Numbness and Tingling effect throught body,Headache

[kiran5980]

Hi,
I am a 30yrs aged male working as software engineer.For the last one year i am suffering from  a disease which i am not able to figure out the exact reason.I have checked with many Neurologists and have done all the possible tests(MRI,Nerve conduction test,Blood test with normal results) without any effective result and this problem seems to be getting severe day by day. I am feeling the tingling sensations in the legs continuously while sitting.At night i have to get up multiple times because of the strain in the legs or hand while sleeping.Now i am taking Maxgabalin as per doctors prescription.The complete left side of my body has became a kind of numb and the  pressure  or pain is different from the right part of my body for any work i do.Please help me with your suggestion.Is this because of any anxiety disorder or depression as my tests always coming out normal.Please please help 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.

If your symptoms only occur in the legs while you are at rest (sitting or lying down) and are worse in the evening and at night compared to the morning, and improve with movement (shaking the legs or walking around) your symptoms may be consistent with restless legs syndrome, a disorder that is treatable with a specific type of medication. Discussion of this possibility with your physicians is recommended if your symptoms are as such.

If not, another possibility is called small fiber 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 EMG/nerve conduction studies (NCS) (tests done to check for neuropathy) will not show an abnormality, and a definitive diagnosis can only be made with a skin biopsy so that the number of nerve endings can literally be counted. There are other tests of the function of small nerves that can be ordered, such as QSART testing which looks at how much sweat the skin makes, since sweating is in a sense of function of these small nerves. There are several causes of small fiber neuropathy, including diabetes, vitamin deficiencies, autoimmune problems. It is treatable with several medications such as the one you are on, and if this is the diagnosis, sometimes increasing doses or more than one medication will improve the symptoms.

Both restless legs and small fiber neuropathy are unlikely to predominantly affect one side of the body so if it is just one arm or one leg that is significantly more affected than the other, the above two disorders would not apply. A brain or cervical spine problem could lead to one-sided symptoms (one arm and leg on one side). Since your MRI is normal, brain diseases such as multiple sclerosis are unlikely. Imaging of the spine is done based on the history and examination as documented by your physicians.

If after extensive neurologic workup a diagnosis can not be made of sensory symptoms or pain, sometimes these are attributed to stress, anxiety or depression, and this can be an appropriate path if other disorders have been definitively ruled out. Treatment of the anxiety and depression is important in and of themselves, but may also improve your symptoms. Continued followup with your neurologist is recommended.

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

[Rascal729]

I assume your doctor (s) have for now ruled out MS, and other scary stuff. A rare disease that many neurologists seem to be unaware of or poorly equipped to diagnose is Peripheral Nerve Hyperexcitability (this is a collection of disorders that includes Isaac's syndrome and benign cramp fasciculation). The hallmark test is an EMG that looks for CMAP after-discharges following repetitive nerve stimulation (10hz) of the abductor hallucis and brevis. Sometimes it is caused by an antibody to a neuronal voltage gated potassium channel (VGKC) and that can be detected by a blood test. Good luck.

[Melissa072]

I don't mean to come across as being rude, but I don't understand how you say that a normal brain mri rules out multiple sclerosis.
I have in the past had 3 mri's on the brain and spine, and a negative L.P.

My neuro told me you can never rule out ms, even with normal testing.

I'm going tomorrow for repeat mri on a 3 telsa this time,  to have another look for ms.

I have several ms symptons, and bad tingling which returns in heat.

So in other words in theory because I have had 3 normal mri's so far and  a negative  L.P. I should be able to rule out ms?????????

Thanks
Melissa

[kiran5980]

Hi Lama,

It is wonderful to receive your reply and thanks a ton for helping numerous people like me with your expert advising.i cannot express the feelings of happiness i am going through right now and glad to know that there are people who are aware of the problem and dilemma i am going through(i even have advised for a session  with psychiatric as they thought i don't have any problem as i am telling them and it is only in my mind).I will try my all to spread the popularity of this site so that many like me can take the benefit of this.

To be more precise about the problem in majority of the time i will have this electric sensations while standing or sitting in a particular position for long time where some part is pressured a little more.as an example when i am riding two wheeler for more than 20 min my palms will have the start electric sensations and i have to shake the palms to have them back to normal.As these symptoms started a long back and due to the lack of diagnosis it became worse now and i am having the feeling in the head now and my sleep is also getting affected.The medications i am having now (Maxgabalin and Naprosyn) dont seems to be of any help as it is already two weeks over.When i suggested the doctor for an EMG test they told that normally EMG has to be done when they found some nerve problems in NCS test to get more details on the problem.As my NCS tests are normal ,Please suggest how i should approach now.As i am based in India i am not sure whether more detailed tests are available here or not. As per other member of this community,My symptoms can also be of another diseases (Peripheral Nerve Hyperexcitability).Please help me in this regard and tell me what are the tests i should take to get all the details.

Thanks you for your support and time.

Best regards,
Kiran