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Neurology (Expert Forum)
Numbness and Tingling Feeling
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Numbness and Tingling Feeling
by Ray M, Feb 13, 2007 12:00AM
I am a 53 yr old male. On no meds. 24 mos ago I started experiencing a numbness/tingling in my left arm. Then started having the same sensation in both hands&arms, both sides of my face, both sides of my rib cage and in my left leg. Then started feeling electrical impulses down both legs. The impulses were constant and cont’d for about a month. Went to GP and ran std blood work-normal. I rec’d a shot of B12. The impulses stopped immediately and the numbness/tingling also were 80% gone. Neurologist did MRI of brain and complete spinal cord (to rule out MS)-normal. I stopped taking the B12 per the Neurologists (placebo effect?) and sensations only got a little worse. It’s now worse and B12 has no effect. Did EMG test-normal. Does not recommend spinal tap. Infectious Disease did blood tests-normal. Did environmental tests in our house. Water tested for bacteria&lead-negative. Air tested for mold & bacteria. A small amount of mold was found in the basement air. We found a carbon monoxide&natural gas leak. It could have been leaking for 24 mos based on prev test dates. The leaks were moderate, not sure how much leaked into house vs up chimney. Currently have the numbness/tingling in my face&hands with a noticeable weakness in my left leg, foot&ankle. Also feel small tremors/vibration in left leg. About 1 second on & 1 second off. I always had ringing in my ears, but when this started it got noticeably worse. Ear drum-normal. Not sure if related, both elbows hurt. No injuries. pH is low (< 6.0). Trying to increase it through alkalizing solutions. Now at 6.6. Any suggestions?
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 22, 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 and history that you provide are complex and there is much data that I do not have. In your case it sounds like your symptoms (the numbness/tingling and the left leg weakness) do not match up with the test that you describe (normal MRI and EMG). Without being able to see the specific sequences done on the MRI or the particular results of the EMG it is hard to make a judgement on this data. Your initial response to B12 is also unclear to me. I do not know if you had an initial B12 level checked or mabye also some supporting labs that could suggest a B12 deficiency (such as methyl malonic acid, homocystiene, MCV) or if the response was related to placebo effect (as you suggested). Given the information that you have presented here, it seems that your neurologists suspected that your symptoms were not related to an underlying neurological cause (possible psychiatric, etc). However, before that diagnosis is made I would suggest a comprehensive workup, including repeating the above tests (the EMG may now be positive if you have 'noticeable weakness'). I would also suggest that your MRI of the brain include an MRA and MRV if not done previously. Given the symptoms that you describe I would suggest a lumbar puncture as well. Given the multiple sensations that do not seem to be explained by the tests that you have had so far, I would also recommend an EEG (electropencephalogram) to evaluate for any seizure activity. Sometimes it is better to take your case to an academic center and have it reviewed by a fresh pair of eyes (it is always a tragedy to miss a possibly treatable condition if one exists). As far as the pH you mentioned goes, I am not sure what body fluid you are referring to? and I am afraid I do not have enough information to make a comment.
I hope this has been helpful.
The symptoms and history that you provide are complex and there is much data that I do not have. In your case it sounds like your symptoms (the numbness/tingling and the left leg weakness) do not match up with the test that you describe (normal MRI and EMG). Without being able to see the specific sequences done on the MRI or the particular results of the EMG it is hard to make a judgement on this data. Your initial response to B12 is also unclear to me. I do not know if you had an initial B12 level checked or mabye also some supporting labs that could suggest a B12 deficiency (such as methyl malonic acid, homocystiene, MCV) or if the response was related to placebo effect (as you suggested). Given the information that you have presented here, it seems that your neurologists suspected that your symptoms were not related to an underlying neurological cause (possible psychiatric, etc). However, before that diagnosis is made I would suggest a comprehensive workup, including repeating the above tests (the EMG may now be positive if you have 'noticeable weakness'). I would also suggest that your MRI of the brain include an MRA and MRV if not done previously. Given the symptoms that you describe I would suggest a lumbar puncture as well. Given the multiple sensations that do not seem to be explained by the tests that you have had so far, I would also recommend an EEG (electropencephalogram) to evaluate for any seizure activity. Sometimes it is better to take your case to an academic center and have it reviewed by a fresh pair of eyes (it is always a tragedy to miss a possibly treatable condition if one exists). As far as the pH you mentioned goes, I am not sure what body fluid you are referring to? and I am afraid I do not have enough information to make a comment.
I hope this has been helpful.
Just thought I would offer my opinion. I have similar symptoms to you and was dx with Lyme disease five months ago. I have had every test known for Ms and everthing has come back normal. Three MS specialist have insisted I do not have MS.
My advice to you would be to get all your testing complete and if nothing is found look into Lyme disease. If you google lyme disease you can find a symptom list.
If you want any other information on Lyme disease just email me. ***@****
Good luck,
Lesley