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Sensory Symptoms, Stiff Hands, Toes
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Sensory Symptoms, Stiff Hands, Toes

After 18 months of varying neurological symptoms that come and go, I am now experiencing a burning tongue, burning fingertips in either hand (left is worse), and stiff fingers and toes on both sides. These symptoms seem to come at the same time and feel like an attack -- they can come and go all day or can last for several hours.

Recently my neurologist ran a nerve conduction study and found what he believes in left side C5-C6 degeneration. I had an MRI of the C spine last week but don't have the results back yet. I had an MRI of the brain in Feb -- it came back clear. Before the symptoms in my hands, my neuro thought I was having some kind of atypical migraine.

Can the C5-C6 degeneration be causing all of my symptoms? If not, what else could this be? The clear MRI of the brain makes MS less likely. I have read that ALS generally does not occur with sensory symptoms. I have had a full CBC, ANA work-up, tests for diabetes, vitamin deficiency, lyme's - all neg.

My other symptoms are as follows. I usually don't have all of them at the same time. Several times I have had weeks or months with no symptoms at all.

Started with dizziness while driving
Tingling of scalp, back of head
Fullness of the ears
Tingling in both sides of face, usually not at the same time
Tinnitus
Pressure in the face and in the head (back of head, top of head)
Tingling or burning in random parts of the body (hands,, feet, thigh, cheeks); both sides, left side worse
Only three or four times, mild heart palpitations that lasted for a few minutes
Have sprained my left ankle twice and my right ankle once in the last 5 months
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Avatar_dr_f_tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

In general, an abnormality at C5-C6 would not lead to problems in the face, the tongue, any area above the neck. This would require either a problem at the level of C2, or a problem in the brain or cranial nerves, which it sounds like you do not have based on MRI. A problem at left C5-C6 would cause symptoms only in the L hand, not both most often. Stiffness of the fingers and toes is not a typical neurologic symptom; rather, rheumatologic or musculoskeletal problems come to mind, most commonly arthritis.

Migrating tingling (tingling in one part of the body that resolves then recurs in another body part) is unusual, and with the extensive work-up you had, a specific neurologic diagnosis does not come to mind. Neuropathy, a disorder of the peripheral nerves, could cause tingling, but this would not be so intermittent and migratory. If the symptoms occur in the hands and feet, are a burning and/or tingling, and EMG/NCS has not shown a large fiber neuropathy, another possibility is a small fiber neuropathy, a neuropathy of the small nerve endings that would not be detected on EMG. The diagnosis is made on skin biopsy or a test called QSART.

If there is dizziness, fullness in the ear, and tinnitus, with normal MRI, an ENT examination is recommended to exclude inner ear causes (vestibular causes)

Continued follow-up with your physicians is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

6 Comments
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Avatar_f_tn
Hi

I hope I don't come across as being rude, I have all these symptons also, plus more and have had normal mri of brain and spine twice and a negative lumbar.

My neuro told me you can never rule out ms, even with every test being normal, especially in early ms.

I just don't understand why so many say that a normal brain mri excludes ms???
Or that those with normal mri's can rule out ms.

There are so many on here that have initial normal mri's before they show up lesions.

Melissa
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1063386_tn?1287882169
that sounds like some of my symptoms except all of mine stated with head aches following a car accident, docs all say everythign is good and thayt is there way of saying I don't know what is wrong .  anyways  ct scan showed a chiari malformation.   and from what I learned so far not many docs consider this and give this as a dx therefore you may want to look into it see if it sounds like you and ask yuour doc if it is possible.  good luck  : )  
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Avatar_f_tn
Dr. Chahine, Thanks for your reply. I'll certainly ask my neurologist about each of your suggestions.

Maybe the idea that certain of these symptoms are not related is  another approach we should be taking. Wouldn't that be strange, though? Until January 2008 I had never had a health problem, and then suddenly I began to have one neurological symptom after another.

After doing lots of research, I was planning to ask my neuro during my next visit about sarcoidosis, a second lyme's test, and a paraneoplastic disorder? Any thoughts on these possibilities, in light of all of the symptoms?

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Avatar_f_tn
Thanks to both of you for your feedback. I'll ask about Chiari and the possibility of MS again.

Melissa,
How long have you been having these symptoms?

Lu,
Did you have symptoms in your arms and legs? What treatment is available for Chiari?

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Avatar_f_tn
My symptons have been with me since June 2007, although I recall having the face pain and burning in feet and dizziness prior this again.

I'm in Australia and my neuro told me we don't get Lyme here, and I have been tested for everything else............

My tingling returns in the heat, which is very ms like.....

I was told on another site that with a normal brain mri you can rule out ms.

My current neuro with 20 years experience says this is not the case, he told me he had a lady once with ms symptons for 20 years before something appeared on mri.

He told me you can never rule out ms, not even with all normal tests.

Thats why its so confusing, being told you can rule it out then not.

I think its got a lot to do with the strength of the mri machine, the drs reading it etc, as they say 3T are picking up more lesions than the 1.5T, so that proves that on a 1.5 T some lesions could be missed...........
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