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What Are Best Tests For Numbness Of The Legs?
Question: 45 year old female
5 year history of GI, neurological and some cardio issues-major syndromes ruled out. Cardio issues ok.
I have about three weeks of constipation which is been relieved by motegrity. However, during that period I started having spasms in my colon which started extending over my body. Then I started having some numbness in the legs and the knees feel a little unsteady but not weak. These two symptoms have seemed to have correlate with each other
Dx:I have small fiber neuropathy that they are not sure how this manifests in the body, as well an elevated ganglionic antibody snd SIBO. Abnormal sweat test. I am seeing a rheumatologist due to elevated ANA 1:320. Getting ENA checked to ensure not common autoimmune diseases present. The gangleonic antibody can cause a parameoplastoc or autoimmune mediated impact on the immune system. Tests are being repeated to ensure this is not tumor related as I did have suspected but unlikely catcaoid dud flushing/high serotonin. Now I have slightly elevated serotonin 323 and urine was always negative. Subsequent MRCPs showed no rumors. PT scan showed abnormal update in the duedonoum and pancreas with no definite tumor.
Questions:what are best tests for numbness of the legs? Through observation, my osteopath said I have some hip rotation issues and rib alignment issues. Feet slightly numb. I have had normal EMG/NCVs and vascular ultrasound for other issues, but these haven’t been done in a while.
Questions:
Just want your opinion on best doctor(s) for evaluation .
What would potentially cause tremors above based on hx/dx?
Lastly, I have a 2.9 left thyroid mass with no prior calcification that now shows some signs of that. I am getting biopsy to rule out cancer. I know it is a relatively treatable conduit, but do they have to rule out metastatic cancer? Just emotionally preparing myself. My doctor didn’t mention that, but wanted to check in.
Thanks!
Mirism
5 year history of GI, neurological and some cardio issues-major syndromes ruled out. Cardio issues ok.
I have about three weeks of constipation which is been relieved by motegrity. However, during that period I started having spasms in my colon which started extending over my body. Then I started having some numbness in the legs and the knees feel a little unsteady but not weak. These two symptoms have seemed to have correlate with each other
Dx:I have small fiber neuropathy that they are not sure how this manifests in the body, as well an elevated ganglionic antibody snd SIBO. Abnormal sweat test. I am seeing a rheumatologist due to elevated ANA 1:320. Getting ENA checked to ensure not common autoimmune diseases present. The gangleonic antibody can cause a parameoplastoc or autoimmune mediated impact on the immune system. Tests are being repeated to ensure this is not tumor related as I did have suspected but unlikely catcaoid dud flushing/high serotonin. Now I have slightly elevated serotonin 323 and urine was always negative. Subsequent MRCPs showed no rumors. PT scan showed abnormal update in the duedonoum and pancreas with no definite tumor.
Questions:what are best tests for numbness of the legs? Through observation, my osteopath said I have some hip rotation issues and rib alignment issues. Feet slightly numb. I have had normal EMG/NCVs and vascular ultrasound for other issues, but these haven’t been done in a while.
Questions:
Just want your opinion on best doctor(s) for evaluation .
What would potentially cause tremors above based on hx/dx?
Lastly, I have a 2.9 left thyroid mass with no prior calcification that now shows some signs of that. I am getting biopsy to rule out cancer. I know it is a relatively treatable conduit, but do they have to rule out metastatic cancer? Just emotionally preparing myself. My doctor didn’t mention that, but wanted to check in.
Thanks!
Mirism
Brief Answer:
Hope you have a good health
Detailed Answer:
Hello,
I am sorry to hear about this. Imaging is the best first study to obtain in some patients. As an example, Magnetic resonance imaging (MRI) of the lumbosacral spine is reasonable in a patient with radiating back pain, sensory loss over the dorsum of the foot, and weakness in the leg muscle. However, in most situations, a patient’s complaints are more nondescript. It is good that you already do EMG/NCVs. MRI is the mainstay of most neurologic imaging, In lumbosacral spine disease, specifics of disc herniation, degeneration, and degree of compression of a specific nerve root. One study compared MRI and EMG in the diagnosis of radiculopathy found that the two procedures were in agreement only 60 percent of the time, with a significant abnormality being identified on one test and not the other in 40 percent of cases. So I would like to recommend you to do an MRI of the lumbosacral spine.
Elevated serotonin also can cause your tremor.
About thyroid mass, they will wait for the result of the biopsy. If there is an abnormal result they will do a further evaluation to rule out metastasis.
I hope that I could be of help to you today. Please let me know if you need any clarification. If you have any more questions, I will discuss them with you further. Wishing you good health.
Best regards,
Dr. Heang Raksmey, General and Family Physician
Hope you have a good health
Detailed Answer:
Hello,
I am sorry to hear about this. Imaging is the best first study to obtain in some patients. As an example, Magnetic resonance imaging (MRI) of the lumbosacral spine is reasonable in a patient with radiating back pain, sensory loss over the dorsum of the foot, and weakness in the leg muscle. However, in most situations, a patient’s complaints are more nondescript. It is good that you already do EMG/NCVs. MRI is the mainstay of most neurologic imaging, In lumbosacral spine disease, specifics of disc herniation, degeneration, and degree of compression of a specific nerve root. One study compared MRI and EMG in the diagnosis of radiculopathy found that the two procedures were in agreement only 60 percent of the time, with a significant abnormality being identified on one test and not the other in 40 percent of cases. So I would like to recommend you to do an MRI of the lumbosacral spine.
Elevated serotonin also can cause your tremor.
About thyroid mass, they will wait for the result of the biopsy. If there is an abnormal result they will do a further evaluation to rule out metastasis.
I hope that I could be of help to you today. Please let me know if you need any clarification. If you have any more questions, I will discuss them with you further. Wishing you good health.
Best regards,
Dr. Heang Raksmey, General and Family Physician
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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