tiredness

iam 46, over the past few years (5) i have been suffering on and off with pain all over and extreme tiredness, about march this year i was struck down with a number of symstoms pins and needles in arms, hands,legs, a feeling of burnining all over,cramp from my hips down my legs, shaking both arm and legs,and a need 2 sleep after small amounts of walking? i have been to my gp but she keeps saying im stressed?? yesterday i experienced a nasty short spell of what i can only describe as the whole room went black and for a few moments could not see, this was frightening but soon passed, whats happening to me.

[Neuro Forum]

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.

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.

The cause of burning and tingling symptoms depends largely on their distribution: what parts of the body they occur in. In many cases, the symptoms could be related to stress, but there are several other possibilities, the suspicion of which would be raised depending on the exact symptoms and on physical examination.

(1) symptoms worst in the hands and feet: this can be caused by a process called a neuropathy. There are 2 types of nerves that provide sensation to the feet, large nerves and small nerves. A problem with either of these could lead to burning and tingling. There are many many causes to this group of disorders called "neuropathies". They include but are not limited to most commonly diabetes, vitamin deficiencies, autoimmune disorders and certain toxins (such as lead). There are several other genetic, metabolic, and hereditary disorders that cause neuropathy, and what tests need to be ordered depend on the history and physical examination of the patient. Neuropathy is best diagnosed with a test called EMG/NCS which tests how nerves conduct electricity and how muscles respond. In large fiber neuropathy, it will be abnormal. Small fiber neuropathy can be diagnosed with a skin biopsy and with a test called a QSART. If a diagnosis of neuropathy is made, there are specific medications that help with the symptoms.

(2) Symptoms present on one side of the body versus the other, or in just one limb. Causes could include a stroke or the condition multiple sclerosis. These would best be excluded by an MRI.

(3) If symptoms migrate (move from one place to the other) and are intermittent, causes might include seizures, migraine disorder or metabolic problems such as low calcium.

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 pains, and is best treated with medications such as lyrica and neurontin, exercise, and physical therapy. These conditions are often diagnosed based on history and examination, after other conditions have been excluded with testing.

Continued follow-up with your GP is recommended.

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