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What Causes Pain And Tingling Sensation In Hands And Foot?
Question: I have been experiencing tingling and pain in my hands as well as my left foot , I had an emg and a nerve conduction test done , and it came back that my motor nerves are severely damaged . Waiting on my insurance to approve a ct and MRI . Also have problems going to the bathroom . I have to digitally evacuate through my vagina . What do you think is wrong with me?
Brief Answer:
Neuropathy
Detailed Answer:
Good evening. I am a neurologist from XXXXXXX Ohio and obviously a bit more information as to how all of this began, how long it's been bothering you, more details on the inability to have a bowel movement without digital assistance would be nice- at the very least we can say that the EMG and NCV have diagnosed a neuropathy. Now, you say that the report calls for a severe MOTOR nerve type of neuropathy, however, the symptoms of pain and tingling is much more consistent with a SENSORY type of neuropathy. Are there symptoms of WEAKNESS in the upper or lower extremities?
It is going to add information to get the MRI and find out whether or not there are nerve root compressions in the neck or not. I would also hope that an MRI of the brain is being contemplated. If you were my patient I would also obtain the study with gadolinium contrast. Depending upon what the brain scan shows I might make a move to perform spinal fluid tests but probably not since CSF analysis is no longer considered a standard part of working patients up with suspected demyelinating types of diseases.
There are many other causes for neuropathy such nutritional deficiencies (B12, Vit. D, folic acid). thyroid disease, and other hormonal imbalances. Infectious diseases including sexually transmitted diseases can also cause these types of neuropathies as can medication, radiation, and tick bites.
Your doctor might refer you to a neurologist for a more complete and fuller workup since there are a number of considerations that have to be looked at in both serum as well as possibly urine which most internists or generalists are not going to automatically consider.
I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?
Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?
The query has required a total of 25 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Neuropathy
Detailed Answer:
Good evening. I am a neurologist from XXXXXXX Ohio and obviously a bit more information as to how all of this began, how long it's been bothering you, more details on the inability to have a bowel movement without digital assistance would be nice- at the very least we can say that the EMG and NCV have diagnosed a neuropathy. Now, you say that the report calls for a severe MOTOR nerve type of neuropathy, however, the symptoms of pain and tingling is much more consistent with a SENSORY type of neuropathy. Are there symptoms of WEAKNESS in the upper or lower extremities?
It is going to add information to get the MRI and find out whether or not there are nerve root compressions in the neck or not. I would also hope that an MRI of the brain is being contemplated. If you were my patient I would also obtain the study with gadolinium contrast. Depending upon what the brain scan shows I might make a move to perform spinal fluid tests but probably not since CSF analysis is no longer considered a standard part of working patients up with suspected demyelinating types of diseases.
There are many other causes for neuropathy such nutritional deficiencies (B12, Vit. D, folic acid). thyroid disease, and other hormonal imbalances. Infectious diseases including sexually transmitted diseases can also cause these types of neuropathies as can medication, radiation, and tick bites.
Your doctor might refer you to a neurologist for a more complete and fuller workup since there are a number of considerations that have to be looked at in both serum as well as possibly urine which most internists or generalists are not going to automatically consider.
I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?
Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?
The query has required a total of 25 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have lost a considerable amount of grip strength in my right hand . I was told we are testing for myopathy as well as motor neuron disease . I'm already on gabapentin 400 mg * 3 times a day .
Brief Answer:
Motor neuron disease would not result in sensory symptoms
Detailed Answer:
Thank you for the updated information. I understand that you are telling me there is a motor component to your picture now in terms of loss of grip strength in the right hand. Motor neuron disease as a single diagnostic entity to explain everything, in my opinion, doesn't really work since you gave me sensory symptoms in the initial question of paresthesias (tingling) and you also report pain (quite unusual for motor neuron disease).
I would first want to make sure that you didn't have something of a metabolic polyneuropathy or even compression syndrome which is likely why they are looking to get an MRI approved. I'm not sure why they have to get a CT approved. I though insurance companies stopped needing pre-auths on CT'S decades ago when they figured out that CT scans are becoming so commonplace nowadays that some people even sell them as part of the kitchen appliances in their homes! LOL.....I'm just kidding about that...but I'll betcha that one day in about 300 years they will sell home compatible CT scanners....for that quick lil scan that you feel you need when you get home from work sometimes! HAHA!
So, we will need to see what the MRI shows for sure...but are you also getting a metabolic workup as I had suggested? If you can get the lab reports or even a copy of the neurologist's consult report or the EMG REPORT...I'd love to read either one of those to see what else they're thinking.
The gabapentin is for the pain and paresthetic sensations. How well is it doing for you?
I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?
Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?
The query has required a total of 40 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Motor neuron disease would not result in sensory symptoms
Detailed Answer:
Thank you for the updated information. I understand that you are telling me there is a motor component to your picture now in terms of loss of grip strength in the right hand. Motor neuron disease as a single diagnostic entity to explain everything, in my opinion, doesn't really work since you gave me sensory symptoms in the initial question of paresthesias (tingling) and you also report pain (quite unusual for motor neuron disease).
I would first want to make sure that you didn't have something of a metabolic polyneuropathy or even compression syndrome which is likely why they are looking to get an MRI approved. I'm not sure why they have to get a CT approved. I though insurance companies stopped needing pre-auths on CT'S decades ago when they figured out that CT scans are becoming so commonplace nowadays that some people even sell them as part of the kitchen appliances in their homes! LOL.....I'm just kidding about that...but I'll betcha that one day in about 300 years they will sell home compatible CT scanners....for that quick lil scan that you feel you need when you get home from work sometimes! HAHA!
So, we will need to see what the MRI shows for sure...but are you also getting a metabolic workup as I had suggested? If you can get the lab reports or even a copy of the neurologist's consult report or the EMG REPORT...I'd love to read either one of those to see what else they're thinking.
The gabapentin is for the pain and paresthetic sensations. How well is it doing for you?
I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?
Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?
The query has required a total of 40 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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