Post Viral Neuropathy? Please help

[wookieenerves]

Hello,

Thanks for having the great support forum. In recent months, I've been experiencing some severe neurological pain. It started in September around a week after experiencing a sinus infection/sore throat. The first noticeable signs included a stabbing type pain in my wrist and lower ankle. As it progressed, the pains appeared to affect my entire body with stabbing like pains everything. Recently, the pain is most noticeable in my fingers and toes.  It feels like pinching nerves under my skin. However, I've felt the pains all over including legs, arms, face, abdomen. I've also had some muscle soreness, random muscle twitches/spasms (quite often all over including in my eyes), some burning pain under my feet, and sometimes it feels as if my limbs go to sleep too easily. I've been to the doctor, who kind of dismissed it as stress (but that was early on, but received basic blood tests, results normal). I also received a nerve conduction study and neurological exam from a neurologist. However, the results appeared normal. I know the nerve conduction doesn't always detect small fiber nerve problems though. They wanted to do an MRI, but my medical bills are piling up and that appears to be on hold. I've also had random itching since earlier this year, but I'm not sure if that has anything to do with it.

As long as I can remember, I've had some pinching/burning nerve pain in my outer thighs if I stand in one place too long but it had never seemed too severe to see anyone about and I had never felt it anywhere else. Also, I've long experience burning under my feet from standing in the same spot too long as well. Not sure if what I have now spread from that?

I understand a diagnosis can't be made online but hopefully I can gather some insight so I can understand better what may be going on.

Thanks

[Christopher R Newey, DO]

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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

There are two types of sensory neuropathies in the body – large and small fibers. With small fiber neuropathies, symptoms include 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 (as you mentioned), 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, and autoimmune problems.

If you haven’t already done so, I would suggest you follow up with a neurologist who specializes in neuromuscular neurology. You may benefit from additional rheumatological workup and vitamin levels. If your symptoms and examination suggests a small fiber neuropathy, you may also need a skin biopsy.  

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

[wookieenerves]

Also, I am a 26 year old male in otherwise good health (if that helps any).