tingling/numbness

[steve]

About 3 years ago I was referred to a neurologist because I had muscle fasiculations and a strange feeling in my legs.  An EMG EEG ECG and CT scan of the brain were done and all negative.  At that point I asked if he thought it was MS and he said it was unlikely.
About 3 months ago I started to have tingling in both of my feet (bottom sides only).  This does not happen when I am laying flat, only when I am sitting, and I have not noticed it when I stand.  I also have a strange sensation in the arches of both feet.  I have no muscle weakness and I actually feel better when I workout at the gym.  

I am wondering about the following:
Could this be MS?
How common is it for MS to manifest itself without weakness, or vision problems as a symptom?



Thanks for your help!

[CCF Neuro[P] MD, RPS]

Dear Steve:

One can never say never in medicine.  But I would say that your symptoms do not have the MS flavor.  If you are experiencing fasciculations over 3 years ago, you should have detectable muscle weakness by this point.  The CT scan is not a sensitive test to detect demyelinating lesions, but if you had moderate to severe you should have seen changes (you would have if the fasciculations were due to MS).  Although we have seen MS begin with parasthesias, it is more uncommon.  I think I would say that MS is very unlikely in your case.  However, if you are still worried, you could ask to have a sample of CSF fluid analyzed for oligoclonal bands, IgG synthesis, MBP levels, and kappa chain levels.

Sincerely,

CCF Neuro MD

[Dear Doctor]

Dear Doctor,

I am confused about neuropathy.  Basically MS has been ruled out, but I have numbness and tingling, buzzing, etc.  Lower legs and other parts of my back, buttocks, etc.  Muscled cramps and spasicity in lower legs. Have lost all reflexes that were normal before. Paraneoplastic syndrome, diabetes, you name it has been ruled out.  Is it possible to have neuropathy without the burning and pain and just have numbness and tingling?  Also, how hard is it to find the cause, my doctor said it could be neuropathy, but they would like to know what is causing it.

Thanks for your help.

[susan on vancouver island]

Approx. 3 months ago my father(65 years old and in excellent health) experienced lower back pain.  Within 10 days he was completely paralyzed from the waist down and experiences numbness up and down his trunk periodically.  He is still in hospital and the only diagnosis (after two neurologists) is an unusual low B12 level.  He is now on a cathetar and gives himself bowel self stimulation.  He has had three MRi's, cat scans, spinal taps, EEG.  He went thru 6 weeks of rehab and came home for 10 minutes and immediately had what we thought was a stroke, but was diagnosed as a focal seizure.(he has never had a seizure prior to this).  That was three weeks ago and he is still in hospital with absolutely no movement in legs.The seizure seems to have taken his paralysis back to the beginning.  He is presently getting a steoid drip to "jump start" the legs and get back into physio therapy.

Could all this be possible due to B12.  Is it permanet?  It seems so unusal and very difficult for all of us to accept.  Should we take him to a larger city for move testing.  The doctor has jokingly said, "short of an autopsy, there is no other tests to perform."

[CCF Neuro[P] MD, RPS]

Dear Steve:

Now you tell me that you have no reflexes amd muscle spasticity.  Is this another posting from someone else or is this new information?

CCF Neuro MD

[Dear Doctor]

Sorry about that,  the muscle thing is a new question from a new person.  It is my question.

So sorry,

Marianne

[CCF Neuro[P] MD, RPS]

Dear Marianne:

The symptoms you describe are not normal.  Some of the symptoms indicate that you have some sort of upper motor neuron disease (spasticity).  This means that there is something going on in your brain or spinal cord.  Other symptoms you describe are lower or perpherial nervous system related (no reflexes). Since spasticity and absence of reflexes are not the normal combination of findings, I would seek another opinion from a good neurologist. You need to get a proper exam and further work-up.

Sincerely,

CCF Neuro MD

[steve]

I have read that prickles in a hot shower (or any hot enviornment) can be a sign that you have MS.  Is this true?  Is there any other explanation for prickles that run in hands and feet during a hot shower?  None of my other  symptoms seem to worsen after the shower.

