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Numbness
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Numbness

Hi, My daughter, age 24 has developed a condition that started with numbness in her right foot and if she sits for any length of time it travels up to her hip area.  She cannot lie on her right side or the numbness extends to her arm.  As she moves around the numbness changes to tingling.  She also chronically tired.  She did see a physician who ran a few basic neurological tests like the needle *****.  She told him she could not feel most of the pricks.  He told her she had an injured nerve and she needed to learn to either live with it or if she had surgery that within 10-12 years the built-up scar tissue would create the same problem but permanently.  I am VERY upset with his approach (I was a nurse for 20 years) and I will be driving back to Utah with her on the 31st of December for a short visit.  I will go to a doctor with her and I need to know what to tell the physician she needs.  I also ran some of my own balance tests and she could not close her eyes and keep her balance nor could she touch her right finger to her nose-it went went way beyond it-although she could touch her left finger to her nose. Seems she should have a complete neuro workup by a neurologist.  I HATE HMO's!  So, I'm sure she will have to fight to see a specialist but don't you thing she should!  JKay
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Avatar_n_tn
I can see how frustrating it must to be to have to fight for a specialist referral. But I agree with you, a young woman with focal neurological problems does need to see a neurologist and have a formal examination. There are a number of disease processes that your daughter's symptoms could represent, some benign and some more serious. But as a neurologist, we have to think about what is the worst thing that could be causing her symptoms, so that we don't miss anything that could potentially be treated. If her arm is truly affected, then it is not just a nerve in her leg that is causing the problem and surgery is not the answer. The diagnostic testing will depend on what the neurologist is able to find on her examination and get from her clinical history. If there are objective abnormalities of her leg and arm, then the next step would be an MRI of the brain or cervical spine. Routine blood testing should also be performed so that simple things such as anemia or B12 deficiency are not overlooked.  Talk to your primary care doc about getting a neuro referral for your daughter and that should get you off in the right direction. Best of luck.
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Avatar_n_tn
I understand what your daughter has been through.I do not have the balance problems, but some symptoms seem familiar. My story below,,
My story is similar, but I also have a Hx of back problems. For at least 10 years I have had low back problems, sciatica , facet syndrome .This flairs up if I twistwhile I am lifting/carrying
heavy objects. March 2000 I strained back lifting firewood. This took many months to feel like I recovered. July 2000 I did fall on
steps and landed on left side just left of spine on the floating rib. That knocked the wind out of me, but left no bruise and one
small scratch. I did not go to ER. I was sore for about a month.
About June 15, 2001 I noticed my back hurting when I would bend over the table to pick up a plate or a book. I had difficulty
getting up from a sitting position .When I carried anything it felt as if my low back was being compressed in the LS area and I had
much pain.
On June 30 2001 I was stooping to look at merchandise on a bottom shelf. Upon standing, I noticed my right foot was 'asleep'.
Not unusual for that to happen. The numbness persisted and spread to my calf, thigh, buttocks and waist in a mid sagittal location front to back right side. The muscles in the waist area at times seemed to spasm and when this happened, the numbness increased in intensity.
The time for the onset and full numbness to occur was less than 15 minutes. The short story is that although the numbness has
decreased in intensity , and the back pain is much less severe, it has persisted for nearly 6 months now. There have not been times that it has disappeared.
If I sit at my desk too long, my right buttock gets very numb, ankle feels like a tight band surrounds it, back of my right calf feels
tight and more numb .If I get up and move around or lie flat on my back, the numbness decreases in intensity.  SOmetimes walking short distancesgets the back and legs numbness and pain increased, sometimes I can walk long distances before this happens.
The little toe and side of foot is the most numb, and has never changed in its severity .
Examinations showed neither hypo nor hyper reflexes. Negative/normal for Rhomberg and Babinski.Heat does not make
symptoms worse but feels good on my sore back. RA latex neg, Sed rate =2.
I have not had visual disturbances .The Eye Doc checked out optic nerves like VERY thoroughly and reported pink healthy optic nerves .Visual field normal. I have not had coordination difficulties with the right leg, numbness appears to be skin only.
I can toe walk and heel walk with no problem .The leg has not felt weak but appears to be equally strong as left leg .I can feel hot and cold, although to a lesser degree with right leg. I have not stumbled or fallen or had drop-foot. At one point I did have sharp
pains behind my knee and joint in buttock area . When the muscles in waist area are not in spasms , the numbness is only slight . I do not have bowel or bladder difficulties.
in that area.
EMG was not remarkable .
MRI reports are :

L-S SPINE
Mild degen @ L5-S1 with no root impingement noted.

MRI CERVICAL SPINE WITH AND WITHOUT CONTRAST
CLINICAL. HISTORY : Pain. Myelopathy Multiplesclerosis
TECHNIQUE:
Sagittal TI, T2-weighted and inversion recovery technique was performed. An axial gradient-echo T2-weighted sequence was performed as well as an axial proton-density. Post-gadolinium TI-weighted sequences were. also performed.
FINDINGS:
The finding of note is demonstration of diffuse cervical spondylosis with degenerative changes at multiple levels,primarily C3-C4, C4-C5 arid C5-C6, There was some canal narrowing and cord abutment. The findings I believe are greatest at C4-C5, C5-C6 and C6-C. The cervical cord however, had a normal appearance with normal signal. Specifically, there were
no findings of abnormal increased signal or areas of enhancement that might suggest foci of myelitis or areas that might
suggest plaque,
IMPRESSION:
Moderato to diffuse cervical spondylosis with findings of possible mild acquired spinal stenosis, greatest
at C5-C6 and C6-C7.

