question for the doctor

Doctor-
can you tell me if ms can present with tingling sensations as the symptom?  I have tingling in hands mouth feet and cheek... mostly left side but also right hand and foot and occasionally face.  I had a headache for 9 days now that is thankfully finally subsiding.  I had the same symptoms almost 5 years ago... then again a year and a half ago... testing was fine and thankfully a good mri.  Can you tell me if I should get another mri now?  is it possible that the ms just didn't show up last time?  I'm concerned about that... thank you in advance.

[Cleveland Clinic, MD]

I am happy to address the questions that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

MS is a disease that is characterized by multiple focal lesions affecting the brain and/or spinal cord. it can present with a wide variety of symptoms. one of these symptoms is sensory abnormalities like numbness, tingling, electric-like pain...etc. different patients have different disease courses, some can have a progressive disease, while others can have an episodic course with recurrent attacks of MS symptoms.

However, there are diagnostic criteria for the diagnosis to be established. these include things from the history, physical exam and MRI findings. The best way to identify the cause of these symptoms is to obtain a detailed history regarding the symptoms including asking about any other associated things that can point to a specific disease process (like weakness, visual disturbance, change in balance, difficulty swallowing or breathing..etc). then perform a thorough neurological examination to detect any objective loss of sensation, strength, or any other deficits. after that comes the tailored workup, which can include brain imaging (there are different magnet field strengths, and then can affect the sensitivity of the scan, stronger magnets can pick up more subtle changes), but the workup might also include simple blood tests to look for other possible causes of the sensory symptoms you are having, sometimes simple things like vitamin deficiency or electrolyte changes (sodium, potassium, calcium...etc) and some other general conditions can cause such symptoms, so it is always a good idea to check these things.

Thanks for using the forum. Good luck.

[jerry1167]

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