Thanks

[CCF Neuro[P] MD, RPS]

Dear Steve:

Yes, they can be a manifestation of MS.  However, they just may be sensitive nerve endings.  In your case, with a normal exam, muscle strength-wise and normal MRI I would vote for the latter.  One can find a symptoms for almost anything if you try hard enough.  That is not to say, what your experiencing is not real, it likely is.  However, it is likely not MS.

Sincerely,

CCF Neuro MD

[Dear Doctor]

I thought I have been to two very good doctors, all mri's are ok, labs ok, and the emg had jitter in two areas of eyelid.  Spacity in the lower legs would be stiffness, please correct me if I used the wrong word, they stiffen up and cramp in the evenings usually.  They gave me baclofen for it and it helped. What else could possibly be implicated by those signs if you do not mind me asking?

Thank you for your help.

Marianne

[steve]

last question!


The hot prickles do not occur everytime I have a shower, but they do occur.  I can also workout at the gym and get them only in my hands while I do a very intense cardio workout on the stairmaster (never anywhere else).  I golf and roller-blade on hot & humid days and never get them.  

Sorry to follow-up again, I am just very concerned.

[CCF Neuro[P] MD, RPS]

Dear Steve:

I don't think you have something that is serious (physical danger of a profound disease) as in MS.  I would just watch and see if the frequency increases, and if it does, go to your neurologist.

CCF Neuro MD

[sue]

I am interested in finding out what I can about Neurontin and its uses and possible side effects.  My mother has had burning and numbness in her feet for years.  It has now gotten so bad that she can hardly walk and has had to change her lifestyle.  The neurologists say she has neuropathy and that there is no cure.  They say now that they can relieve the symptoms and have prescribed Neurontin.  She is working her way up to a dose of 2700 mg./day.  We have been advised that there can be some problems with taking Neurontin however, and I am inquiring to find out just what these problems can be.  She is experiencing the wooziness from the Neurontin but has been told that it will pass when she is used to it.  Are there dangerous side effects that we should be aware of??

[CCF Neuro[P] MD, RPS]

Dear Sue:

There are few side effects to neurontin, usually the most complained about one is athenia or fatigue/tiredness.  This is the reason why we usually progress slow on the medication.  Neurontin has been shown to work very well for parathesias.  There is nothing that is real dangerous that is common.  Most of the real dangerous things are extremely rare.  Actually 2700 mg/day is a low dose.  I have pushed the dose to 7500mg/day for pain control in some cancer patients.  I hope yourmohter is helped.

Sincerely,

CCF Neuro MD

[Barb]

I have a question-About 3 wks ago I started getting a tingling down my left arm.  Happened 10-12 times that day. Called the ER and they said if no chest pain probably not heart related. I waited for 3 days and called my family Dr. He sent me to a Neurologist. MRI was ok, EEG showed  up as abnormal. Said the right front and back of my brain showed a slowing.  She tells me she thinks I have simple partial seizures. She has done no blood work only the MRI and EEG.  I am fighting taking the Tegretol that she has given me to start.   Could this not be a pinched nerve?  If I bend  forward at the waist or put my head back or to the side is when I notice the tingling the most.  Is there not some other tests that can be done to be 100% sure before I start on the anti-seizure medicine.  I am scared to death to start this medicine if they aren't 100% sure. Everything I read says that by taking this medicine and not really needing it can actually cause you to start having seizures even if you weren't before.  I am so confused on what to do and what to ask my Dr to do.

[A friend]

Barb,
I've taken Tegretol 800mg daily for 12 years. You said your EEG was abnormal, my doctor told me I face the same kind of seizures yours told you. My family doctor said no. When I told this to my Nero, he ask me what the doctor was trying to tell me.  My family doctor looked at my problem as mental illness. My nero. laught, so I asked him is there a chance the EEG could be wrong and it is not seizure related. He told me flat out no an abnormal EEG tells the story. If you find this to be different please re post and let me know.
A friend

[CCF Neuro[P] MD, RPS]

Dear Barb:

Go see a neurologist who specializes in epilepsy.  Slowing on an EEG does not mean you have epilepsy.  

