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What Causes Shocking Sensations In Left Foot After Injury?
Question: Greetings Doctor,
In 1980, I had a sports related injury and caused nerve damage to my left foot/toe. In 2007 I began experiencing shocking sensations in that area. In 2011, I was diagnosed with peripheral neuropathy. I thought this was solely based on my foot injury. I began taking gabapentin beginning with 300mg and up to 2400mg. This year I had sections of the nerve removed in my left foot/toe. I’m currently taking 900mg of gabapentin, hoping to reduce to zero at some point. My EMG’s (Sensory and Motor) done in 2012-2015 were basically the same. With one exception; my Left Sural Anti Sensory deceased from 42 to 34. The remaining numbers didn’t change, but were slightly below normal. In 2014, I was diagnosed with BFS (benign fasciculation syndrome).
My current neurologist policy prohibits providing any advice or answer questions over the phone. I’m anxious and wanted to know if the conclusion “Mild Axonal Sensory-Motor Peripheral Neuropathy” meant that I could have ALS or MS or something else terrible. If you need specific information, please let me know. Thank you.
In 1980, I had a sports related injury and caused nerve damage to my left foot/toe. In 2007 I began experiencing shocking sensations in that area. In 2011, I was diagnosed with peripheral neuropathy. I thought this was solely based on my foot injury. I began taking gabapentin beginning with 300mg and up to 2400mg. This year I had sections of the nerve removed in my left foot/toe. I’m currently taking 900mg of gabapentin, hoping to reduce to zero at some point. My EMG’s (Sensory and Motor) done in 2012-2015 were basically the same. With one exception; my Left Sural Anti Sensory deceased from 42 to 34. The remaining numbers didn’t change, but were slightly below normal. In 2014, I was diagnosed with BFS (benign fasciculation syndrome).
My current neurologist policy prohibits providing any advice or answer questions over the phone. I’m anxious and wanted to know if the conclusion “Mild Axonal Sensory-Motor Peripheral Neuropathy” meant that I could have ALS or MS or something else terrible. If you need specific information, please let me know. Thank you.
Brief Answer:
No MS or ALS.
Detailed Answer:
I read you question carefully and I understand you must be concerned.
First let me start by saying that that report doesn't indicate MS or ALS in any possible way. MS is a central nervous system disease, involves brain and spine, so has no relation to the peripheral nerves. It doesn't indicate ALS either, in ALS sensory nerve conduction studies are usually normal, it is otherwise called motor neuron disease, it involves only motor nerves, not sensory, so a sensory-motor neuropathy is against it.
Now what else could it indicate....it doesn't indicate any acute life threatening issue. It speaks of mild impairment of the peripheral nerve fibers which is usually of a chronic nature. To further speak on what to expect in the future, whether it will progress, first the cause must be found.
That is not always simple though. The causes of peripheral neuropathy can be many. Most common ones are diabetes, alcohol, nutritional deficiencies, toxins/drugs, hormonal alterations, some infectious disease etc etc.
So some more tests need to be done, this time to look for the cause. It is started by most common and if negative it is proceeded with rarer causes. Some initial tests would be: complete blood count, MCV, ESR, blood glucose, hemoglobin A1c, liver and kidney function, electrolytes, CPK, thyroid function tests, antinuclear antibodies, vitamin B12.
If a cause is found it should be addressed accordingly. Frustratingly at times (in 25% of cases) no cause can be found even after extensive testing.
I remain at your disposal for further questions.
No MS or ALS.
Detailed Answer:
I read you question carefully and I understand you must be concerned.
First let me start by saying that that report doesn't indicate MS or ALS in any possible way. MS is a central nervous system disease, involves brain and spine, so has no relation to the peripheral nerves. It doesn't indicate ALS either, in ALS sensory nerve conduction studies are usually normal, it is otherwise called motor neuron disease, it involves only motor nerves, not sensory, so a sensory-motor neuropathy is against it.
Now what else could it indicate....it doesn't indicate any acute life threatening issue. It speaks of mild impairment of the peripheral nerve fibers which is usually of a chronic nature. To further speak on what to expect in the future, whether it will progress, first the cause must be found.
That is not always simple though. The causes of peripheral neuropathy can be many. Most common ones are diabetes, alcohol, nutritional deficiencies, toxins/drugs, hormonal alterations, some infectious disease etc etc.
So some more tests need to be done, this time to look for the cause. It is started by most common and if negative it is proceeded with rarer causes. Some initial tests would be: complete blood count, MCV, ESR, blood glucose, hemoglobin A1c, liver and kidney function, electrolytes, CPK, thyroid function tests, antinuclear antibodies, vitamin B12.
If a cause is found it should be addressed accordingly. Frustratingly at times (in 25% of cases) no cause can be found even after extensive testing.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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