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What Causes Carpal Tunnel Syndrome?
Brief Answer:
Carpal tunnel not in the legs?!!!
Detailed Answer:
I read your query carefully and I understand your concern.
However I am afraid that there is some mistake, because carpal tunnel syndrome is a diagnosis related to compression of the median nerve during its passage in the carpal tunnel which is in the upper extremities. So the symptoms are in the hands not in the legs. So it wouldn't explain your symptoms.
So, if that has been given to you as the cause of the symptoms please go back to your documentation and check again, could it perhaps be tarsal tunnel? If indeed it's carpal tunnel then it is a coincidental finding which doesn't play any role in explaining you tingling.
As for improvement that of course depends on the cause. I would say MS is excluded both by your age and normal MRI findings. So would other central brain or spine lesions thanks to the MRI so do not worry. That leaves us peripheral nerve system issues for which it is important the EMG/NCS report so please verify it again.
I am looking forward to hearing from you again.
Carpal tunnel not in the legs?!!!
Detailed Answer:
I read your query carefully and I understand your concern.
However I am afraid that there is some mistake, because carpal tunnel syndrome is a diagnosis related to compression of the median nerve during its passage in the carpal tunnel which is in the upper extremities. So the symptoms are in the hands not in the legs. So it wouldn't explain your symptoms.
So, if that has been given to you as the cause of the symptoms please go back to your documentation and check again, could it perhaps be tarsal tunnel? If indeed it's carpal tunnel then it is a coincidental finding which doesn't play any role in explaining you tingling.
As for improvement that of course depends on the cause. I would say MS is excluded both by your age and normal MRI findings. So would other central brain or spine lesions thanks to the MRI so do not worry. That leaves us peripheral nerve system issues for which it is important the EMG/NCS report so please verify it again.
I am looking forward to hearing from you again.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you for your reply. To clarify, the EMG was done on my right arm and both legs. Neuro indicated that I didn't have peripheral neurapathy but I still have the numbess tingling and weakness in the legs. Also relentless fatigue and depression during the day. Can depression cause weakness numbess & tingling in my legs? Neuro won't do
A spinal tap.
A spinal tap.
Brief Answer:
Peripheral neuropathy unlikely, depression can be related.
Detailed Answer:
Thank you for getting back at me so quickly.
So I understand it is indeed carpal tunnel but it is not responsible for your findings and the exam has found no other abnormality suggesting a peripheral nerve disorder.
Coming back to your question about how accurate the test is, it doesn't have 100% specificity, but it does complete the neurologic findings. If there are no changes suggesting neuropathy in your doctors neurological exam (such as diminished reflexes) peripheral neuropathy is not likely. If in addition the symptoms don't have the characteristic distribution, starting from the feet and later working up to the legs, the whole combination of history, exam and nerve conduction studies makes your doctor correct in saying you don't have peripheral neuropathy. A spinal tap wouldn't add much information considering your symptoms either.
Also I am assuming you have had some routine blood tests such as blood count, blood glucose, liver and kidney function tests, electrolytes, Vitamin B12 level, thyroid function. Vascular causes such as bilateral varicose veins would have been noted on physical exam as well.
Depression and anxiety can cause those symptoms at times. Also in women undergoing menopause such as your age seems to suggest, mood changes and abnormal sensory findings like tingling extremities can be found together due to hormonal changes.
I hope to have been of help.
Peripheral neuropathy unlikely, depression can be related.
Detailed Answer:
Thank you for getting back at me so quickly.
So I understand it is indeed carpal tunnel but it is not responsible for your findings and the exam has found no other abnormality suggesting a peripheral nerve disorder.
Coming back to your question about how accurate the test is, it doesn't have 100% specificity, but it does complete the neurologic findings. If there are no changes suggesting neuropathy in your doctors neurological exam (such as diminished reflexes) peripheral neuropathy is not likely. If in addition the symptoms don't have the characteristic distribution, starting from the feet and later working up to the legs, the whole combination of history, exam and nerve conduction studies makes your doctor correct in saying you don't have peripheral neuropathy. A spinal tap wouldn't add much information considering your symptoms either.
Also I am assuming you have had some routine blood tests such as blood count, blood glucose, liver and kidney function tests, electrolytes, Vitamin B12 level, thyroid function. Vascular causes such as bilateral varicose veins would have been noted on physical exam as well.
Depression and anxiety can cause those symptoms at times. Also in women undergoing menopause such as your age seems to suggest, mood changes and abnormal sensory findings like tingling extremities can be found together due to hormonal changes.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you Dr Taka. You have been tremendously helpful. Yes I have had a battery of blood work including CBC, thyroid liver kidney, etc. All were normal. I'm pretty certain I don't have varicose veins. I've been told my FSH was elevated which means I'm entering perimenopause. It's difficult for me to accept this is hormones and depression. Hopefully an anti-depressant will help.
Thanks again! XXXXXXX
Thanks again! XXXXXXX
Brief Answer:
Thank you and good luck.
Detailed Answer:
Thank you for your appreciative words. Hopefully antidepressants will help. While they are classified as antidepressants they are widely used for several other indications including neuropathic symptoms.
I remain at your disposal for other questions. If /when you don't have any more questions I would kindly ask you to close the query.
Wishing you good health.
Thank you and good luck.
Detailed Answer:
Thank you for your appreciative words. Hopefully antidepressants will help. While they are classified as antidepressants they are widely used for several other indications including neuropathic symptoms.
I remain at your disposal for other questions. If /when you don't have any more questions I would kindly ask you to close the query.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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