Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
I Have In The Last 2 Weeks Been Experiencing At
Question: I have in the last 2 weeks been experiencing at night when I am sleeping being waken to my hands and some of my arms asleep tingly and also it may be both. I also get the same feeling in my left lower cheek down to my chin. I also have a burning sensation in the bottom of my feet for the last 3-4 days. Also l all day today my lower left side of face has felt tingly or prickly whatever you would call it.
I believe my blood work is attached .
High triglycerides 401
Alkaline Phostase was 127 when it should have been 117
One of my fears is HIV and I have tested with Oraquick several times outside the 90 days window up to 1 year with all negative all where mouth swab test all do by me except one at 15 months that was a oraquick oral swab test done by a clinic.
So I had a tick in me and was not sure how long and I did remove it and about 2-3 weeks later felt really tired and chills no fever or rash along with joint pain. So my Dr placed me on Doxy a antibiotic for 10 days so cold this be a post effect if I actually had Lyme disease? My doctor never really checked but ordered me the doxy by phone. I also had several get embedded in me in the spring around April and May but I believe I got them out fast enough.
So thins just the last 2 days have gotten better but I still have numbness when sleeping but not as bad greatly improved and occasionally a tingling sensation around the left side of my mouth. I did go to the ER yesterday and they did a CT scan of my neck only not sure why they did not do a whole head scan. Any thoughts or ideas what this is going on they placed my on a steriod yesterday where you take 21 pills over 5 days.
I believe my blood work is attached .
High triglycerides 401
Alkaline Phostase was 127 when it should have been 117
One of my fears is HIV and I have tested with Oraquick several times outside the 90 days window up to 1 year with all negative all where mouth swab test all do by me except one at 15 months that was a oraquick oral swab test done by a clinic.
So I had a tick in me and was not sure how long and I did remove it and about 2-3 weeks later felt really tired and chills no fever or rash along with joint pain. So my Dr placed me on Doxy a antibiotic for 10 days so cold this be a post effect if I actually had Lyme disease? My doctor never really checked but ordered me the doxy by phone. I also had several get embedded in me in the spring around April and May but I believe I got them out fast enough.
So thins just the last 2 days have gotten better but I still have numbness when sleeping but not as bad greatly improved and occasionally a tingling sensation around the left side of my mouth. I did go to the ER yesterday and they did a CT scan of my neck only not sure why they did not do a whole head scan. Any thoughts or ideas what this is going on they placed my on a steriod yesterday where you take 21 pills over 5 days.
Also bottom of feet have not been burning for the last 2 days.
Brief Answer:
Peripheral neuropathy to be considered
Detailed Answer:
I read your question carefully and I understand your concern.
Looking at the blood work you have provided I do not see anything which would explain the current symptoms. Certainly that cholesterol and triglyceride level should be addressed through a healthier diet and exercise, but it is not the cause of your symptoms. Electrolyte alterations or thyroid dysfunction can be a potential cause but they look normal in your case.
I do not see HIV being an issue, the symptoms do not indicate it and the tests were normal. Lyme disease is a possibility so it was well that you took a course of antibiotics, however blood tests for specific antibodies should have been done.
As for other causes, I see from a past question of yours that you worry about XXXXXXX strokes, but that seems highly unlikely, those symptoms aren't typical at all in their distribution and nature. Among neurological causes a peripheral neuropathy should be considered which may cause such sensory changes. For that purpose a neurological physical exam and nerve conduction studies test would be necessary. Other neurological possibilities would include multiple sclerosis and spinal degenerative disease (though the later wouldn't cause symptoms in the mouth). In truth I find them unlikely as well, because while they can cause the above symptoms, they usually are not alone but accompanied by other manifestations. However if the physical exam reveals any abnormalities Head and neck MRI might be scheduled (CT may miss these two conditions).
Another possibility to be considered, in particular if neurological exam and tests are normal would be anxiety. It can commonly cause all your symptoms.
I remain at your disposal for other questions.
Peripheral neuropathy to be considered
Detailed Answer:
I read your question carefully and I understand your concern.
Looking at the blood work you have provided I do not see anything which would explain the current symptoms. Certainly that cholesterol and triglyceride level should be addressed through a healthier diet and exercise, but it is not the cause of your symptoms. Electrolyte alterations or thyroid dysfunction can be a potential cause but they look normal in your case.
I do not see HIV being an issue, the symptoms do not indicate it and the tests were normal. Lyme disease is a possibility so it was well that you took a course of antibiotics, however blood tests for specific antibodies should have been done.
As for other causes, I see from a past question of yours that you worry about XXXXXXX strokes, but that seems highly unlikely, those symptoms aren't typical at all in their distribution and nature. Among neurological causes a peripheral neuropathy should be considered which may cause such sensory changes. For that purpose a neurological physical exam and nerve conduction studies test would be necessary. Other neurological possibilities would include multiple sclerosis and spinal degenerative disease (though the later wouldn't cause symptoms in the mouth). In truth I find them unlikely as well, because while they can cause the above symptoms, they usually are not alone but accompanied by other manifestations. However if the physical exam reveals any abnormalities Head and neck MRI might be scheduled (CT may miss these two conditions).
Another possibility to be considered, in particular if neurological exam and tests are normal would be anxiety. It can commonly cause all your symptoms.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Read below
Detailed Answer:
Hello again!
A CT scan of the spine may show damage to the vertebrae, like fractures or displacements, changes to the bones.
When it comes to lesions to the spinal cord or the brain, such as those caused by MS (multiple sclerosis) then a CT is not good enough, it detects only major gross lesions, not small ones, it can't by no means exclude the diagnosis (one can't expect ER doctors to do that anyway, their duty is to exclude emergency cases such as fractures not to diagnose chronic issues such as MS).
