paresthesia unrelenting

[magster123]

Hello. I have had 11 weeks of intermittent paresthesia and burning in my right hand and right foot, and a very  occasional minor set of the same symptoms in my left hand or foot. The neurologist can find nothing in his neuro exams. The brain and spinal MRI's are normal except for some long-standing osteophyte/ bone spur at the C6-6 level. Nerve conduction studies and EMG are normal I had been taking over 200 mg of B6 in my various supplements until February, when I stopped all supplements. My B6 blood level, tested for the first and only time last week, is 27, at the high end of normal. I have no help for the severs intermittent pain but Tramadol and ocaionally some diazepam to try to lessen the symptoms. Is there anything left to test or anyone else to consult with? Or any ideas? Perhaps I have lingering neurotoxicity from the B^, and being hypothyroid? Pinched nerves not strong enough to show on nerve conduction studies? Any ideas?

[magster123]

Thank you very much  for your replies. MS has already been ruled out by my MRI's and normal nerve conduction and EMG tests. The MRI did show show c5-6 disc degenerative changes, osteophyte spurring and median bar formation with right paracentral protrusion slightly distorting the cervical cord and narrowing the right neural foramina at C5-6. Mild degenerative changes at C6-7 as well without foraminal narrowing. Facet joint hypertrophy seen at C4-5, right greater than left. Could these findings alone account for all my paresthesia symptoms? If so, what treatment is there to heal me?

[Dr Sharma]

Hi there.  I understand your predicament and dilemma. The bony spur at C6-7 level could cause the upper ling tingling and numbness. Did you have any spinal stenosis in the MRI findings? This could cause tingling, numbness in the lower limbs due to the nerve passing through the spinal canal. Consult your neurologist for a possibility of multiple sclerosis. Multiple sclerosis is a chronic demyelinating neurological disorder where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. You have many of these symptoms. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI and a spinal tap. Take care.