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Numbness and L'Hermitte's Sign: B-12?

For 2 weeks I have had a perpetual mild numbness in my right thumb, index finger, outer arm, shoulder, and top of breast. The numbness is not severe, but there is a defnite lack of sensation. It slightly extends to my lower trunk and back. I also experience what may be L'Hermitte's sign.  When I flex my neck forward, I get a buzz in my low back which moves into my hips. It only lasts for a couple seconds and is not painful, just uncomfortable.  I do not notice any muscular weakness or have any unusual pains.

I had an MRI of the cervical spine.  Doc suspected cervical radiculopathy.  What I know of results-they were "Mildly Abnormal" with 'no herniation, bulging disks or stenosis' but with two 'questionable' areas at C3 and T2.  A repeat of the MRI (again without contrast) was recommended. There was no indication as to why these areas were considered questionable - maybe artifacts.

Could these symptoms could be caused by a Vitamin B-12 deficiency?  I have two aphthous ulcers, a slightly sore tongue (the tip feels like I tasted something hot) and my palette is a little sore.  I sometimes wake up with both arms numb, but it seems to be connected to sleeping with my arms over my head and  always resolves quickly.

I took a high dose B-12 supplement (half of a 5000 mcg sublingual tablet)  Will this interfere with blood tests?  Do you think my symptoms could be related to B-12?  If not, what are some of the things that this might be?  What tests should I have?  Would MS lesions show up on an MRI?  Would B-12 def. show up on MRI if it affected the cervical cord?
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Avatar universal
Keep in mind that you can also get too much b-12 and that causes bad problems also  - be careful and take care.
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Avatar universal
Hi,  This is the first time I've ever posted a comment so please be patient with me.  I understand your frustration with doctors when it comes to B-12.  I was diagnosed with Celiac(at my insistence-- my dr. said, "You don't have it) in 2002.  I had my kids tested and my daughter also has celiac.  I've felt for years that I was low in B-12, however, I've never been able to get a doctor to take me seriously.  Back when I was in my late teens (didn't know I was a celiac) a D.O. gave me B-12 shots for pernicious anemia and I felt much better.  I was young and didn't pay much attention at the time to the shots or anything else.  I moved out of town shortly after that. I had blood work done last year and I was feeling so bad I asked if I could have B-12 shots.  He told me my B-12 was fine and therefore, no shots.  (Celiac disease is a malabsorption problem).  This year I called the dr. for a referral to the DO gastroenterologist hoping for some answers.  I've been on the celiac diet for awhile (it's a hard diet).  My dr. wouldn't give me a referral until I came back in to see him.  I had just seen him 13 mos. ago, but it had to be within a year.  I'm currently unemployed with no insurance, so this was not good news.  I went in to see him (he never even looked at me).  The nurse took my height and weight and temperature (with their latest new gadget).  She took my blood pressure.  He came in and asked me the name of the doctor I wanted to see and then said the nurse would get me the paperwork.  It lasted about 7 minutes and cost me $70.00.  Now I have an appt. with gastroenterologist (his bill is $270 and the tests were another $275.00)who checks my back, listens to my stomach and orders a CBC, iron work, and thyroid. He also wants to do a biopsy to see if it's celiac, I've already had blood work that confirms I'm celiac - believe me I know) - that bill will add another %250.00 for the dr. and $3,000 for the hospital) I think I could have told me it will all come back looking fine - that's what they told me. It always does.(Then why do I feel so lousy).  This time I got my own copy of the results and my RDW and RBC are both high indicating a B-12, folic acid deficiency .He said I could get shots, but to go to my regular dr.  I'm sure my dr. won't be very happy.  Why do doctors have such a hard time ordering  B-12 shots for patients.  I've researched this problem extensively and am sure that once I'm on shots I'll feel much better.  He only ordered shots for once a month.  I feel I need weekly shots.  I called the office and said I wanted the methylcobalamin shot as opposed to cobalamin as it's easier to absorb and my problem is an absorption probelm.  I just had to write as I've been so frustrated with doctors taking such a laxidasical attitude toward people's need for this vitamin.  There is not as much money in shots as there is in tests and MRI's.  After reading many stories of people with similar symptoms; I hope they can find help with B-12. I've just found out I can get 5,000mg of methycobalamin in a sublingual form which I will also take.  This problem has caused untold problems, including neurologic.  I'm praying this is the answer to my depresion as antidepressants have never helped.  I hope those of you who have those problems that don't seem to have any answer will look at perhaps taking B-12. I'm sorry my post was so long.
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Avatar universal
I had the same symptoms, numbness and pins and needles especially when I would turn my neck or yawn. I had l'hermittte's sign also,it progressively got worse. My numbness started almost a year ago. Now my entire left side is numb. My family doctor told me I had MS, then she told me I had lupus. I was very worried about MS.

