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neurology/numbness in feet
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neurology/numbness in feet

I have been told by my choropidist that I may have neurology/numbness in both feet, she done a test on my feet with an instrument I could not feel any senstation in my feet. could you please advice me on what I should do
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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.

Numbness in the feet could potentially be due to a neuropathy. There are 2 types of nerves in our body, large and small. There are two types of sensory neuropathy: small fiber and large fiber (depending on the size of the nerves affected). With small fiber neuropathies, symptoms including burning or buzzing or other vague symptoms starting in the feet and hands then in some cases spreading to other parts of the body.

The other type of sensory neuropathy is called a large fiber neuropathy. There are several categories of this type of neuropathy, and there are many many causes. Sensory neuropathies can involve just one nerve or several nerves in the body. The symptoms are sensory loss and if motor nerves are involved, weakness. Some types of sensory neuropathies occur and progress very slowly, others sort of wax and wane (with flare-ups) and some are progressive.

One of the most common causes of neuropathy is diabetes, and sometimes only glucose intolerances, or abnormal rises in blood sugar after a glucose load can be the only indication (this is called a oral glucose tolerance test. Other causes include but are not limited to hereditary/genetic causes, autoimmune problems, and demyelinating diseases (such as CIDP). Vitamin B12 and B6 deficiency, as well as excess vitamin B6, can also cause neuropathy. Some toxins, such as lead, arsenic, and thalium can cause large fiber sensory neuropathy. Other causes include abnormalities of protein metabolism, as in a type called amyloidosis or monoclonal proteinemia. In many neuropathies, both the sensory and motor nerves (the nerves that supply the muscles) are involved, leading to sensory symptoms as well as weakness.

In some people, the symptoms can be very mild such that you are not even aware of the neuropathy until your feet are checked, such as in you. In that case, it is still important to be diagnosed if a neuropathy is suspected, so that if there is a treatable cause such as diabetes it can be identified and treated, and hopefully prevent progression. Also, preventing foot damage (due to loss of sensation, for example hurting your foot and not realizing it until later because the sensation is poor) is important.

The diagnosis of large fiber neuropathy is made by findings on a test called EMG/NCS which assess how well the nerve conduct electricity and how well muscles respond. If this test is normal and a small fiber neuropathy is suspected ,other tests such as skin biopsy or other tests of autonomic skin function may be necessary. I recommend you discuss your concerns with your primary doctor (internist, family physician) and after he/she examines you, if the concern is confirmed, testing could be ordered or you could be referred to a neurologist if your primary physician feels this is warranted.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
2 Comments
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Avatar_f_tn
I would make sure your doctor does both a brain and spinal MRI with contrast to rule out MS.  These symptoms are indictative of a neurological disorder and the family history from mother to daughter could indicate MS.  Doctors hate talking about MS because of the stigma surrounding it so they don't want to scare their patients.  MS is usually not permanently disabling and is probably not a true illness but a syndrome.  Good luck with your diagnosis!  
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