probably some form of demyelination

[Frances-Wetstein]

    
      Re: probably some form of demyelination
    


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Posted by CCF Neuro MD *!* on January 09, 1998 at 14:00:19:

In Reply to: probably some form of demyelination posted by Frances Wettstein on January 09, 1998 at 11:23:55:

: I have tingling sensation in the lower limbs and feet, but not complete numbness.
  I am not a diabetic.
  My skin has become extremely sensitive to touch, especially my nipples.
  I have had breast cancer (4 years ago) and radiation treatments
  (30) but no chemotherapy.  I do not take Tamoxiphen.
  As a child, I had Chicken Pox and Shingles, as a young adult (is
  this significant?)
  About 15 year ago I was treated for bacterial meningitis with intra-
  venous antibiotics, and recovered completely.
  I am female, 58 years old.  
  I still have night sweats, and also suffer from leg cramps at night.
  The onset of my neurological symptoms began about 3 years after my
  cancer surgery.  A year ago, I had an MRI scan, but the results were
  inconclusive, according to my radiologist and neurologist.  A ten-
  tative diagnosis of "maybe MS" was contraindicated by little observed
  demyelination, although some was present, and my age, then 57.
  Have you any information for me?  Particularly the increased sensitivity
  to touch is bothersome, although I cannot call this "pain".
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The symptoms  you describe do not sound suggestive of MS, they are more suggestive of a peripheral nerve disorder than a problem involving the brain or spinal cord.
The increased sensitivity to pain is called dysesthesia, and can be a feature of peripheral neuropathy.
MS can start with vague sensory complaints but within a few months definite signs of focal muscle or limb weakness  have usually  developed.
Tingling and numbness can be related to MS but they tend to involve one side of the body in a fairly complete fashion as opposed to effecting the peripheries only.
Peripheral nerve disorders on the other hand tend to be more symmetrical and start at the periphery usually the feet and work their way up.
Sometimes the pathological process involved in peripheral neuropathy is a form of demyelination but it is not related to MS and is not visible on MRI scans, it can however be diagnosed by  means of nerve conduction studies.
There are a number of underlying disorders which may cause peripheral neuropathy these include tumors, thyroid disease, vitamin deficiencies, diabetes, heavy  metal toxicity, side effects of medications including vitamin toxicity or inflammatory disorders like lupus. In a large proportion of cases an underlying cause is not found but a number of basic blood tests need to be performed to outrule these possibilities, an appointment with a neurologist , ideally one who specializes in neuromuscular disorders would be a good next step.
If you need to make such an appointment at the Cleveland Clinic the number for appointments is [phone].
This information is provided for general medical education purposes only.
Please consult your physician for diagnostic and treatment options of your specific medical condition.