Months later I finally went to a neurologist. I don't have either, but I do have a problem in  my C2 and C3 spine. I am waiting for a referral for UofM hospital. I have a compressed nerve C2-C3 that is causing all my numbess. It sounds like your problem.
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Avatar universal
YOu should have the spinal cord evalauted as you are doing. A cannot comment on the MRI scan, as I cannot see the films. I'm not sure what the questionable areas are - a pinched nerve at C3 would cause some numbness in the neck, and or breathing problems (diaphragm innervation), and a pinched nerve at T2 would cause numbness in teh upper chest area and back. If you have symptoms in the chest/back area, the thoracic spine should be included on MR imaging. Your Lhermittes symptom coulb be consistent with this sign. In these cases it is usual to check some blood tests looking for B12/folate deficiency, and a variety of other testable disorders such as syphilis, Lyme, HIV, HTLV, autoimmune disorders, that can affect the spinal cord. Your symptoms do not soulnd like MS. Taking one B12 tablet like that sould not affect the blood test. MS lesion would show up on MRI. B12 deficiency in severe cases can show up on MRI, but MRI is usually normal in the early stages.
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Avatar universal
I got a copy of the MRI results on CD to take to the neurologist.  The abnormality was pretty easy for me to spot in the first three images that I picked out.  I am not sure about the last one.   I just thought it looked strange. I have no idea what this signal intensity is likely to represent or of the cause. :(

http://www.greyskies.org/myspine/  


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Avatar universal
My B-12 level was 476.  This was about 24 hours after taking half of a 5000 mcg sublingual tablet and a B-complex vitamin.
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Avatar universal
I forgot to ask - were your neurological symptoms one-sided?   My doctor said that B-12 deficiencies do not typically manifest themselves on one side only, but I'm hoping I might be different.  I'd rather this be related to B-12 than a progressive nerve disease or tumor. :(
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Avatar universal
Actually the L'hermitte's ran down my left leg but the initial numbing and tingling was right arm (I started dropping things). I knew nothing about L'hermittes and I mentioned to Dr. when I turned my neck while driving (checking both ways) I felt my left leg getting zapped (L'hermittes).

Dr's are funny -my Dr. here acts like it is wasting time for me to have regular B12 level checks because if he is injecting it I am getting it. However when I finally got upset he ordered it and my level was very low again which would have gone undetected if I hadn't insisted (I get shots now every 3 weeks rather than 4).Your B12 needs to be checked even if it had been tested a while ago.  B12 deficiency can cause permanent neurologial symptoms that are the same as MS if it goes untreated.  It is a no big deal blood test - they can just include with other bloodwork.

Let me know how things go-

Linda
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Avatar universal
Thanks for the commment.

I've not yet had an MRI of the brain.  I'm scheduled for another c-spine MRI on Monday w/contrast.  I requested a B-12 and MMA test from my GP today, but he would only order the B-12 saying he would order the MMA serum if the B-12 was borderline.  I've started taking supplements with some hope it might help. No change yet. Frankly, from what research I've done, I think a B-12, MMA, Homocysteine and Lyme disease are all blood tests that could have been performed on my initial visit.  But I'm now over two weeks into symptoms and only at the point of redoing just the c-spine MRI and having to beg for a B-12 test.  Hopefully by Tuesday, I'll get a referral to a good neurologist.  Or I might just call and request an immediate referral and let the neurologist order any further MRIs.  I'm always second guessing medical advice, which my husband tells me is a bad thing, but I'm not so sure. :)

The L'hermitte's sign seems to be getting worse, and I'm trying to stay positive, but worry is setting in.

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Avatar universal
Let me add that you need to do alot of research yourself and ask a lot of questions. Personally, I would try to go straight to nuerologist who should have no problem giving you a B12 test to rule that out before moving onto other things- it is the easiest one to fix!
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Avatar universal
I got a copy of the MRI report:

Technique:  Saggital and axial T1 and turbo-spin echo T2 weighted images were obtained.

Findings: No herniated discs are identified.  No spinal stenosis is seen.  The bone marrow signal appears within normal limits.  No abnormal signal is identified on the sagittal images, however, there is motion artifact.  There is a questionable small area with some increased signal on the T2, RIGHT posterior cord at the level of the bottom of C3.  I would have the patient return for post gadolinum enhancement MR with attention to this region as well as repeat saggittal to be certain there is no lesion within the cervical cord.

Impression:  Questionable area of increased signal in the cervical cord at about the level of the C3 vertebral body.  Further work-up as discussed would be recommended.
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Avatar universal
Have you had an MRI of brain?  I had very similar symptoms years ago and tests suggested it might be MS.  Sevearl years later a Dr. suspected it was not MS but B12 deficiency. It turned out I had VERY low B12 and have received shots monthly for years to keep level up. It is very frustrating and the more forums you read, you will find that there are many people with these types of symptoms and there are no easy answers.  Good Luck!

Linda
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