Pain and tingling in hands and feet

[sophiementer]

I am a 34 year old female. Recently I have been experiencing some uncomfortable symptoms that include:

-Pain ("electrical", burning, shooting, stabbing or like having needles) in my feet/legs and hands/arms. It fluctuates a lot and goes from one place to another, but it affects mostly my right side.
-Tingling in the same places. Sometimes it is so strong, that it really hurts.
-Alodinia (only from time to time).
-Involuntary muscular spasms. It is not a subjective feeling: you can actually see my fingers or my feet moving. They happen also in my back and torso. Sometimes they are so continous that make the muscle contract for several days.
-Fatigue.
-Dizziness (sometimes strong enough to make me go to ER, where they have found nothing after having done a blood pressure test and a blood test).
-Difficulty grasping things.
-Tremor in hands and legs when I make an effort (usually when I feel worse in general).
-Tremor in head (it shakes mildly when I am semi-relaxed).
-Gait disturbance (when symptoms are at their peak).
-Problems when I urinate: sometimes I cannot keep the bladder shut, so I have a certain degree of incontinence; urge to urinate; other times I find it difficult to empty the bladder, and urine comes out in several steps.
-Pain in the eye.
-Dental pain.
-Nausea (sometimes).
-High sensitivity to temperature changes. Sometimes I feel as if it were too cold but thermometer indicates the contrary. Heat makes symptoms much worse (summer was terrible).


I have had all these symptoms for several months already. First time I experienced tingling in feet and hands was a year and a half ago. It lasted for a couple of months and then went away. Since last autumn, I have been having periodical episodes of severe fatigue, with recoveries in between. In June I had the first episode of involuntary muscular movements, which lasted for three weeks. The worst outburst of the whole thing, with all the symptoms described above, started on the end of July and lasts until today. Some days I feel like I am recovering, and I even think the whole thing is over, but then symptoms appear again and remain there for a couple of weeks.

I suffer from very strong and frequent migraines since 2002. I am now on Topamax, and I have only had three attacks (all of them during the same week) in a month and a half, which is great for me (I used to have more days with migraine attacks than days free of them). I am on Nuvaring (contraceptive vaginal ring) to regulate my menstruations because otherwise my periods last for sixteen days (!!!).

I have had mononucleosis (EBV) in 2001 and chicken pox in 2002. I also have a tiny Rathke cyst (3 mm).

I am an active woman. I exercise regularly, keep a normal body weight and eat healthly. I have a very satisfying professional and personal life.

My GP sent me to the neurologist, after having ruled out himself disorders like lupus, thyroid problems, and several autoinmune or rheumatic diseases (I do not know exactly which ones). All blood tests were normal.

The neurologist ordered a brain and spinal MRI without contrast, which showed no alterations which could explain my symptoms. Then I underwent an EMG, which also was completely normal. I had another blood test done: Lyme disease was ruled out, I have no folic acid or B12 vitamin deficiencies and there are no antibodies against striated muscle. Levels of acetylcholine receptors were in the indetermined zone (0.25 nmol/l), but the neurologist said that was not relevant at all. So, having seen all these results, she told me any neurological or neuromuscular disorder was ruled out, and sent me to the rheumatologist.

I would like to know your opinion. Do you think any other tests could have been ordered for diagnosis, or was it enough?

Thank you very much. I look forward to your answers.

[Dr Sharma]

Hi there. I can understand your predicament and what you must be going through without a plausible diagnosis and a plethora of crippling symptoms. I can visualize that you have not been checked for multiple sclerosis. Multiple sclerosis is a chronic demyelinating neurological disorder where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. You have many of these symptoms. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI and a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Take care.

[Athena1140]

Hello,

Think about any medications or birth control or even herbal supplements you are taking....sometimes its just as simple as this. Try to stop taking all these things if any and see if things improve. I was on Acutane for my acne at age 21 and started have joint pain and had no idea what it was...when oit got worse I figured okay well maybe its my vitamins birthcontrol or acutane so i stopped all three, next morning was fine! Recently I have only been on Nuvaring nothing else and started to get tremors in hands and feet, I took it out a week after when I realized these symptoms were only getting worse even after quitting coffee and other stimulants so I took out my Nuvaring and the trmors have started to subside. I was on it for a year and everything was great before this so its just an example of how it can be something you would never think of because youve had no problems with it. Anyway if all this doesnt work and the doctors cant figure it out try a Naturopathic Doctor and also find a medicine man from a native community and bring him a small red pouch of clean tobacco, this is called an 'offering' and then ask him for help. I have also gone down this road for an issue I was having and he performed a ceremony with sage and prayers and it worked!!! Have faith and keep fighting for answers!

Jenny


Jenny