cervical herniated disk - tingling, etc.

[meghanmcc]

I

[meghanmcc]

The tingling started about 4-5 months ago and was just in the pinky and ring finger on my right hand. Then a few months later it started in the left but in a middle finger. Now I get the tingling all the time--non stop--in various fingers. The same with my legs/feet (the feet seem to mostly tingle right below my toes, on the padded area).  I notice the tingling mostly while trying to sleep or reclining while watching TV. It's always present but sometimes the sensations are more powerful.

I have been going to PT for 3 months for my back so that's probably why my back doesn't hurt as much... yet the tingling in the legs has worsened.

The neurologist said I didn't have carpel tunnel syndrome... but who knows. None of this makes a lot of sense to me.

meghan

[tropicalgarden]

When does the numbing and tingling of the hands/fingers happen mostly?? I wonder if the hand/finger tingling/numbness is related to carpel tunnel syndrome. I have it in both wrist and my arms/ hands  have pain, numbness and tingling sensations and tends to "go to sleep" alot. When it first started, I was waking up at night with sharp radiating pains/numbness from my shoulder to the my fingertips.

[meghanmcc]

Oops, I accidentally deleted the line at the end of the MRI report-- "Single focus of hyperintensity noted on sagittal T2-weighted images... While this represents a focus of demyelination this finding cannot be confirmed on other images or sequences and therefore it may be an artifact." The neurologist sent me for an MRI of the head to rule out MS but I don't have any visual problems, etc. so it's doubtful that the spot really exists (I think so anyway).

I should also add that the neurologist said the tingling in my arms is caused by the herniated disk BUT a doctor (I don't have a primary care physician) told me the disk is no big deal and wasn't causing any of my problems. The tingling won't go away and it's driving me nuts!

thanks
meghan

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. The symptoms you describe seem to be more concerning for demyelinating disease (Multiple sclerosis or a variant) than disc disease.  The MRI of your cervical spine demonstrated a T2 hyperintensity (can be caused by demyelination (or the loss of the "insulation" around nerve "wires")) in the C3-C4 region (not in an area that has disc disease).  Also your disc disease at C6-C7 (although I am unable to see your films) sounds relatively minor from the impression.  A disc that compressed your cervical spine to the point that it caused leg symptoms would show signal abnormalities (none noted in your spine at C6-7).
  Mutliple sclerosis often presents with isolated numbness and pain in an extremity that then improves over several weeks.  Demyelinating disease can also affect the C-Spine without much brain involvement (Devic's syndrome). The electrical feeling that shoots down your spine sounds like a L'Hermitte's sign (which is often seen in MS/spinal cord inflammation).  Other things that would be possible (but less likely) include partial transverse myelitis, spinal cord tumor, or syrinx.
  There are ways to differentiate MS from radiculopathy (disc disease) on exam, such as increased reflexes and eye problems often found with MS vs. decreased reflexes, atrophy and/or weakness often associated with radiculopathy.
  That being said, you need a comprehensive workup, before you will know what you have.  First, I would recommend an MRI of your Brain and C-spine with and without contrast (there was no mention of contrast on your previous c-spine). You will need a lumbar puncture to evaluate for spinal fluid inflammation(Tourtelotte panel, oligoclonal bands). An EMG would be able to evaluate for signs of radiculopathy. Either way, you will benefit from physical therapy.  
  The diagnosis of multi-focal pain/numbness symptoms is often frusterating and it is not uncommon to go to several doctors before you gets answers.  I would recommend you see a neurologist that specializes in multiple sclerosis. I hope this has been helpful.