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    Question on tingling

    Hi All-

    I'm still in limbo diagnostically, but feeling like I'm slowly being drawn towards the conclusion of MS with a big magnet. Could be wrong, but my symptoms have me thinking this is MS....anyway, a repeat brain MRI next month is scheduled and we'll see. And I had the VEP and BAER tests last week so I'm eager to hear what they do or do not show.

    Meanwhile, I'm still having different episodes of numbness and tingling, but it's popping up in more widespread areas, and in new locations.

    My questions:
    1.Is it true to MS symptoms for tingling to move around to different locations at different moments?

    2. Do temperature changes- even extremely slight- like a mildly cool breeze, or a touch of warmth, trigger the tingling/pins and needles MS'ers experience?

    3. For these symptoms to be a part of MS how long do they need to be present *in the same location*?

    4. What other diagnoses might include the paresthesias, especially ones that are not limited solely to peripheral locations like fingers and toes?


    5. If this is MS, and I'm having all of these tingling,needly sensations would this be called an exacerbation if my other symptoms are very minor at the moment?


    The numbness and tingling began only as fingers and toes for the last 2 years but now are cropping up in additional locations. This seems like it might be a clue that could possibly help me eliminate some other potential diagnosis, maybe? What do you think, does the location matter, even in the sense of eliminating other things?

    My doctors have been considering other dx's like Sarcoidosis/neuroscarcoidosis and lupus. I was told by 3 docs Lupus is out- no ANA or any other markers in my blood. My symptoms surely seemed a lot like Lupus to me so I kept thinking maybe, but I really don't have ANY of the markers so IF I had that it would be one of the very rare presentations where a patient doesn't. So odds are very slim.


    For instance right now my fingers are buzzing/tingling, as they were last night.

    But in addition I've been getting some mild tingly stabbing sensations on my nose, cheeks and scalp. Not very painful- I'm just aware and am getting increasingly concerned because the past few weeks the needly tingly thing has been coming up a lot, and in varied locations. Tops of feet, thighs, hands, head/scalp, face, in addition to the original locations of just fingers and toes,,,, and later balls of feet began getting shocky nerve "ZAP" like sensation.

    Any insight would be very much appreciated.

    Thank you!

    #2
    1. I'm pretty sure paresthesia from MS doesn't normally move around. Mine certainly doesn't (although the intensity varies).
    2. Paresthesia covers a pretty wide range of sensations, and I think extreme sensitivity to temperature change is certainly possible.
    3. I'll leave this to someone with medical dictionary knowledge, but see #1.
    4. All kinds of back/spine problems can cause all kinds of sx, many of which are the same as MS. Part of my own dx was figuring out that I had both spine problems & MS. I hope you have seen a physiatrist or other back specialist...
    5. IF you have MS, the new sx seem different enough that they could indicate an exacerbation, which may be verifiable with new MRIs (esp. c-spine).

    I think that the variability and 'mobility' of your sx points away from MS. Are your sx at all posture/position dependent? That would point me toward musculoskeletal issues, for sure...
    1st sx 11/26/09; Copaxone from 12/1/11 to 7/13/18
    NOT ALL SX ARE MS!

    Comment


      #3
      Tingling, what makes you think that MS is the cause? There are a ton of reasons why you might have tingling, could be as simple as something structural like the neck curvature, pinched nerves etc., but to answer your question, no my tingling does not alter with temperature differences and my tingling does not move around. If I have had some brief like a couple of seconds tingling in my face/head it has had a structural explanation.

      Comment


        #4
        Hi ocean:
        There are literally dozens of things that can cause tingling sensations -- so many that you'll have to read several of the sources that come up in search results in order to get a broad enough sense of what they are. A website that no longer exists listed more than 900 potential causes. There are no symptoms that are unique to MS, so the answers to questions about neurological symptoms as they relate to MS might be yes, no or maybe. Which means you aren't going to crack the case based only on symptoms.

        Originally posted by ocean_8 View Post
        1.Is it true to MS symptoms for tingling to move around to different locations at different moments?
        If by "true" you mean typical, no it's not typical of MS paresthesias to move around at different moments.

