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What Causes Numbness With Pins And Needles On Lower Leg Of A Hypertensive Patient?

Posted on Fri, 26 Jun 2015

Question: Hi I am a 58 year old woman with a history of hypothyroidism and well controlled hypertension. I take eltroxin 200mcg x 3 wkly and 150mcg x 4 wkly and nebilet 2.5mg daily. I am off work the past couple of months with general fatigue and stress and my house is up for sale. I do feel much improved fatigue wise. In the past couple of weeks I have developed numbness and and pins and needles in my lower left leg with continuous longstanding numbness in my two little toes of my left foot. I feel occasional pins and needles in my face (left side) and left hand. I am concerned I may have Multiple Sclerosis?
I woke up one morning two years ago with left sided numbness lasting 3 hours and was investigated in casualty but they were more concerned with a possible TIA at the time. This was ruled out after an MRI and MRA. No neurological investigations were carried out at that time. I think the general diagnosis then was due to stress? I am not overweight and take regular exercise. What do you think?

Answered by Dr. Neeraj Kumar (19 minutes later)

Brief Answer:
L5 radiculopathy may be a possibility

Detailed Answer:
Hello XXXXXXX
I have gone through your question. You have hypothyroidism controlled on medication. Your old complain of transient numbness may be TIA, sensory partial seizure or demyelinating lesions and may be nothing significant.
Now your problem in little toes of left seems to be lumbosacral radiculopathy involving L5 root. Are you having back pain.
It is less likely to be multiple sclerosis.
I will advise you to consult a neurologist for proper examination and treatment. You may be requiring imaging of lumbosacral region.
For treatment you can try physiotherapy, avoiding stooping forward, lifting heavy objects.
For treatment pregabalin, gabapentin and amitryptiline.
Hope you recover early.
God bless you.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neeraj Kumar (32 minutes later)

Dear Dr. XXXXXXX thankyou for your prompt reply. I forgot to mention that I do have
Facet Joint arthritis L 4/5 so it probably is associated with that. In view of this,should I still continue with a neurological review?

Thanks again

XXXX

Answered by Dr. Neeraj Kumar (2 hours later)

Brief Answer:
yes consult neurologist or neurosurgeon

Detailed Answer:
Hello XXXXXXX
Yes you need to be in consultation with neurologist
as repeat imaging, pain reliever and physiotherapy may be helpful.
Last option of surgery will be there.
You continue as advised previously.
Hope you recover early.
God bless you
Thanks
Dr Neeraj XXXXXXX
Neurologist

Above answer was peer-reviewed by : Dr. Shanthi.E