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Getting tingling sensation on foot. Taking advil and klonopin. MRI done. Syphillis or neurological disorder?

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Neurologist
Practicing since : 1974
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Hello,

I am terrified that I have a neurological disorder or other disease causing my symptoms.

A few week ago my foot felt a little different when I was wearing a certain pay of high heeled boots. This was only happening in the boots and I felt like my foot was feeling suffocated and maybe even a little wider. When I went on my tippy toe to check it out it almost felt like "hit a funny bone feeling" on the ball of my foot. After this, I became obsessed with and began having panic attacks where my legs would get shaky and would tighten up (more so my right leg, which is where i felt the off sensation in the boot)

As I began to feel less of this sensation, a few weeks later, i had a feeling like i had something under my two toes on that foot, but no pain. Then there was a little tingling between my third and fourth toe (where i felt like a piece of paper was stuck, but wasn't) and on the side of my big toe. This has gone one for a week. Advil seems to help this sensation a little (i think) and klonopin makes it disappear.

I have recently had a slew of bloodwork done. All came back ok, including the anti-inflammatory piece, except I have a very high vit d 1, 25 dihydroxy level. Calcium fine and phosphorus fine. This was a test ordered by mistake. I then had a ct scan of the chest, abdomen and pelvis to rule out tb or sarcoidosis or lymphoma. I am terrified this is all related and they missed something. I had a lymes test about a year and half ago and syhpillis tests 8 and 2 years ago and made my husband just get one and was neg...but maybe these were taken too many years later?? I am terrified of syphillis. I worry bc these are granulomas diseases and maybe they can cause this high 1, 25 value? Are these syphills tests accurate?

What do you think this could be? Also i had a brain mri a year and half and was ok but this was the finding: (I will post below)

So this is why I am terrified i could have some infectious disease. I originally went to the nuero bc i had a sensation on my face that i guess was linked w muscle tension in my neck.

Could the tingling on my foot be due to a foot problem and not a neuro or disease issue. I have no pain on my foot, but I am worried about systemic diseases. i think the tingling is getting less, but i will have to wait and see.
No acute intracranial abnormality. Two small nonspecific foci of hyperintense signal within the deep white matter of the left posterior frontal lobe, measuring 4mm, and may be the result of a prior infectious or inflammatory process or less likely a prior small vessel ischemic event.


This was the MRI findings. Is this very concerning? What else could this mean?
Thank you.
Posted Sat, 20 Apr 2013 in Brain and Spine
 
 
Answered by Dr. Pratap Sanchetee 1 hour later
Dear XXXXXX

I have gone through history provided by you and multiple symptoms you have. The symptom complex in your case does not provide any clue for any specific illness or disease process. At this stage, I will suggest that you have a consultation with a neurologist and have detailed clinical examination. In all probability, it will tell us whether you have a significant illness or you need observation and follow-up.

To treat your symptoms, your doctor after clinical evaluation may consider low dose of antidepressant drugs (e.g. amitriptyline or citalopram), gabapentin, pregabalin or similar group of drugs.

At this stage, feel reassured and there is no pointer for any serious illness.

Regards and good wishes

Pratap sanchetee
Above answer was peer-reviewed by
 
Follow-up: Getting tingling sensation on foot. Taking advil and klonopin. MRI done. Syphillis or neurological disorder? 59 minutes later
What do you make of the MRI results? Is that concerning? What type of things can cause this and have you even seen that?


Also, what does it mean that Klonopin takes the tingling away? Is that what it's supposed to do?
 
 
Answered by Dr. Pratap Sanchetee 21 minutes later
Dear XXXXXX

MRI findings of two small 4mm foci of hyperintense signal within the deep white matter of the left posterior frontal lobe is unlikely to explain your present symptoms. They are not active lesions and as such do not warrant any treatment.

Your doctor will decide whether you had any significant infection in the past or any reasons for less blood supply, if any. By itself, these findings on MRI are not of a big concern.

Klonopin (Clonazepam) is basically an anti-anxiety drug and does help some patients.

Regards

Pratap
Above answer was peer-reviewed by
 
Follow-up: Getting tingling sensation on foot. Taking advil and klonopin. MRI done. Syphillis or neurological disorder? 25 minutes later
I did smoke for 12 years. Would that be the issue even though I am 37? Also are there numerous infections that can cause that or only syphills and lymes? Does two negative rpr for syphills in past seem ok to rule that out?
 
 
Answered by Dr. Pratap Sanchetee 5 hours later
Dear XXXXXX
While heavy smoking does negatively influence health, it is not directly connected to present symptoms or MRI findings.

There are many infections that can cause MRI findings e.g. tuberculosis, fungal infections etc. Considering history provided, they are not likely. However, I will again stress that consultation with a neurologist and have detailed clinical examination. In all probability, it will tell answer some of queries specifically. If you can attach complete MRI report as well as few relevant MRI films frame, it will give me a better idea about the situation.

Regards

Pratap
Above answer was peer-reviewed by
 
Follow-up: Getting tingling sensation on foot. Taking advil and klonopin. MRI done. Syphillis or neurological disorder? 15 hours later
Hello,

This is the MRI Report and i am not sure I will be able to send the films.

Exam: MRI-BRAIN WITHOUT CONTRAST
Clinical Indication:
Headaches.
Technique: Multiplanar and multisequence noncontrast MR images of the brain without intravenous contrast were obtained on a 3.0 Tesla ultra high field Skyra wide bore magnet.
No prior studies are available for comparison.
Findings: Evaluation of the brain demonstrates normal midline morphology. There is no evidence of Chiari malformation of the posterior fossa. There is no evidence of abnormal intracranial mass effect, midline shift, hydrocephalus, or abnormal extra-axial fluid collection.
Diffusion weighted imaging demonstrates no regions of abnormal restricted diffusion. There is no evidence of acute or early subacute infarct. Susceptibility weighted imaging demonstrates no regions of abnormal susceptibility artifact to suggest intracranial blood products. FLAIR imaging demonstrates a solitary small focus of hyperintense signal within the deep white matter of the left posterior frontal lobe, measuring 4 mm, and is nonspecific in appearance. This focus may be related to a prior infectious or inflammatory process or may represent a tiny focus of chronic microvascular ischemic injury. On T2 weighted imaging, an additional 4 mm focus of hyperintense signal is identified adjacent to the above mentioned FLAIR focus.
The mastoid sinuses are clear bilaterally. The mastoids and middle ear cavities are clear bilaterally. The visualized paranasal sinuses are essentially clear . The visualized orbits are grossly unremarkable.
Impression:
No acute intracranial abnormality.
Two small nonspecific foci of hyperintense signal within the deep white matter of the left frontal lobe, nonspecific in appearance, and may be the result of prior infectious or inflammatory processes or prior small vessel ischemic event.
 
 
Answered by Dr. Pratap Sanchetee 8 hours later
Hi again,

In first instance this MRI report does not suggest any serious illness at present. It suggests a healed lesion and in all probability is not related to your present symptoms. You have a check up with a neurologist and feel assured.

Regards,


Dr Pratap
Above answer was peer-reviewed by
 
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