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What Causes Tingling And Burning Sensation In The Limbs Along With Weakness?
Question: I have been having leg weakness that comes and goes. tingling and burning in my arms and legs. The symptoms get worse around my period. I have a few blurred visions. The leg weakness is the worst. I also get very fatigued, climbing the stairs is getting more diifficlut. It stays and then goes? I have my MRi results. Could the be MS? if not what else?
I have several supratentorial white matter foci that are non specific
I have several supratentorial white matter foci that are non specific
Brief Answer:
MRI interpretation
Detailed Answer:
Hi XXXX, thanks for asking from HCM.
I can understand your concern. Your symptoms are suggestive of "multiple sclerosis". But your MRI brain has been reported normal with doubtful significant white intensities in subcortical white matter.
Now to reach unto some conclusion, I have to rule out other causes along with multiple sclerosis by few investigations. These are
- Vitamin B12 level - get your serum B12 level checked. Low B12 level can cause all of the mentioned symptoms.
- Autoimmune disorder like sarcoidosis - It can affect any organ in body. Sarcoidosis usual present in mid twenties to late thirties. If you have a family history of autoimmune disorder, it can be a possibility. It can be ruled out by serum ACE level and safe biopsy from involved organ.
- Multiple sclerosis - MRI brain is positive in 90-95% patients and MRI spinal cord is positive in upto 75% cases. So it is less likely in your case. Other tests which can also help is Cerebrospinal fluid (CSF).CSF is evaluated for oligoclonal bands (OCBs) and intrathecal immunoglobulin G (IgG) production, as well as for signs of infection.
You can also ask the doctor to do Somatosensory evoked potential as you are having tingling sensations.
CSF study will also rule out any infection like Lyme disease. It can also cause similar kind of symptoms.
Hope it will you in reaching unto some conclusion. If you are having any kind of doubts, do let me know.
Thanks. Take care.
MRI interpretation
Detailed Answer:
Hi XXXX, thanks for asking from HCM.
I can understand your concern. Your symptoms are suggestive of "multiple sclerosis". But your MRI brain has been reported normal with doubtful significant white intensities in subcortical white matter.
Now to reach unto some conclusion, I have to rule out other causes along with multiple sclerosis by few investigations. These are
- Vitamin B12 level - get your serum B12 level checked. Low B12 level can cause all of the mentioned symptoms.
- Autoimmune disorder like sarcoidosis - It can affect any organ in body. Sarcoidosis usual present in mid twenties to late thirties. If you have a family history of autoimmune disorder, it can be a possibility. It can be ruled out by serum ACE level and safe biopsy from involved organ.
- Multiple sclerosis - MRI brain is positive in 90-95% patients and MRI spinal cord is positive in upto 75% cases. So it is less likely in your case. Other tests which can also help is Cerebrospinal fluid (CSF).CSF is evaluated for oligoclonal bands (OCBs) and intrathecal immunoglobulin G (IgG) production, as well as for signs of infection.
You can also ask the doctor to do Somatosensory evoked potential as you are having tingling sensations.
CSF study will also rule out any infection like Lyme disease. It can also cause similar kind of symptoms.
Hope it will you in reaching unto some conclusion. If you are having any kind of doubts, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hi,
What does doubtful significant white intensities in subcortical white matter.
I have b 12 injections to see if that would help. I have had these symptoms come and go for a while. However the legs weakens is so bad I can't climb stairs some days and have to use my hands to lift my legs.
What does doubtful significant white intensities in subcortical white matter.
I have b 12 injections to see if that would help. I have had these symptoms come and go for a while. However the legs weakens is so bad I can't climb stairs some days and have to use my hands to lift my legs.
Brief Answer:
White intensities significance
Detailed Answer:
Hi XXXX, welcome back.
The white intensities are usually suggestive of demyelination or infarct. But in your MRI report, the radiologist has mentioned that the intensities are not suggestive of any pathological lesions.
However as you are symptomatic and your MRI brain has some positive lesions, it is possible that these lesions might be significant.
Thats why I called them doubtful significant. One thing I forgot to mention is "Myasthenia graves". It is a type of autoimmune disorder in which continuous use of muscles leads to severe temporary weakness. the weakness is reversible and regain in strength occurs after rest. It is most commonly noticed in eyelid muscles and drooping of eyelid is usual first sign.
