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tingling hands, feet, face
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tingling hands, feet, face

Having tingling symptons in hands, feet, face and fatigue, depression. I was diagnosed with fibromyalgia several years ago. Can this be fibro or possibly MS?
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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.

Tingling in various body parts has several possible causes. These include neuropathy and multiple sclerosis. Since I do not know how extensive your work-up has been nor what exactly your history and physical examination show, I will provide you with detailed information on these two conditions. however please understand i am not trying to imply I think you have one of these conditions.

One possible cause is neuropathy. There are 2 types of nerves in our body, large and small. The small nerve endings supply the skin and sweat glands. 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 intolerance. There are several other metabolic causes which are tested for based on the presence of certain objective or historical findings. 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. In some cases a lumbar puncture provides useful in formation, and very rarely a nerve biopsy is required. If the EMG/NCS is normal, the presence of a large fiber neuropathy is unlikely.

Multiple sclerosis is a disease that primarily affects the central nervous system (brain, spinal cord, nerves from the eye, the optic nerves). Symptoms may be mild to severe, ranging from tingling and numbness to paralysis. There is not one test alone or one symptom that can diagnose MS, but there are well-established criteria that help neurologists make the diagnosis. These include taking a thorough history, doing a thorough physical exam, conducting an MRI of the brain and sometimes the spine, and sometimes ancillary testing such as lumbar puncture and evoked potentials. If an MRI of the brain and spine is normal, the diagnosis of MS becomes highly unlikely.

Often these symptoms may reflect emotional/psychiatric problems related to stress (what is called somatization disorder). The latter is a true medical condition whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve. Fibromyalagia is another medical condition that leads to whole body symptoms such as aches and pains, and is best treated with medications such as lyrica and neurontin, exercise, and physical therapy.

I recommend continued follow-up with your regular (primary) doctor. After he/she examines you, he/she may feel your symptoms are related to your fibromyalgia, or may choose to do further testing or refer you to a neurologist if indicated.

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