Roaming/Patchy Numbness

[berj275]

My wife has had roaming numbness for about the last 6 weeks.  She also gets fatigued more easily.
Her numbness is more of a partial loss of sensation (never complete numbness) and it can move between her
arms, legs, bottom of feet, face, and sometimes scalp.  It is more prevalent on her right side than left, but
can also occur on her left side at times.  Sometimes her lower back also hurts.  She said that when
her back hurts the numbness is less intense.

We went to our PCP and to a Neurologist, and between the two they ordered tests such as a CBC, rheumatoid
arthritis, thyroid levels, heavy metals, B12, folate, diabetes, and an MRI.  Everything came back fine except
that her MCV was a little high.  Also, on one of the tests they found "a faint IgG (kappa) monoclonal
immunoglobulin".  He has reordered that test to see if it appears again.  Also, the Neurologist is checking
her for lyme disease.

The Neurologist did mention MGUS, but is waiting to send us to a Hematologist after the next set of blood work
comes back.  The thing that has the Neurologist the most puzzled (according to him) is the fact that the
numbness roams around.  It never stays in just one place all the time.

What is your opinion?  Can it be something else besides MGUS?  I know that we will probably have to follow
the path of Neurologist --> Hematologist --> Oncologist to make sure she does not have Multiple Myeloma.  The
doctor said that her chances of getting that are about one in a million (she is currently 47 years old).

Do you have any additional recommendations besides the path of investigating MGUS?


berj275

[berj275]

Hello Dr. Newey,

Thank you for answering my questions.  Since my last post I can update my post a little.  The Neurologist re-tested for monoclonal protein and this time it came back fine.  He also tested for lyme disease and that came back negative.  He has her on vitamin B1 in case it is something related to eating fish, but I think my wife's symptoms are a little bit of a mystery right now.

The next step the Neurologist will have us do is a nerve study, but he has already said that he thought it would come back fine.

What my wife is wondering is why none of the doctors (PCP, Neurologist) has done tests to see if her kidneys, liver, pancreas, etc. are functioning well.  Maybe this information is implied in some of the other tests she has had, but since neither of us is actually a doctor we don't know.

[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.

Migrating symptoms could be from many etiologies including migraines, seizures, etc. If it is a neuropathy affecting peripheral nerves only (such as what the neurologist is looking for) then you must consider rheumatologic, vitamin deficiency, hereditary, malignancy, etc. These tests include glucose intolerance test, ANA, ENA, B12, B6, heavy metal screening, and monoclonal proteins.

Since your wife had a positive monoclonal protein, I agree this should be followed up with a hematologist/oncologist. She would also benefit from seeing a neuromuscular specialist or a neurologist familiar with treating MGUS (a condition associated with the monoclonal protein).

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