Odd sensations in foot and hands

[Pav5]

I am a 41 year old female, 5'5" tall, 108 pounds, low blood pressure, low cholesterol and found to have a pituitary adenoma about 10 years ago (the adenoma has not changed in 10 years, nor has it affected my vision or hormones.  It was found during an MRI I had to check for reasons of infertility).

About 5 years ago, after exerting myself, I felt a strange sensation in my foot (almost as though there were something tight around it) and forearms/wrists.  My arms/wrists recovered quickly, but the foot sensation lasted. As there is MS in my family I was referred to a neurologist. He told me he saw no evidence of MS at that time and thought that maybe I had strained myself too much.

Over the years the foot sensation has come and gone.  Sometimes it feels as though I am wearing a sock on that foot, sometimes it feels like I am stepping on something or that the ball of the foot is swollen, or that the last two toes are swollen.

In the last few months I have also been experiencing strange sensations in my hands ranging from feeling as though I have gloves over my palms when I touch things, or that someone is pressing down on my finger nails.  On several occasions my hands have become very weak - as though I had been out in the cold too long.  My lips have also started to tingle and burn at times and sometimes look a little blue around the edges.

None of these symptoms are constant.  They come and go over the course of the day.  I have been tested for B-12 deficiency, lyme disease, mercury and Celiac.  So far all tests are fine (although I went on a gluten free diet anyway and the weakness in my hands has not returned and the odd sensations in hands and lips seem to be greatly reduced).

Due to the pituitary adenoma I have an MRI done every year or so.  In the latest MRI it was noted that  "There are a few small nonenhancing T2-FLAIR high signal foci in the white matter...This is most consistent with microvascular ischemic changes.  There is no midline shift or subdural fluid collection.  There is no hemorrhage."  Back I went to the neurologist who gave me a full examination as well as a nerve conductivity test and electromyography.  All results were normal eliminating carpal tunnel and a pinched nerve from the list of possible causes.  He also said that the high signal foci were not specific and are not what one would expect to see with MS. He gave me the choice of waiting 6 months and having another MRI, doing a spinal tap now, or just doing nothing and wait to see what happens.

Does this sound like MS to you?  Are there any other diseases, conditions, deficiencies, food intolerances that you think may have something to do with the odd sensations in my foot, hands and lips?  Could this be some sort of virus or infection? Aside from MS, what could be causing the high signal foci in the white matter?

Any help or advice as to what other tests might shed some light on this situation would be most appreciated.

[Pav5]

Dr. Godofredo,
I did have gestational diabetes with my last pregnancy and we do have some diabetes in the family. The endicrinologist that tests my blood each year for my pituitary also checks glucose levels (but feels strongly I will never get diabetes because of my weight and healthy eating habits).  My primary care physician checked my thyroid and says it is ok.  I have never had a spine MRI but will suggest it to my doctor.  
Thank you so much for your fast reply.

[Godofredo MD]

Hi.

Have you been screened for diabetes or thyroid disorder? Any back pain? Has a spine MRI been performed in the past?

The symptoms seem to suggest a lesion localized to the peripheral nerves with no upper motor neuron signs. The apparent glove and stocking distribution and the mild distal muscle weakness suggests peripheral neuropathy.

It would be premature to consider MS as the diagnosis at this point. White matter lesions can occur in a lot of disorders and is usually non-specific.

Hope this helps.