In your case, I think leg weakness is commoner than other muscles. Still you should get Nerve conduction velocity and electromyography of involved limbs to confirm the disease.
I hope it will help you. Final treatment can be given after confirmation of disease.
Thanks. Take care.
White intensities significance
Detailed Answer:
Hi XXXX, welcome back.
The white intensities are usually suggestive of demyelination or infarct. But in your MRI report, the radiologist has mentioned that the intensities are not suggestive of any pathological lesions.
However as you are symptomatic and your MRI brain has some positive lesions, it is possible that these lesions might be significant.
Thats why I called them doubtful significant. One thing I forgot to mention is "Myasthenia graves". It is a type of autoimmune disorder in which continuous use of muscles leads to severe temporary weakness. the weakness is reversible and regain in strength occurs after rest. It is most commonly noticed in eyelid muscles and drooping of eyelid is usual first sign.
In your case, I think leg weakness is commoner than other muscles. Still you should get Nerve conduction velocity and electromyography of involved limbs to confirm the disease.
I hope it will help you. Final treatment can be given after confirmation of disease.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Kampana
If it was Ms what would the report say? They want to do another MRI in a year. Why is that?
Brief Answer:
MS MRI findings and need of another MRI
Detailed Answer:
Hi XXXX, welcome back.
MS has specific findings in MRI.
- MS lesion are like plaques. They can be found throughout the brain.
- They have a predilection for periventricular white matter and tend to have an ovoid configuration with the major axes perpendicular to the ventricular surface.
- At the initial stage, the lesions are typically thin and appear to be linear (Dawson’s fingers along periventricular fingers.
- The focal demyelinating lesions located along the lateral borders of the corpus callosum are best depicted by sagittal fluid-attenuated inversion recovery (FLAIR) imaging.
All these findings appear bright white on T2 and FLAIR images of MRI brain.
These findings were not present in your MRI brain.
The doctors have advised another MRI brain to compare the new findings from first MRI. They want to see if there is any progression of those small white intensities or not. At present your MRI is not conclusive.
Hope it will help you. If you have any doubt, do let me know.
Thanks. Take care.
MS MRI findings and need of another MRI
Detailed Answer:
Hi XXXX, welcome back.
MS has specific findings in MRI.
- MS lesion are like plaques. They can be found throughout the brain.
- They have a predilection for periventricular white matter and tend to have an ovoid configuration with the major axes perpendicular to the ventricular surface.
- At the initial stage, the lesions are typically thin and appear to be linear (Dawson’s fingers along periventricular fingers.
- The focal demyelinating lesions located along the lateral borders of the corpus callosum are best depicted by sagittal fluid-attenuated inversion recovery (FLAIR) imaging.
All these findings appear bright white on T2 and FLAIR images of MRI brain.
These findings were not present in your MRI brain.
The doctors have advised another MRI brain to compare the new findings from first MRI. They want to see if there is any progression of those small white intensities or not. At present your MRI is not conclusive.
Hope it will help you. If you have any doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Even though I have such bad symptoms?yhe leg weaskness is so bad some days. I have had to get help from family to care for my kids. I have stopped working. From this and the fatigue.
Brief Answer:
Leg weakness treatment
Detailed Answer:
Hi XXXX, welcome back.
The leg weakness can be treated by
- Physiotherapy - Start leg exercise under physiotherapist guidance.
- Nerve specific vitamin - Take B12, folic acid, pentothanic acid, pyridoxine for nerve recovery after proper prescription.
- Diet rich in protein - Protein rich diet helps in muscle building.
After confirming diagnosis, recovery will be fastened with medication.
Hope it will help you. Thanks.
Take care.
Leg weakness treatment
Detailed Answer:
Hi XXXX, welcome back.
The leg weakness can be treated by
- Physiotherapy - Start leg exercise under physiotherapist guidance.
- Nerve specific vitamin - Take B12, folic acid, pentothanic acid, pyridoxine for nerve recovery after proper prescription.
- Diet rich in protein - Protein rich diet helps in muscle building.
After confirming diagnosis, recovery will be fastened with medication.
Hope it will help you. Thanks.
Take care.
Above answer was peer-reviewed by :
Dr. Prasad
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