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Re: constant tingling
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Re: constant tingling

Posted By joy on July 23, 1999 at 09:50:43
For six weeks I have had tingling which started in my left leg, then two weeks later spread to my right leg. After left leg began tingling, I had lower back pain. Two days ago my hands spontaneously when numb, then spread to basically my whole body, including mouth and groin area. I went to see a neuologist, who after a physical exam determinied that I was having panic attacks, although he agreed to to Vep Baer and EMG so I would be convinced I didn't have MS. I have had a high level of anxiety this year as well as pretty severe depression. He prescribed klonopin. Now a week later, back pain is gone, as well as most tingling except for constant pins and needles feeling in hands and a "vibration" feeling in feet. It seems unusual to me that anxiety could cause symptoms that last this long, but my doctor says be patient. ALso he says a neurological disease would not have started in my legs and moved upwards. Is this true? I don't have any other symptoms, except long-term migrating joint pain and fatigue ( no weakness). Is my doctor taking me seriously? Could all this tingling be caused by anxiety and could he determine this after a physical exam? Should I insist on an MRI? What is the likelyhood that this is MS? Could Chronic Fatigue casue tingling?  --------------------------------------------------------------------------------





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Posted By joy on July 23, 1999 at 10:02:39
I forgot to mention I am a 25 year female.




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Posted By CCF MD mdf on July 23, 1999 at 10:41:14
The first job of a neurologist is to determine where in the nervous system your symptoms are coming from. Numbness in one part of the body can be localized to nerve endings, nerve root, spinal cord, or various parts of the brain, and we use other clues to help narrow it down. Numbness in other patterns (one side, or both legs, both arms, etc) helps narrow down where it is coming from, sort of like triangulation on a map.
Note - I haven't made any comment about WHAT causes the problem at a given location - that is the next step. For example, if your doctor concludes that the problem is from a nerve root, then he/she uses other information to decide whether it is a compressive problem (usuall a disc) or something else. This is an example; I don't necessarily think your problem is related to pinched nerve.
Widespread numbness, along with the other symptoms you mention, is most often a result of anxiety, and symptoms can last quite a long time. Your doctor was wise to make sure that nothing else was lurking, but the probability is low.
When a neurologist considers MS, the primary issue is whether the symptoms can be related to interruption of signals from one part of the brain (and spinal cord) to another - that's because MS is a disease in which fibers carrying this information are stripped of their myelin by the body's immune system.
There is a systematic way to test for this, though no single test definitively proves or disproves MS - it can be difficult to make a diagnosis in some cases. But the most important thing: if your symptoms can't be related to demyelination, then the suspicion for MS is very low.
I hope this helps you understand the thought process behind the diagnosis and the tests used. Of course, specific diagnosis, prognosis, and treatment options must come from your doctor after approrpriate evaluation. CCF MD mdf.





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Posted By Been There on July 23, 1999 at 19:33:27
Joy-
7 years ago I was in your shoes. I am also a 25 year old female by the way. I started having tingling in both lower legs. It progressed to both my arms in a symmetrical fashion. Doctors first wrote it off saying it was due to hyperventilation. Not the case however.....5 weeks into my tingling a band progressed around my thorasic area (which I believe was my first episode of transverse myelitis). My MRI's (brain and spinal came up clean, as did my evoked potential tests and spinal tap {no oligoclonal bands). All of my testing was done within a three month time frame when my symptoms arose. I was followed by a neurologist on a periodic basis for almost 3 years. I have had three additional episodes of what I call decreased sensation from my breast bone down to both of my feet since that first episode in 1992. All four episodes receded to the point where I just feel tingling 24/7 in both arms/legs and sometimes my back. I know that what I have experienced was repeated episodes of transverse myelitis due to all my investigations and subsequent research....I don't know if what I have constitutes an undiagnosed case of multiple sclerosis due to lack of evidence on both lab testing and clinical examination. I have researched however that repeated cases of transverse myelitis (although rare] do occur without etiology being unknown. There are some articles on medline that back this up. Lack of oligoclonity in spinal fluid and a clear cranial MRI on examination reduce the possibility of MS greatly. I recommend that you visit a site on the web: http://www.myelitis.org. It is a great site where people share there experiences. I appreciated it because I had no idea what was the basis of my symptoms. It was quite informative. Good luck!




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Posted By CCF MD mdf on July 24, 1999 at 16:52:39
One comment:
Joy, the fact that your mouth is involved in your symptoms suggests that the problem is not localized to the spinal cord. If the problem is not in the cord, it isn't myelitis (transverse or any other kind), by definition.
CCF MD mdf.





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Posted By joy on July 25, 1999 at 00:01:34
The symptoms related to my mouth have been transitory, while the others have been more or less constant. Could the anxiety I feel about the cause of my ongoing symptoms be confounding my diagnosis? It seems so unusual that anxiety alone could cause constant tingling in just one leg, then both. What other criteria, besides mouth numbness, might my doctor have used during his exam to rule out organic causes?










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