIETY OR DEPRESSION" as a copout!  My suggestion is keep on riding the doctors to research, after all that is why we have insurance....