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Bizzarre neuropathic symptoms- extremely worried

Hi Doc

I am a 26 year old male with no history of diabetes or HIV, or any other diseases. For the past month, I've been experiencing very intermittent throbbing, stabbing and tingling, and today, itching sensations.  Most of these sensations are minor though occasionally I will get a bit more moderate ***** sensations on my calves.

This all started 1 month ago when I developed a very intermittent throbbing pain on the top of my foot. It was a deep aching/throbbing pain which was sometimes relieved by massage.  The pain was between 2 and 4 on the pain scale.  It persisted for about a month.  Then I started feeling these similar intermittent pains in my left ankle/calf, but still focused on my left foot.  Now, recently, I've started getting intermittent episodes of tingling in my right hand and very mild pain on my wrist. Today, the tingling is non-existent, but now I have random itching all over my body!  I have had NO numbness, weakness, or burning pains, all though I would feel some strange sensations in my toes on occasion. My GP gave me a physical yesterday and all came normal.  But the foot pain practically disappeared yesterday.

For the past 2 weeks I've been frantically googling my symptoms and have come across PN and Small Fiber Sensory Neuropathy.  It has consumed my every day life and has made me diagnose myself with "Idiopathic Neuropathy".  Note I do suffer from anxiety with associated depression, and the anxiety has been skyhigh through the roof the last 2 weeks.  I currently have been withdrawing from Benzodiazepines (Diazepam), and some sites say this is withdrawal effect (reported by many withdrawal persons).

The bottom line is I cannot get this extreme fear out of my head, even with reassurance from family, and my GP. I don't know what to expect as this thing seems to shift cycles and forms where I can't tell if it's improving to heal, or if it is progressing.  I am also wondering if this is anxiety/stress related.

Is this a temporary phase?
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Avatar universal
MEDICAL PROFESSIONAL
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.

You are correct that your symptoms could be symptoms of small fiber or large fiber neuropathy. However, given that your symptoms are intermittent, and can completely be absent for times and return at others, this seems less likely. Also, a normal physical examination makes large fiber neuropathy unlikely, though small fber neuropathy could still be a possibility. (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). 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. Other tests are used to diagnose small fiber neuropathy. But again, your symptoms are less likely to be neuropathy given your description of them.

Regarding the twitching your experience, this may be benign fasciculation syndrome, which I will abbreviate as BFS. It is a condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. If the diagnosis is confirmed and other causes are excluded, it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low. In such cases, the twitches may be related to anxiety/stress, caffeine, and often occur after recent strenuous activity or muscle over-use. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake.

It is certainly possible that you may be having some withdrawal from benzodiazepines, and if this is the case, these symptoms should resolve with time. If you feel your anxiety and depression are not under control, I recommend you discuss this with your GP as there are many medications such as SSRIs (like prozac, celexa, lexapro etc) which can be used to treat both anxiety and depression and they are not addicting.

Again, while your symptom description does not sound like a serious neurologic disorder, I can not of course reassure you further without obtaining a history and examining you. I recommend continued follow-up with your GP, with referral to a neurologist as he/she sees fit.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Helpful - 1
Avatar universal
Hi Doc,

Thanks for your very informative and partially reassuring answer.  All though it will take more confidence from myself obviously to get past these somewhat irrational fears, considering the circumstances.

However, you mentioned "twitching" in your answer.  I never mentioned twitching...did you perhaps mean tingling?   FYI- I actually have gotten some muscle twitching now that you mention it.  Are you reading my mind? LOL
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