Doctors Lounge - Neurology Answers
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Forum Name: Neurology Topics
|doc_question - Thu Jul 05, 2007 5:55 pm||
I am a healthy 34 yr old female. I have never had any health problems. The only surgery I have had was 12/2005 which was a cesarean due to breech presentation of my son. I am 80 pounds overweight. I started walking everyday for 30-75 minutes for the last 2 weeks.
Father died of metastatic colon cancer at age 66, as did his father. His mother died in her 40's from a stroke (she was a smoker and had 10 children)
I am on no medications and take multivitamins, fish oil and calcium.
I have been to a naturopath the last few months for fatigue. She did lab tests and found my hemaglobin to be slightly low 13.0g/dL and my TSH was slightly elevated at 3.35 uIU/mL. I am still breastfeeding my son so to treat the thyroid and hemoglobin I am taking selenium, zinc and iron.
I have had tingling in both feet for close to 2 months. I was using a small exercise ball as an office chair for my home office. I noticed my legs were falling asleep and hurting after being at my desk for an hour or more. I finally purchased a desk chair 3 weeks ago and thought the tingling would subside. I have noticed the tingling in my feet more often. Usually most of the day and in all positions. Now today there is tingling in my left hand, though that may be due to sleeping on it for an extended period last night.
Could this be due to my weight? I am working hard now to lose the excess weight.
I have a primary care doctor that is rarely in the office so I am looking for a new doctor.
Do you have any suggestions as to what it might be.
Thank you in advance for your response.
Have a wonderful day.
|Dr. Tamer Fouad - Fri Jul 06, 2007 1:18 am||
Paresthesia is a medical term that refers to a spontaneous sensory disturbance that is usually described as tingling or numbness. The sensation can be painless or painful, usually occurs without a stimulus and, is commonly felt in the hands, arms, legs, or feet, although it can occur in different parts of the body.
Every sensation starts by nerve stimulation, these nerves in turn carry out the stimulus as an electric message to the brain through a chain of neurons that are presents at different levels in the spinal cord till it is sent to the brain. Any disturbance in the sensory pathway can lead to paresthesia.
There are two types of paresthesia; temporary or chronic. Temporary paresthesia is usually due to a sustained pressure on a nerve. This temporary sensation disappears once the pressure is relieved. A common example of temporary paresthesia is when somebody sleeps with his arms lies above or under the head or while sitting with the legs tightly crossed. This is due to compression of the artery while passing in the flexed joint leading to vascular ischemia in addition to the nerve compression.
There are many causes of chronic parasthesia in the feet and my advice is to have it evaluated. Was this condition related to your pregnancy?
Here is a list of possible causes to give you an idea.
In disc disease or spinal arthritis the nerve roots are compressed (radiculopathy) leading to paresthesia that is felt according to the level of affection. If it involves the lumbar spine, the sciatic nerve is compressed leading to paresthesia of the legs, a classic symptom of sciatica.
Trauma and irritation to the nerve can also come from inflammation to the surrounding tissue. This includes conditions such as rheumatoid arthritis.
Some metabolic diseases give characteristic pictures of paresthesia, for instance, the symmetrical "glove and stocking" distribution in the hands and feet which is well known in people affected by diabetes. Other causes include hypothyroidism. In your cause the slight elevation of TSH may require re-evaluation.
Paresthesia is also a symptom of vitamin deficiency (vitamin B12 deficiency) and malnutrition, in addition to alcoholism.
Toxins such as heavy metals (eg, lead poisoning), radiation poisoning may cause parasthesia. Drugs including certain antibiotics and some chemotherapeutic agents (vincristine, cisplatin, taxanes), anticonvulsant drugs (topiramate, sulthiame, and acetazolamide) and overdose of pyridoxine (vitamin B6). Withdrawal from certain antidepressants (SSRIs), such as paroxetine has been reported to cause paresthesia in addition lidocaine poisoning.
Connective tissue diseases, like arthritis (direct trauma) and SLE (neurological manifestation) are among the etiologic factors.
Infections as human immunodeficiency virus (HIV) can lead to parasthesia.
Disorders affecting the central nervous system include stroke, transient ischemic attacks (TIAs or mini-strokes), multiple sclerosis, transverse myelitis, and infections (encephalitis). A space occupying lesion (tumor or vascular) that causes compression on the brain or spinal cord can also cause paresthesia.
The best way to go is to consult a neurologist.
Please update your post and let us know what happens.
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