        2. Do temperature changes- even extremely slight- like a mildly cool breeze, or a touch of warmth, trigger the tingling/pins and needles MS'ers experience?
        Maybe yes, maybe no, typically no, but the answer can be maybe yes or no for tingling from other conditions, too.

        3. For these symptoms to be a part of MS how long do they need to be present *in the same location*?
        There's no definitive time limit that can connect a symptom to MS. Characteristically, the more brief or fleeting a symptom is, the less typical of MS it is. Length of time is a factor in determining an MS exacerbation, but that's different than your question. Duration isn't what makes a symptom "part of MS." In a way, the opposite is true: when MS is the given, its variables determine how long a symptom lasts.

        4. What other diagnoses might include the paresthesias, especially ones that are not limited solely to peripheral locations like fingers and toes?
        Too many to list.

        5. If this is MS, and I'm having all of these tingling, needly sensations would this be called an exacerbation if my other symptoms are very minor at the moment?
        Exacerbations aren't determined by how major or minor other symptoms are. So by the way your question is worded, the answer is definitely no. Further, exacerbations are determined by new or worsening symptoms that are characteristic of an acute inflammatory or demyelinating event. Tingling sensations that move around the body at different moments aren't characteristic of an acute event. Your doctor would have to determine whether your symptoms equate to an exacerbation based on their context.

        What do you think, does the location matter, even in the sense of eliminating other things?
        Location matters, but not in the way you might be thinking. Location can give clues to a list of possibilities and what kinds of tests need to be done, but a diagnosis can't be made by location alone.

        Also, it's important to remember that the body is wired in halves. Whatever nerve damage is present in MS affects only its own corresponding half of the body. So the more symmetrical a symptom is at initial presentation, the less likely it is to be caused by MS (it can happen with transverse myelitis, but that's not what you're describing and is outside the scope of your question). That's because the chances of nerve damage occurring in exactly the same place on both sides of the body at the same time are small. For that I'll use the cow pie example. If you were to turn two cows loose on a football field at the 50 yard line at the same time, what are the chances that the cows will each drop their cow pie exactly on the 20 yard line on opposite ends of the field at the same time? It could happen, but the chances are small.

        Comment


          #5
          My numbness and 'tingling' doesn't move about. Like MarkLavelle said, it's always in the same places, but the intensity goes up and down.
          Up when hot and tired. Down when cool and well-rested, but there's no guarantee, MS being what it is.
          In the olden days, after a flare, it would sometimes go away completely. But now, it is back where it was, and it's here to stay.

          Comment


            #6
            My symptoms began with numbness and tingling sensations in the wrists, then moved away to the arms and lower legs. I would also get little quick stabbing feelings in the chest area, primarily. I will have times when the numbness/tingling will move around at different times - it may be mostly the legs, then later mostly the arms, etc.

            Please take precautions now and get on a good MS diet.

            Comment


              #7
              ocean,
              If there is one thing that can be said about MS, that would be MS is very 'dynamic'. It changes with every person that gets the diagnosis. I heard one of my regions' 'big shot' neurologists say that 'MS is very personalized'.
              I was given the false diagnosis of 'carpal tunnel syndrome'. I did have surgery on my left hand and was scheduled to have the right hand done. Then, I saw my first neurologist. He discovered that my dx should have been MS. But I had tingling in both of my hands and arms, awake or asleep.
              I can only say that you need to do every test available to eliminate every possibility. I was fortunate to have a good insurance plan, it paid for a lot of tests.
              I wish you the best in getting a positive dx of something. Please believe me that all of us have some kind of story about the MS experience, no happy endings!!
              Good luck

              Comment


                #8
                Wow!! Thank you ALL for your clear,detailed answers.

                Jhawk- I will look up what a good MS diet is- I'm betting no matter what this turns out to be it is a healthy diet that would benefit me. Thank you!

                Thinkimjob- to clarify- the tingling/needly sensation doesn't drift about once it sets into a location. What I mean is it used to only occur in my fingers and toes (at that point I thought it must be a circulatory problem, maybe small clots as other things had me thinking that way, too) Now it occurs in many different locations in addition to the fingers and toes, and a few weeks ago when it set in it was more intense than it had ever been. Since then it has been occurring more than usual, and the new locations have been added to the baseline of fingers and toes.