Sincerely,

CCF Neuro  MD

[Mary]

My mom has had tingling, aching in her hands for a couple of years.
The only time it doesn't hurt is when she sleeps. It doesn't matter what the weather is. They just hurt all the time. Her hands change colors like they can be blue or red. The doctors have just perscribed neurotin.What do you think is the problem?

[CCF Neuro[P] MD, RPS]

Dear Mary:

It is impossible to give you an accurate diagnosis over the internet.  What you describe could be a collagen vascular disease.  I would check with your physician about your mother.

Sincerely,

CCF Neuro MD

[Allison]

I'm writing out of concern for my father who at 46, has been experiencing a strange numbness in various parts of the body for the past 3 years. This has worsened over time and he now has no sensory perception (other than that of mucular mouvement), in the hands, feet and head and reduced feeling in the face, arms and legs. Doctors first thought that he had MS, but a negative MRI test ruled that out. Just yesterday, he went again to the neurologist for more tests, this time of his sensory nervous response system, and the doctors had a wierd shock. There was absolutely no response. The specialist was dumbfounded and thought that his machine was not working properly, so he called in another specialist to test it on him. Everthing was in order and a second test on my father gave the same startling results. Is this normal? Both specialists admitted to not having encountered this type of reading before. All they could say was that they thought it might be a rare hereditary neurological disease and they are sending my father off for more tests.I , on the other hand , fear that it may not be neurological at all, but rather circulatory, as there have been cases of strokes (I had a mild one myself at the age of 20) and a rare circulatory disease in our family. If you have any suggestions as to what this might be, please let me know.                           Thank you.

[Allison]

continued from Thurs. Nov. 18th, 1999
The doctors are now calling my father's condition sensory neuropathy. After reading up a little on it I find it to be a rather broad topic which still lacks to explain the why and how of my father's suffering  and whether or not it is , in fact, hereditary. If you have any more specifics on sensory or peripheral neuropathy, I would be grateful especially concerning any longterm ramifications.    Thanks again.

[Allison]

continued from Thurs. Nov. 18th, 1999
The doctors are now calling my father's condition sensory neuropathy. After reading up a little on it I find it to be a rather broad topic which still lacks to explain the why and how of my father's suffering  and whether or not it is , in fact, hereditary. If you have any more specifics on sensory or peripheral neuropathy, I would be grateful especially concerning any longterm ramifications.    Thanks again.

[Caroline]

I have just been diagnosed with cidp.  Sarcoidosis, Lymes Disease and MS have been ruled out.  I have had MRIs and CT scans of most of my body.  I have had disc surgery twice and my neurosurgeon agees with my neurologist's diagnosis.

I have numbness in both feet and legs with the left being worse than the right at this point, but the numbness is gradually moving up my legs.  My finger tips are now becoming numb.

Is there any new treatment for cidp?  I really don't want to take steroids because ofr the side effects which seem to be worse than the disease. I also would like to know how fast this disease progresses and is there a chance for remission?

Thank you.

[Shawn Johnson]

I started having pain & burning in my right shoulder blade almost 2 yrs ago.  I went to the doctor when my pinky and ring fingers started feeling numb and my elbow ached.  After 3 visits, they said I had carpal tunnel syndrome, though no tests were done.  After about 8 months, all symptoms disappeared until about 2 months ago.  Now along with all the above in my right arm, the beginning of these symptoms in my left arm, I am concerned.  My own dr. sent me to a neurologist, she took x-rays and ordered nerve testing, though I have yet to be tested.  Now my neck, shoulders, and lower back ache all the time, and I have a headache that won't go away, heat and motrin help alot.  I think the doc is looking in the wrong direction but I don't know enough to ask her to look somewhere else.  Any advice or ideas about what is going on would be greatly appreciated.

[CCF Neuro[P] MD, RPS]

Dear Shawn Johnson:

The distribution in your hand would indicate that it is your ulnar nerve and not your median nerve (carpal tunnel).  There are many entities that can give you the symptoms that your describing.  There are any number of ways to investigate these, and your neurologist is beginning the process with an EMG.  This is appropriate.

Sincerely,

CCF Neuro MD