It has some value for spinal degenerative disease as it shows arthritic changes in the bones, but even in that case it is not as good as MRI which also shows the discs between the vertebrae and also visualizes the nerve roots and the cords, evidencing their compression when present. The CT doesn't really exclude spinal cord lesions I am afraid.
Read below
Detailed Answer:
Hello again!
A CT scan of the spine may show damage to the vertebrae, like fractures or displacements, changes to the bones.
When it comes to lesions to the spinal cord or the brain, such as those caused by MS (multiple sclerosis) then a CT is not good enough, it detects only major gross lesions, not small ones, it can't by no means exclude the diagnosis (one can't expect ER doctors to do that anyway, their duty is to exclude emergency cases such as fractures not to diagnose chronic issues such as MS).
It has some value for spinal degenerative disease as it shows arthritic changes in the bones, but even in that case it is not as good as MRI which also shows the discs between the vertebrae and also visualizes the nerve roots and the cords, evidencing their compression when present. The CT doesn't really exclude spinal cord lesions I am afraid.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So Are you leaning toward multiple sclerosis? Where do you think this could be a side effect of Lyme disease? I know these are reach but I was just curious what direction you actually Leaned towards.
Brief Answer:
Read below.
Detailed Answer:
I am leaning in the direction of a peripheral polyneuropathy as I said in my first answer. Peripheral neuropathy may be due to many possible causes, Lyme is one of them. So if peripheral neuropathy is confirmed by nerve conduction studies test, Lyme would have to be investigated for, as a possible cause.
If neurological exam is normal and nerve conduction studies show nothing, then my most likely hypothesis would be anxiety.
As for MS as I said in my first answer, while possible, I think it unlikely. I only elaborated on the advantages of MRI over CT since you were wondering whether the CT was of any value. As I said if I was to request an imaging exam (not necessarily if neuro exam is normal) I would request MRI as CT doesn't exclude inflammatory conditions like MS.
Let me know if I can further assist you.
Read below.
Detailed Answer:
I am leaning in the direction of a peripheral polyneuropathy as I said in my first answer. Peripheral neuropathy may be due to many possible causes, Lyme is one of them. So if peripheral neuropathy is confirmed by nerve conduction studies test, Lyme would have to be investigated for, as a possible cause.
If neurological exam is normal and nerve conduction studies show nothing, then my most likely hypothesis would be anxiety.
As for MS as I said in my first answer, while possible, I think it unlikely. I only elaborated on the advantages of MRI over CT since you were wondering whether the CT was of any value. As I said if I was to request an imaging exam (not necessarily if neuro exam is normal) I would request MRI as CT doesn't exclude inflammatory conditions like MS.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
If it was HIV and my oral swab test were inaccurate would there more to the story of symptoms? In the back of my mind this has been a huge fear!
This will be my last question and I do truly appreciate your responses and patience.
This will be my last question and I do truly appreciate your responses and patience.
Brief Answer:
If HIV there would be other manifestations.
Detailed Answer:
Hello again and thank you for your appreciative words.
HIV can in theory manifest those symptoms as it can potentially be a cause of polyneuropathy. So when polyneuropathy is confirmed, HIV is among the many potential causes which is investigated.
However polyneuropathy in HIV is usually a late stage manifestation, not the initial presentation, there are other typical infections preceding it. So for that reason alone it would be unlikely. Add to that the negative oral swab test that you've had and it becomes an even more unlikely hypothesis, almost impossible.
If HIV there would be other manifestations.
Detailed Answer:
Hello again and thank you for your appreciative words.
HIV can in theory manifest those symptoms as it can potentially be a cause of polyneuropathy. So when polyneuropathy is confirmed, HIV is among the many potential causes which is investigated.
However polyneuropathy in HIV is usually a late stage manifestation, not the initial presentation, there are other typical infections preceding it. So for that reason alone it would be unlikely. Add to that the negative oral swab test that you've had and it becomes an even more unlikely hypothesis, almost impossible.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks I just figured with the high triglycerides and now the polyneuropathy I thought it was the writing on the wall since I read both are associated with HIV.
My arms and hands have greatly improved and today my face has had no issue but now again I have a slight burning of the feet and it is aggravated by wearing shoes if I remove the shoes I barely notice.
My arms and hands have greatly improved and today my face has had no issue but now again I have a slight burning of the feet and it is aggravated by wearing shoes if I remove the shoes I barely notice.
Brief Answer:
Read below
Detailed Answer:
Thanks for the follow up.
Raised triglycerides and polyneuropathy can be caused by many causes other than HIV. The list of possible causes is really long, in particular for neuropathy, actually HIV is not even close to the top of the list of causes in term of frequency.
This fluctuation of the symptoms you refer, with symptoms changing in severity from your face to your feet, makes me suspect that perhaps anxiety might be the actual culprit. Neither peripheral neuropathy nor central nervous conditions like MS should fluctuate in this manner or be affected by wearing shoes or not. So the hypothesis of anxiety being the cause remains very much possible.
Read below
Detailed Answer:
Thanks for the follow up.
Raised triglycerides and polyneuropathy can be caused by many causes other than HIV. The list of possible causes is really long, in particular for neuropathy, actually HIV is not even close to the top of the list of causes in term of frequency.
This fluctuation of the symptoms you refer, with symptoms changing in severity from your face to your feet, makes me suspect that perhaps anxiety might be the actual culprit. Neither peripheral neuropathy nor central nervous conditions like MS should fluctuate in this manner or be affected by wearing shoes or not. So the hypothesis of anxiety being the cause remains very much possible.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