                But it isn't always in ALL locations.

                Heat triggers it sometimes, cool can also but generally not as intensely as heat, and other times it's simply there and I can't identify a trigger.

                Hi redwings- I have many symptoms and will post about that in another post so I don't confuse the tingling thread. In general when I'm reading articles online and trying to figure out if this is MS, Sarcoidosis, Lupus, or something else I look up all symptoms, irregular lab results and imaging findings to see if I think the docs are on a track I agree with. But suddenly I thought if I also take one symptom at a time like this tingling since it's been the most noticeable thing that's changed/increased in the past 3 weeks and pick it apart it may be simpler to see if it points me in any particular direction.

                Your explanation of the sides of the body is SO helpful!! Wow! Using that as a guideline I could possibly consider that the last two years of toes and finger numbness and tingling may NOT be from MS;I'm not sure....It was mainly only present on my left side to begin with, then sometimes both sides, now most times both sides. On my face its on one cheek, my nose, bit on my forehead and on my scalp.

                there- Because I have so many MS like symptoms, a few lab and imaging findings that might point towards MS and my neuro is still focusing on MS, I have been drifting towards it more. My neuro has worked to differentiate from many other things like Lyme, Lupus, and...well, honestly I'm not completely sure but I have all lab and imaging results. The two things that seem to be on the table still are MS and Sarc. As we all know it doesn't have to mean I have either, or both, but I'm in agreement that they are strong possibilities.

                Mark- I have had the spinal series MRI's done, and I do have some spinal stenosis, some disc degeneration and some osteophytes . Arthritis runs in my family; my sister has osteoarthritis, my mother was dx'd w/rheumatoid, her mother with arthritis, but I don't know what kind, and my other sister arthritis, type unknown. I was attributing the osteophytes as possibly being from osteoarthritis- not sure yet. I saw a rheumatologist ho said she felt my arthritis symptoms were NOT connected to other symptoms I'm having and that we should look at them and treat them separately. i.e. I have some spinal issues and arthritis but she doesn't feel overall I have Lupus. She feels I happen to have arthritis as well as ???

                I sent the reports from the spinal MRI's to a back surgeon who said I don't need him right now. I had hoped he would recommend some safe exercises to do with a PT as I WAS having what seemed to me to be nerve pain from spinal issues (this started up mainly after my spinal tap, other than some pain and stiffness in my neck which had been there and increasing for maybe a year or more) That pain was very different than the pins and needles though. It was a radiating pain from neck into shoulders, arms and hands. the longer I remained upright or on my feet the worse it got. If I stayed up too long it would make it down my legs as well. I felt I must have had less spinal fluid at that time and so less cushioning, equalling more pressing and pinching. Spinal was Feb 14, go ahead- laugh- Valentine's Day(!) . Those symptoms and lots of post spinal symptoms like nausea, dizziness, double vision have all improved as time passes.

                In answer to whether these sx are positional- some feeling like my hands are asleep can occur pretty easily if my wrist is bent, or if my hand is thrown over my head in bed rather than laid down and flat. But that is different than this, and resolves when I correct the position.

                So, does all this leave me kind of where I was? That this might be part of MS if I have MS, but doesn't have to be part of it? That what I'm taking away after reading all of your replies and working through my answers to you. ( And I realize those who said it doesn't move may think it's not part of it, but I don't know if I was unclear in my original description, so I'll wait to see what you have to say about that, if you return to this post.)

                Thank you, all of you!

                Comment


                  #9
                  Yikes! Thank you, Jerry! I am grateful to say I have great insurance right now and feel like I am getting every test anyone can dream up. I was delayed by insurance on a repeat brain MRI with contrast, but it's approved now, and the first one was in January. I'm purposely waiting a few more weeks because a second opinion neuro recommended a longer time gap to allow a greater chance for symptoms to occur and therefore appear on the brain MRI.

                  Although the visit to a neuro only happened in Jan I have been seeking answers and solutions to my health issues for many, many years. Especially the last 5 years....if indeed this is MS, I have woven my own wobbly path. We'll see.

                  Thanks again for your response.

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