MRI OF THORACIC SPINE WITHOUT AND WITH CONTRAST
Clinical HX: Pain, Myelopathy, Multiple Sclerosis
TECHNIQUE
Sagittal T1,T2-weighted and inversion recover sequences were performed along with an axial T1 and T2- weighted sequence.
A post-gadolinium T1-weighted sagittal and axial sequence was also performed.
FINDINGS:
Overall the examination was unremarkable. There is felt to be no abnormal signal from the vertebral bodies or the spinal
canal. There were changes of slight disc space narrowing, but no definite evidence of focal disc protrusion or cord abutment.
No other specific abnormalities were identified.
IMPRESSION: Negative.


HEAD MRI WITHOUT AND WITH CONTRAST 10/19/01
indication: persistent Numbness right side of body extending from waist to toes.
TECHNIQUE: flair, axial and sagittal acquisitions. T2 weighted turbo spin echo axial acquisition. Ti weighted spin echo acquisitions both prior to (Axial plane) and following (axial and coronal plane) uneventful iv administration of omniscan.
FINDINGS:
There are no comparison studies available for review at this institution. This patient has orthodontic braces on the maxillary
teeth. There is significant, associated susceptibility artifact primarily in the distribution of the middle cranial fossa. This
makes evaluation somewhat limited. On the flair and t2 weighted turbo spin echo images note is made of multiple, small foci of T2 prolongation within the cerebral white matter bilaterally. At lest ten or twelve small focal lesions are identified, none of which
show any significant associated mass effect and none of which show enhancement on the postcontrast images. Most of the
lesions are distributed in a peripheral, almost subcortical location. The appearance is nonspecific. There is one lesion that lies near the body of the corpus callosum on the right. The appearance of this lesion is more suspicious for the presence of a demyelinating process. However, the corpus callosum is otherwise noninvolved and no lesions are identified in the distribution of
the brain stem or middle cerebellar peduncles .Therefore, it is difficult to impart a diagnosis of multiple sclerosis for this patient.
There are no imaging findings to suggest recent or remote cerebral infarction.
Normal flow voids are noted in the major intracranial vascular structures.
The size and configuration of the ventricular system is within normal limits for stated age. The cortical sulci and cisternal
subarachnoid spaces appear normal. No focal brain stem or cerebellar lesion is identified.
IMPRESSION:
1. There is significant susceptibility artifact arising from the patient' s orthodontic braces. This makes assessment, particularly
in the middle and posterior cranial Fossa somewhat limited.
2. Several small foci of t2 prolongation are identified in the cerebral white matter as described. The appearance is nonspecific.
Such findings can be seen with multiple sclerosis, however, differential diagnostic considerations would also include
vasculitis, posttraumatic change, etc. there are no, specific diagnostic features that would raise one to consider a diagnosis
of demyelinating disease.
3. There is no evidence of previous stroke.

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Avatar_n_tn
Thank you for your insights. I have a herniated disk l-5 s-1. I find that a jucuzzi or whirlpool really seems to help me heal and ease the pain. I was at the point of surgery and now I am almost asymptomatic. My question is there any literature supporting my thoughts. Thank you.Sandor
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Avatar_n_tn
Hi, I just wanted to give you something else to look into.  I was diagnosed with syringomyelia, which is a cyst within the spinal cord.  It can be caused by many different things, mine was due to trauma.  The symptoms that your daughter complains of are very similar to mine.  My numbness travels down the left side of my body and causes great fatigue.  It took three years after the original diagnosis to get a docter to take it seriously.  I was told that I had MS, fibermyalgia (fibromyalgia), lupus,pinched nerve, and a muscle enzyme disorder.  After all of them were ruled out, and a switch back to the original diagnosing doctor, I was given a second mri that showed a small cyst at the c7-t1 level that was 1.5mm. I am very blessed to have found out at such an early stage in this disease, there is no cure and it is considered a surgical disease, with that being the last option. but in knowing at such an early stage has given me an advantage in that I can do what ever I can to stop the progession the disease by modifing my life.  Good luck, check out the American syringomyelia Alliance web site.
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Avatar_n_tn
Hello,hi.
I am posting on this board because my sister found it for me.
A couple days ago (saturday), I noticed that the side of my right foot and ankle area was numb. The next day (sunday)It moved to my whole foot and above the ankle area and I had problems walking. (clumbsiness and what not) Today I walked right into my doctors office and asked if she had a moment to talk to me about something. I told her about the numbness and she saw me right away. She did the ***** test and I told her that I felt nothing but tingles on my right leg but my left was fine. She told me that I should see a nurologist most likely. She was going to write me out a prescription for a nerve relaxer and take it from there. She then asked me if I had vision problems,(no)or back aches.(no) When I told her that I have problems keeping my balance while walking, sitting or what not....she automatically looked at me and said get dressed You need to get to a nurologist and she will call me as soon as she gets me an appointment.
I wish all doctors could be like mine. (by the looks of the other postings) Much luck to all...Kathy :)
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