Spreading numbness and pain

[Kal07]

I have been experiencing burning numbness and pain in my left fingers, right leg and ankle and high on my ribs. I have fatigue that leaves me with very little endurance. This morning the bottom of by toes and balls of both feet at getting numb. My vitamin levels and blood work were normal as was the brain MRI done yesterday. Next is an EMG. Are we going on the right diagnostic track? Any thoughts about these developing symptoms?

[Lama Chahine, MD]

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.

Your symptoms could be consistent with a neuropathy, which is broadly defined as any sort of peripheral nerve damage. There are two types of sensory neuropathy: small fiber and large fiber (depending on the size of the nerves affected). Depending on the type of neuropathy (whether it is a small fiber or large fiber neuropathy), symptoms include burning or buzzing or other vague symptoms starting in the feet and hands then in some cases spreading to other parts of the body, sensory loss and if motor nerves are involved, weakness. One of the most common causes of neuropathy is diabetes, and sometimes only glucose intolerances. Other causes include vitamin deficiencies, toxin exposures, abnormalities of protein, and many others.

Your fatigue could be related to thyroid problems, vitamin deficiencies, anemia, sleep disorder (such as obstructive sleep apnea, and others), depression, and many other causes.

You are on the right track with having had an MRI and with an EMG scheduled. Continued follow-up with your neurologist is recommended, as is evaluation by an internist (primary doctor, family physician) to investigate your fatigue.

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

[cazmir]

I am glad you had the brain MRI.  I would ask for a spinal MRI to rule out MS.  I had a negative brain MRI but my spinal MRI came back with lesions on it, one of them active.  MS can cause many symptoms but the primary ones are numbness, tingling, stabbing nerve pains, burning pains, twitching, blurriness of vision (temporary), a foggy feeling in the head and fatigue.  You don't have to have all the symptoms at one time and you may never get all of the symptoms.  Any comination of these symptoms are neurological and a good neuro should be able to figure it out.  Good luck with your diagnosis.  And remember if one doctor doesn't figure it out you can always switch to another.  That was what I had to do to get an accurate diagnosis.

[cazmir]

I definitely would seek out a good neurologist.  They symptoms you are describing are very similar to the symptoms I have.  I was finally diagnosed with MS after ten years but it took more than one neurologist.  Ask for a brain and a spinal MRI with contrast.  You could be in the middle of an exacerbation and a round of steroids would help calm down the immune system.  The MRI with contrast will show if this is the case or not.  Good luck!  MS is only disabling for 8-11% of the people diagnosed so don't get overly worried.  The best thing is to know what you have and to start available treatments right away.