Numbness with mild twitching developing

Posted by Ian Umland on July 20, 1999 at 09:09:46
I am a 30 year old male 6' 4'' 248 lbs. with no other helath problems aside from mild hypertension (145/90). Approx. 50 days ago, I noticed that my right shoulder, right arm and hand as well as the right side of my torso, from my armpit to waist felt numb. I had no feelings of pins and needles, just numbness. About 30 days ago, I saw a doctor (internal medicine) who had poked at and raised my arm and asked if there was any pain but there was none to speak of. He took blood for a CBC and also took x-rays of my shoulder and arm. The x-rays were negative as well as an in office blood test which he said could indicate "swelling". The CBC results were normal.
Since my numbness did not go away, I saw a neurologist about 15 days ago, and after an office exam (strength test, key scratch on my foot, read eye chart, etc.) he felt that my numbness was benign and we should monitor the stmptoms. To date, the numbness in my right hand arm shoulder and torso has not subsided nor has it gotten any worse. Over the last few days I have noticed mild numbness in my right foot,(it is less severe than my other numbness and I ususally notice it only when I am wearing certain sneakers) and also the skin under my left eye twitched on and off over a period of a half hour last night. In addition, a few days ago, my right big toe started twitching on and off for about an hour or so.
Should I be concerned with these new symptoms? If I go to see the neurologist again is there anything I should suggest or bring to his attention? Also, the PCP took x-rays of my arm and shoulder and said they were normal. However,when I first went to him complaining of numbness, he also said I had cervical ridiculitis and perscribed Celebrex, and when that had no effect, he gave me Viox, even though I never said I had any pain, just numbness. My neuro said there was no way I had CR. Thus, my confidence in my PCP is diminished, I am now concerned that my PCP may not have read the x-rays right or did not x-ray enough areas to positively rule out problems which would show up on an x-ray. My question is do neurologists normally use/benefit from looking at x-rays and should I try to get them from my PCP if I go to the Neuro again?
Thanks for your help,
Ian


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Follow Ups:

Posted by CCF MD GS on July 20, 1999 at 10:38:50
Thanks for the question Ian. Of course in cases such as this when we can not examine the patient it makes dx the case more difficult but let me give you a few thoughts. The exam that was done included looking for evidence of demyelinating diseases by the information that you have provided. In your age group multiple sclerosis or spinal cord transverse myelitis (inflammation of the spinal cord) would be considerations. The plain film xrays that you had done would not show evidence of these types of problems. It would be an unusual story for a pinched nerve type problem. I think you should consider having an MRI of the cervical-thoracic spine and also the brain to rule out the above problems. This of course is at the discretion of the neuerologist who you should floowup on. Good luck
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